Female, 38, cracked filling #12 found during cleaning, is crowning best course? (Photo)

Based on what you’ve described, the recommended treatment sounds like a good and conservative approach for your situation. Here’s a breakdown:
Severe Sensitivity: The instant, severe pain with air and the cracked tooth edge suggest the nerve is still healthy but the tooth is compromised. A crown will protect the tooth and prevent further cracking or sensitivity.
Removing Fillings & Using Dental Mesh: Removing the old fillings and using dental mesh to stabilize the tooth before placing the crown is a common and effective practice. It avoids over-reducing the tooth structure and ensures the crown fits securely.
Temporary Crown: The temporary crown will protect the tooth while your permanent porcelain crown is being made. This is a standard step in crown procedures.
No Root Canal: If there are no signs of infection, decay near the nerve, or lingering pain after treatment, skipping the root canal is appropriate. Preserving the natural nerve avoids unnecessary procedures.
Severe Dental Anxiety: Let your dentist know about your anxiety—they may offer options like nitrous oxide (laughing gas), sedation, or frequent breaks to make you more comfortable during the process.
Why This Plan Works:It protects and strengthens your tooth while avoiding unnecessary invasive treatments (like a root canal).It addresses the sensitivity, cracked edge, and compromised tooth structure without excessive removal of healthy enamel.With proper follow-up and care, this treatment plan should help you avoid future issues. Be sure to communicate any pain or discomfort after the procedure.
Dr. Miller Vieira Paula

Your filling can be renewed. I see that only a very small piece of it has broken. Since part of your healthy tooth tissue would need to be cut for a crown, it would be healthier to have your filling renewed.

Thank you for providing the information and the X-ray image. Based on your description and the image, it sounds like you’re dealing with a cracked tooth (#12) with a compromised filling. Let me address your questions in detail:
1. Is crowning the tooth the best course to avoid future issues?
• Yes, placing a crown is generally the best solution for a tooth with cracks and damaged fillings, as it provides structural reinforcement and prevents the crack from worsening. Your dentist’s plan to avoid unnecessary tooth structure removal (no flattening or reduction) and opting for a crown without a root canal (if the nerve is healthy) aligns with modern conservative dental principles.
2. Using a temporary crown first:
• The use of a temporary crown allows for observation of the tooth’s response. If you experience no pain or sensitivity during the two-week period, it indicates the nerve is healthy, and a root canal is likely unnecessary. This step is prudent, especially given your dental anxiety, as it minimizes the risk of post-treatment complications.
3. Dental mesh to protect the tooth:
• Using mesh (likely referring to a fiber-reinforced material or matrix) is a good choice to stabilize the remaining tooth structure while preparing for the crown. This technique helps preserve as much of the natural tooth as possible, reducing the chances of further cracking or failure.
4. Pain with air or pressure:
• The severe pain with air or cleaning suggests the crack has exposed the dentin or is near the pulp (nerve chamber). Crowning the tooth will seal and protect it from external stimuli, alleviating sensitivity.
Recommendations:
• Follow Your Dentist’s Plan: Your dentist’s approach appears well thought out and minimally invasive, prioritizing preservation and avoiding unnecessary procedures.• Manage Dental Anxiety: Consider discussing sedation options (e.g., nitrous oxide or oral sedation) to keep you comfortable during the procedure.• Monitor Symptoms: If you develop lingering pain (spontaneous or constant), discuss the possibility of pulp testing or further diagnostics to rule out the need for a root canal.
You’re taking the right steps to address this issue. Ensuring proper communication with your dentist and following their guidance will help achieve a successful outcome with minimal stress.