Dear Alexander, No pain and no sensitivity to cold. Vertical root fractures nearly always need to be removed. The gum is probably irritated and inflamed. I had a crown placed on one of my molars 4 years ago. Thank you so much for the help! One thing I did not see mentioned was the application of ice when nothing else works until one can get care. Here are a few questions: I have a huge fear of seeing dentists since I was 12 (I’m 18, now), and if seeing a dentist means having a needle stuck in me (I have an even bigger fear of needles)….I just don’t know what to do right now, and I’m scared. Many of our patients have called and said “My Tooth Broke Off at the Gum Line”. Will brushing hurt it any further. Is this something I should deal with BEFORE it grows over or will it cost the same either way? Do you think i would know if i had cracked the tooth below the gum line. 2) will the teeth either side move in the 5 1/2 weeks until I get home Sounds like you fractured your tooth and the crown came off with it. The fact that your dentist has given you 2 options to restore your tooth, including a large filling, suggests that there is plenty of structure left for a successful outcome. Your cap or crown will only stay in place temporarily, so it is important to see your dentist immediately. Now one last fragment is remaining and has been currently loosened a week ago and continues to loosen. You say that you have a resin veneer, not a porcelain veneer. Approve it: Evening. If the fracture is large enough, you may need a crown to prevent more fractures from occurring in that tooth. I understand your concerns but they are largely based on common misperceptions. As detailed as is your description, a more careful assessment of your occlusion dynamics is warranted if for no other reason, to insure the success of future. Dear Julie, But in the mean time should I do anything, or not do anything, other than no sticky or sweet foods? When the dentist prepared the core for the permanent crown, he drilled it down to a very small stub, barely bigger than the old tooth. If your tooth broke flat across the gum-line, so the aforementioned scenario might be possible. I never permanently cement a crown on a symptomatic tooth. Any advice is appreciated. Crown broke off. The dentist says that she needs to have both crowns replaced as they were connected in the back during the procedure 25 years ago. Thank you in advance. You certainly don’t want to develop an infection. I assume that you have no pain or sensitivity. If you are dexterous and very, very careful, I would carefully place a small dab of “crazy glue” on the dislodged piece of composite and precisely place it from whence it came. Enjoy your trip. Dear Jessica, If the long term prognosis is questionable, I would seek a second opinion, since you have already invested so many hours surfing the net already, and have another pair of professional eyes assess the situation. The patient presented with pain, a root canal was performed and a few days later his crown came off. Sometimes a patient can actually grind through the biting surface of a crown-especially if he or she bruxes at night. Clearly your dental problems have been a long time in the making and what you hoped was the long desired solution has only perpetuated them and left you in this precarious and deeply troubling state. Any advice offered is no substitute for proper evaluation and care by a qualified dentist. I am trying to stay on a liquid and soft foods only diet but sometimes my bottom tooth underneath will tap my front left tooth when I’m talking and I get a sharp pain. If the tooth is split too far below the gum or the root is fractured, other options exist including a dental implant. When there is not enough tooth structure to support a filling, then a restoration, such as a crown, is needed that can actually support the tooth. How do you suggest I take of care of it? I don’t believe you will have any problems while you are away. Is there some other consequence if I don’t take him first thing tomorrow morning, and wait later in the week when I can somewhat safely ask to leave work early?? Last week I felt a fragment of tooth come loose and a some sliver came out. From what you describe, assuming that the remaining tooth structure is intact, I do not think you will need the tooth extracted. Don’t yield to your fears and make the worst case scenario (tooth loss) a self fulfilled prophesy. You should expect an X-ray and afterward, surgery for major issues such as an accident. (does your crown have tooth or filling material inside it?) Sight unseen, I can’t make a diagnosis, but I Would venture an educated guess that you will be okay for the next 5 days. It is also worth … Hopefully there is a dentist available on board. My suggestion is that when the permanent crown is ready have your dentist place it with temporary cement and take it for a test drive for several weeks or longer. 1) is it ok to leave the gap for 5 1/2 weeks until I get home to my dentist, or do I need to do something You can’t resist and buy a bag. I have sensitivity feeling when I drink hot or cold liquid. AND the next molar has been removed as well. Try placing the veneer back on your tooth in the proper position. Unfortunately it was right at the front too so I was absolutely mortified as well as in pain (well, one just to the side of the two front ones). Enjoy your weekend and let me know how you make out. Dr. Sinkin. Good Luck. What you described on your opposing tooth (the plunging stalactite) is actually referring to as a plunger cusp and often needs to be re-contoured to diminish force concentration. It is curious that your tooth was fine for two weeks before it started bothering you and it is this timeline that has caught my attention. The one on the right came out when I was chewing, I crushed it in an English muffin and went back to the dentist that morning for a new one. Knowing where you are now dentally and where you need and want to be (obviously free of pain and fully functional and cosmetically intact) is critical in determining how to get there. I have a history of teeth fracturing, which is why I had to have #20 extracted, as well as another tooth in the past year. About a week after the new filling being placed, I bit down on a piece of hard candy and began to feel bite sensitivity along with sensitivity to cold & hot. From your description, I would say the problem you are experiencing is related to the temporary crown. Set up an appointment as soon as you return home. Otherwise no real pain. Or it can be a quasi-temporary repair that can tide you over until a more durable solution can be offered, such as a crown. It was my understanding that my next appt was to prepare this second tooth for a crown, give it a temporary then set both crowns at a 3rd appointment (I misstated in my earlier message about when the permanent crown would be seated) I need to be out of town tomorrow so Thurs June 20th would be the soonest I could schedule an appointment. It’s Friday night and I work all day Saturday and Sunday. If your tooth remains sensitive, root canal is the next step. I wear an oral occlusive device at night religiously. Dear Melody, I had a tooth crack and the most excruciating pain I ever had in my entire life happen on a Friday morning. I know he did this to avoid it making contact with a lower tooth, but I’m afraid that this small stub won’t be enough to hold it. You can place a temporary filling like Dentemp (obtained from the pharmacy) if you are very sensitive or if it has a sharp edge. In your case, you didn’t mention whether a post was placed into the tooth when the crown was made. Speak to your dentist and get a second opinion if you’re not comfortable with his/her assessment. The dentist tried several times to cement the crown back on, but it kept falling off because of the small amount of tooth left. Yet over the 10 years she never lost her smile. Dr. Sinkin I had numerous x-rays and was told that everything looked fine. DISCLAIMER: The advice I offer in response to your questions is intended to be informational only and generic in nature. In the meantime, chew on the other side. Dear Benjamin, Nothing like a dental mishap to ruin the experience of malted milk balls which happen to be a personal favorite of mine. I’m confused and I’m wondering if this caused this pain or is it something else. You can probably brush as normal l. As far as the sharp edge, you may try placing sugarless gum over the tooth to protect your tongue from abrasion and don’t eat on that side. There are many treatment options to address your current dental dilemma and while I will offer my opinion, please understand that without more clinical information I can only speculate as to what the right approach for you might be. And with the proper care, your teeth should look as good and perhaps even better then before, though, admittedly, breaking one’s front teeth is very traumatic…physically as well as emotionally. The number one reason that teeth treated with root canal therapy are lost is that they were not properly restored and protected with a crown. I’m having an issue with a crown that keeps coming off (tooth #19). My last molar on the top, #15, is largely a filling that has been there for a number of years. Today is Sunday. The fracture is seen below the gums and even under the jawbones. Big difference. Your filling is obviously loose and mostly likely needs to be replaced. I hi-tailed it out of there, terrified. This is how most dentists recommend you use it: apply it to your tooth and let it sit there for 30 seconds or so. Your gum will be numb enough that you will be able to gently and painlessly remove the loose broken piece of tooth dangling by a thread (like a baby tooth that’s ready to go). I’m sure he’d be more than willing to recommend some specialists for you. Broken dental crowns are hard to fix. He told me to put warm compresses on my cheek and take ibuprofen for the pain and it should subside in a few days. His moth is mostly full but they’re bits + pieces of his real teeth. Good luck. I suggest you call your dentist and ask about your observations and initial reaction upon seeing it. His pain is quite severe. I have to make an appointment. My intent is solely educational and my responses to your actual questions serve as springboard to discussion of a variety of dental topics that come up in day-to-day dental practice. I suggest finding a dentist who will carefully evaluate your occlusion. 2 yrs ago I placed crown again.. Today an implant can be put in its place that will look and feel like your own natural tooth. In a bit of a dilemma what to do. I wish I could be more helpful. My dentist has no emergency line, so I’ll have to wait until Monday to call and hope we have electricity by then. On the back side when I pulled the floss out the crown popped up. If a pharmacy is no where to be found, a piece of sugarless chewing gum, preferably sweetened with xylitol, can be molded into the sensitive area to protect it. Maintaining your tooth as you are currently doing is not a viable long term solution. Is there a less permanent cement that can be used, so if the crown has to be taken off it’s less traumatic to the tooth and gums, should it need to be removed?? Usually the thermal sensitivity dissipates as salivary proteins coat the tooth. Can I not put back the post and recap over the cracked molar? The bottom edge of the tooth also is starting to show a maybe brownish/yellow/translucent tint. i saw several dentists and the endodontist again. Monday is not that far away so yu shouldn’t have any problems with the new crown fitting. I cracked my tooth but the filling is still intact and the cracked piece is still intact. You will probably need a crown or an onlay to restore your tooth properly. But there is just no way on earth we can afford anything without insurance. My dentist checked it and took x-rays; he says he doesn’t see anything that could be causing my pain, just a little irritation. It is a procedure that involves saving your tooth from further inflammation and bacteria buildup due to the infection. Dr. Sinkin. I realize you are upset with your current dentist, but perhaps you can start with him and find out what exactly is your problem and why you are still having such issues. Hi Dr.Sinkin What it may boil down to is this: a “patch” could save you time and money now but it may cost you much more in the future, be it in 2 months or two years from now. Plz help me ? Do you think I will need an extraction done or will a crown still be a possibility? What should I do? Please tell me what do. You can try warm salt water rinsing as well. Since there are fragments pressuring the bones, it causes extreme pain and discomfort in a person’s mouth. U sound like a truly wonderful combination of genuine professional who is equally gifted wth a big caring heart/very impressive “bedside manner”, if u will..cheers, kristel, Dear Kristel, For about 2 weeks after the crown, I had no pain. Once we stopped for a bite, he took a big bite of his burger, only to encounter a piece of rock hard bacon, and either cracked or chipped his tooth (back, right bottom molar). Bite into it while it’s still soft and scrape away excess material with a toothpick. When my tongue touches it, it feel somewhat smooth not jagged. And diet plays an important role in the forces placed or teeth, restored or otherwise. Make an appointment BEFORE THIS GETS WORSE. Dear Parash, If I leave without extracting will it cause issue? I went to the dentist and he said he would have to pull it, but that there wasn’t enough tooth to pull so it would need to be surgically removed. In your case gum growth will probably not complicate the surgery but I would not delay any longer. ), I cannot look at it, without risking fainting!! I’m concerned about the pain that was 20 minutes a day to now 24 hours after he attempted to remove the crown and also concerned about infection. Of course i said NO. I have a temporary currently on the tooth while we await the permanent to come in. It has a cap/crown on it and it’s a baby tooth. Be well. Unfortunately there is no way that I can meaningfully respond to your question without personally examining your tooth and seeing an x-ray. The tooth has a large filling. If the crack extends below the gum line, it can’t be saved, so it will need to be extracted. I can feel a sharp bit when I brush my tongue over the tooth. 2. Dent Temp: Whether you use the premixed version or the powder and liquid place it in the tooth’s void and pat it with water to harden the material. Dont know what to do. Feel better. I’m glad you don’t have pain but the tooth may have had root canal OR you MAY need it. I cannot make any treatment recommendations regarding your chipping teeth without more information. It is encouraging that the crown stays in except when challenged by caramel-which you should not be eating! What you must do is get to a dentist before the pain becomes unrelenting or before you develop an abscess. Delaying care will only lead to greater problems like serious infection or more pain. That your crown has failed after 35 years of service does not disturb me; it served you well. I was able to make an apt with the Dentist tomorrow at 130pm. Especially since the post went down the tube with the crown. He told me to continue wearing my mouth guard because he thinks that’s why it’s hurting because of my grinding. Could be a result of teeth grinding. If you wait too long your crown may not fit properly because teeth can move and your gum can grow over your tooth. I look forward to hearing from you and can be reached both by phone or email. I wonder if you can please help me with a query about my half crown which which fell out a few weeks ago – this tooth has had root canal work about 5 years ago. Last night when I was eating chips, I felt a sharp pain in my tongue and when I run my tongue over my molar I felt something sharp. It was ill fitting from the very start, too small and extremely painful, he told me not to worry I would get used to it and to keep it in my mouth at all times. Sorry to be such a pain but i am a little terrified at the moment. I don’t know what to do, I’m driving myself nuts worrying about this. Hi I don’t know if this is where I’m sapose to ask you but I had a tooth filled as a child and now its obviously fallen out disintegrated and has become a giant cavity in my far left bottom moler the sensitivity is un bearable as my cheek touching it causes constant pain is there any thing I can do to create a temperarty mold or something for relief I have called my dentist waiting for a call back to make an appointment but in the time being I have 2 children that require my attention and its hard ? I would like to know, can I still save my tooth? Comment: Would appreciate your advise. Anyway it’s hard to know if you have enough exposed tooth structure to offer enough “hold” or retention. In the meantime, enjoy the holiday weekend and be ready to make some calls first thing Monday morning. You may just need a simple bonding procedure to correct the the damage. As long as there is sufficient tooth structure (which sounds to be your situation) and the surrounding bone is healthy and any treatment doesn’t compromise the adjacent teeth, having a crown placed on this tooth is the desired treatment. I wish I lived close so I could be a patient. If you are adventurous, you can look for the temporary crown when it passes (I know it sounds gross) but if it were a permant crown I would encourage you to look for two reasons First, a crown is expensive to just flush away. With time and the addition of teeth grinding at night in my twenties, more work needed to be done, so I have 4 crowns and every filling has been redone. Just follow the instructions and be sure you aren’t allergic to any of the ingredients. Hey there! I went to the dentist looking for a preventive measure that could be done to eliminate the interference and instead was told, “That’s what happens when we get older, our bite changes. Be aware you will have to keep reapplying the Polygrip and brush the stump when the crown is out. Dear Nikki, How long will a temporary crown last?…..thank you. Dr. Sinkin, Hi Doctor, I completely empathize with you and your predicament. You certainly dont want to risk ruining or breaking an intact veneer if its not placed properly. Could I just have this stuck back. You probably cleaved of the weakened cusp while biting and what remains is the filling and the rest of your tooth. I had a root canal on a molar years ago. The fracture below the gum line is called oblique subgingival fracture. Get yee to a dentist asap. The description of your molar is a situation that I have seen on literally hundreds of occasions. My pain is increasing and my gum is turning black. Dr. Sinkin. Cant see a dentist until next Wednesday after returning from camping trip. Thanks I just took it out so I could eat without worrying so much. Good luck. Im surpose to get the tooth extracted in two weeks. Clearly, you need to convey your experience with your dentist. Of course, I know that finances play a big part in this frequent conundrum. At that point the dentist prepared the core for the permanent crown, and gave me a new temporary crown. Take one step at a time. FYI…the filling protects the tooth; the tooth doesn’t protect your filling. If that doesn’t happen, I would not have the new crown permanently cemented until your tooth is perfectly comfortable. Everyday I spit out blood. If you are not satisfied with his response, then you might consider making a change. Please let me know what happens. Let me know what you learn. And less treatment can be tantamount to “patch” work that may ultimately fail. My back molar tooth has a crown that keeps falling out because there isn’t enough tooth structure to hold it (it’s like two flat surface cemented together). Do not gargle. Of all the days for a major dental issue…Sunday afternoon as I prepare to start a new job tomorrow!!! If you can’t find a dentist, be careful not to damage the tooth and give your dentist the heads up on Monday. Often times the nerve of an over- retained baby tooth disintegrates naturally. I’m going to put myself out on a limb and conjecture that your wife’s original treatment was the result of trauma; hence, 2 crowns splinted together on teeth with root canal and posts. Good luck. Good luck. Brush your prepared tooth as normal and make an appointment. It is a temporary dental filling material made for this very problem. ..48 hours. I had tooth #20 extracted and a bone graft three weeks ago and my dentist said that the pain I’m experiencing in #19 is because the bone graft isn’t quite healed and is still exposed because the tissue hasn’t covered it yet. Glad to hear you were able to manage the pain until you saw your dentist. If you are out of town, find an emergency dentist to assess your condition. Molars can suffer everything from tiny, unnoticeable hairline cracks below the gum line to dramatic breaks resulting in sudden and immediate destruction of nearly the entire tooth structure, pulp tissue, tooth enamel, and damaged nerve endings. Scene l – Pain that Halts you in “Mid-Chew” Dear LeAnn, Most important, your gum irritation suggests that something needs to be done ASAP the surrounding bone is lost. In such a situation, bonding could have been performed to “restore” the broken piece. I wish you luck. Referred from, another tooth in the area? I’ll keep you posted also! What dangers do I face if I don’t get this repaired anytime soon? A patient may feel intense pain and will not be able to chew, speak, or open one’s mouth. As for your other front tooth, there is really no way to refortify your tooth as in remineralizing those cracks. For example, oatmeal is easier on the system than granola. Unfortunately, if the abutment is fractured or broke off at the gum line you will see some of it inside the crown. So I had a root canal on a bottom molar tooth few years ago and never followed through with finalizing crown treatment etc. How he/she handles your current dilemma may give you insight as to whether you’ve chosen the right dentist for you. It didn’t hurt though because there was root canal on that tooth, so I wasn’t too worried. Assuming that the bicuspid needs to be removed, as I see it you have 2 options: 1. Most likely, this is a minor problem that can be easily addressed. This could have happened for any one of a number of reasons but the bottom line is that once the seal was disturbed, bacteria was getting under the crown….hence the smell. I’m in PAIN! Hello Dr., I am on vacation in NYC until July 6th. 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