I have a bridge on my upper right side, and my dentist says it needs replacing because one of the supporting teeth is cracked. I have no pain or other symptoms, and replacing the bridge and crowns will be expensive. Is repair instead of replacement a possibility? Thanks. Gaius from NJ
Gaius,
Schedule a consultation with a periodontist if you are interested in tooth replacement with a dental implant
If one of the teeth supporting your dental bridge has a cracked root, you may need to replace the entire bridge. However, because you have no pain or other symptoms, we recommend getting a second opinion before agreeing to treatment.
Your situation illustrates one advantage of dental implants over bridges. Although a bridge may cost less initially, a problem with one supporting tooth can affect the entire bridge. An implant stands independently, so problems with neighboring teeth generally won’t affect it.
If the crack extends through the root, you may need an extraction. You would then need a longer bridge to replace two missing teeth, or you could consider replacing the teeth with dental implants.
Could the Diagnosis Be Incorrect?
When a tooth cracks, a dentist must consider if the root is cracked. Ask your dentist about the cracked tooth’s roots.
Factors to consider:
- Your symptoms. A cracked root may cause sharp pain when you bite, especially on hard foods. However, some root fractures cause little or no discomfort. If you have no symptoms, the tooth root may still be intact.
- The tooth has a crown. Crowns help protect weakened or cracked teeth by holding the remaining tooth structure together. Although a crowned tooth can still develop a root fracture, the crown provides some protection.
Research has also shown that, under certain conditions, dentists can preserve some fractured teeth by repositioning and stabilizing the broken segments. However, this treatment is appropriate only in select cases.
Why Should You Get a Second Opinion?
Before replacing your bridge, we recommend having another dentist evaluate the supporting teeth. Rather than saying your dentist diagnosed a cracked tooth, ask, “Could you examine my upper right bridge and tell me if you see any problems?”
You can also wait until the second dentist completes the initial examination before sharing the first diagnosis. This allows the dentist to form an independent opinion. If the second dentist identifies a fracture, ask how they confirmed it and whether any treatment could preserve the tooth or existing bridge.
Given the expense involved, taking time to confirm the diagnosis is worth it.
Dr. David Pumphrey, an Atlanta periodontist, sponsors this post.
