Extract or Crown 1st Molar: What Options Available? (photo)

My 1st lower left molar is fractured & has RCT. The tooth is being held by filling which is lower than the gumline. I experience intermittent gum pains that eventually pass. I have a wisdom tooth on the same lower left side that has not erupted. Q1) If I extract the tooth: 1-Will the 2nd molar will drift forwards? 2-Can the wisdom tooth will erupt? 3-Is it guaranteed that the opposing upper left molar will supra-erupt? If i don't extract the tooth what other options are available?

Doctor Answers 4

Crown Or Extraction After Tooth Fracture

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If you're interested in keeping the tooth, I would see an endodontist (root canal specialist) to see if the root canal needs re-treatment or if it's possible or worth it to retreat. If the tooth is good you can have a bonded filling and a crown. If the tooth is extracted your options are an implant or a bridge. The second molar will probably drift forward and the opposing tooth supra-erupt but no way to say how quickly. Can't say if third molar will erupt further.

Cleveland Dentist

Extract or Crown

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From the photo I would say crown I am unable to read the radiograph sorry but if the periodontal health is good and the radiograph wnl I say maintain the tooth good luck



Kevin Coughlin DMD, MBA, MAGD     CEO Baystate Dental PC

Kevin Coughlin, DMD
Springfield Dentist

Options following tooth fracture

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Hey Ken,

Thanks for the photo and x-ray . Unfortunately, the quality of the x-ray is not good enough to be diagnostic. From what you're describing the tooth may be fractured.  You should have it checked out by a dentist to see if that's indeed the case.

If there's a fracture and the tooth cannot be saved, a dental implant is the first option. A 3-unit bridge is also an option.  You're right in thinking that if the space is left empty the teeth will shift over time to close the gap.  We don't know how fast the teeth will shift or how fast the upper teeth will super-erupt.  But, almost daily I see patients who did not replace missing teeth and the remaining teeth have shifted into the gap. Good Luck!

Peter Mann, DDS
Manhattan Dentist

Extraction is not a good solution.

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Based on the photo, the x-ray which is not very good, and your description I would recommend that if your dentist (you may want to get more than one opinion) says that the Root Canal is okay that you have your tooth restored with a Post and Core and then a Crown as soon as possible.  I would guess that your pain is coming from food impaction due to the fracture and home care/ oral hygiene is difficult or impossible.  The tooth should have been restored as soon as the Root Canal was completed and at this point it needs treatment immediately.  As far extraction is concerned the teeth behind the first molar will not move to properly replace this tooth and an implant would not be as good a solution and would be more expensive.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.