What are a patient's options when a molar or tooth cusp breaks?

Question

I've been to 2 dentists who tell me different things. I have an intact large filling, held in a tooth with a broken/eroded cusp on the lingual side. They say, either get a crown or do nothing. 1 said if I asked for an onlay they have to remove my filling. X rays are fine but my tooth feels weaker when biting/more sensitive. Why can't I just get an only to repair the missing piece of a healthy tooth? I don't want to shave the remaining tooth to put on a crown. Options? #crown #onlay #broken cusp

Vachik Danoukh, DMD · Answer

Hi Grey Ghost from, New York!  You can do nothing, have an onlay  or have the tooth crowned. Keeping your own natural teeth is the best way to go. You are feeling more sensitivity and your tooth feels weaker when biting.  I would opt for the crown and your worrying would stop. You eventually will have to have one anyway, and I would not want to keep worrying about the sensitivity and the symptoms coming from the tooth. The crown will last you a very long time and you will stop worrying and enjoy your food!

Andrea Stevens, DMD · Answer

The answer is...both of those dentists are correct! Nothing is as good as your own, natural, healthy tooth, free of cavity and free of any type of filling material. Once your system breaks down and cavity occurs, anything else a dentist does will never be as good as your own complete and healthy tooth. Having said that, dentists have developed a number of ways to repair your damage.Whenever I have a patient in a situation like yours, I tell him the tooth is at high risk of continuing to break apart. Then I tell him to lower the risk of further decay I can put in a filling to seal the tooth, but to lower the risk of breaking apart AND seal the tooth, I would need to put in a crown. Then my patients have three options: do nothing, have a filling, or have a crown. The patient chooses the risk level he is willing to accept, and when he has complications from a riskier decision...he knew the risks from the start.Your tooth feels weaker and more sensitive because IT IS weaker and likely to break apart. The question is, are you interested to risk losing the tooth completely when it splits between the roots and up into the jawbone? Because that’s a likely next step, and the next treatment would be a dental implant. Good luck!

Dipesh Sitaram, MICCMO, FICCMO, DDS · Answer

If there is a large filling in the tooth along with a broken cusp, then an onlay would be a conservative route to go in order to restore the tooth.

What are a patient's options when a molar or tooth cusp breaks?

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What are a patient's options when a molar or tooth cusp breaks?

Answers (3)

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Everything you need to know about Tooth Repair

Our mission is to create a world where every investment in modern beauty is Worth It.