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Q. The tooth is sharp and cracked. What is the treatment?

Answered by
Dr. Divya Banu M
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Apr 12, 2018 and last reviewed on: Oct 09, 2018

Hello doctor,

The tooth is sharp and cracked. It is leaving a space in the mouth. What is the treatment?

#

Hi,

Welcome to icliniq.com.

How are you doing?

I saw the image, but it is not clear (attachment removed to protect patient identity). But, based on how much ever I could appreciate, it seems you have deep caries in your first molar and to some extent nearby second premolar too. The crack or sharpness is due to the loss of tooth structure because of caries (cavity).

Kindly take an IOPA (intraoral periapical radiograph) of both the teeth together (in one X-ray itself) and send it to me, along with a clear image of your teeth to help you with a proper diagnosis and treatment plan.

Do you have or had pain, especially during chewing or sleeping? The treatment plan will vary based on the diagnosis. If the cavity has reached the pulp (blood supply of tooth), it will need a root canal treatment followed by a crown. If it is approximating the pulp, then we will give a temporary filling, wait for a month and if there are no symptoms, then we will change it to a permanent filling (restoration).

If it is not even approximating pulp and is in dentin or just enamel (hard structures of teeth), then we will straight away go for permanent restoration (tooth filling). All these will eventually treat your cavity and the sharpness and the gap will go away.

Kindly send me a clear picture and the radiograph to help you precisely. Take care.

For more information consult a dentist online --> https://www.icliniq.com/ask-a-doctor-online/dentist


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Thank you doctor,

I do not have X-rays. I provided close up photo. Will this cause any emergent problems like an infection or can I wait a bit for insurance to kick in?

#

Hello,

Welcome back to icliniq.com.

Yeah, this is definitely deep caries in the first molar. If you do not have pain or swelling, and lymphadenopathy (painful swelling below the angle of lower jaw), then it is not an emergency. You can wait. But, get it treated as soon as possible. The infection will be based on the stage of caries and your immunity level. Do not worry. This is a very common dental problem. You can get it cured.

Till then, do not chew anything very hard on that tooth surface, maintain oral hygiene. Again, since you do not have any symptoms, it is not an emergency, but try to get it treated as soon as possible.

And also, your nearby tooth has caries (cavity), which does not seem to be deep. Hence, get that also filled with a permanent filling.

Take care.

For more information consult a dentist online --> https://www.icliniq.com/ask-a-doctor-online/dentist


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Thank you doctor,

What would be the treatment as there is no tooth to fill? There is a space.

#

Hello,

Welcome back to icliniq.com.

Since I do not have the radiograph, I cannot exactly tell whether it will go for root canal or just a filling. I have already explained what could be three cases.

So, if it is a root canal, they will clean the root canal of the tooth, then fill the canal with an inert material, followed by a permanent filling in the crown portion. After a week, if you do not have any symptoms, they will reduce the shape of tooth, make an impression and finally, you will get a crown mimicking the original tooth structure cemented over the prepared tooth. Hence, the gap will be closed. You can just search online and see the images or video of the procedure.

If at all, it is not approximating the pulp, then you will have a temporary filling as I mentioned earlier. Later, after a month or so, it is advisable for you to get a metal inlay filling there instead of any other cement filling as the cavity is deep and this tooth is important for chewing. So, it needs a stronger filling. Here again, after cleaning and shaping the cavity, an impression will be made and then you will get an inlay filling cemented in the cavity to restore back your tooth form.

In both the cases, your tooth form will be restored with artificial restorations/material. Do not worry. Just go and show it to your dentist as soon as possible, and before it starts to give you pain or eat away more of your tooth material, they will take care of it. Not an emergency but get it done soon.

Regarding the nearby molar, the cavity will be cleaned and shaped and filled with a tooth-colored filling. I have given you all the possibilities as I do not have the X-ray to check the level of progression of caries. And, in any way, your tooth can be saved and will be restored back to the form and function.

For more information consult a dentist online --> https://www.icliniq.com/ask-a-doctor-online/dentist


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