My dentist told me that one of the teeth supporting my upper right bridge is cracked. I have no pain or symptoms, but I was told that the bridge and crowns need to be replaced.
This would be an expensive treatment, especially since the tooth isn’t bothering me. Should I get a second opinion before replacing the bridge? Are there any alternatives to replacing the bridge? – Thanks. Kymberleigh from GA
Kymberleigh,
This situation highlights one advantage of replacing a missing tooth with a dental implant rather than a bridge. A bridge may cost less initially, but the supporting teeth become part of the restoration. If one of those teeth later fails, the entire bridge may need to be replaced. An implant stands independently, so a problem with a neighboring tooth usually does not affect it.
If one of the abutment teeth supporting this bridge is truly cracked and cannot be saved, the tooth would need to be extracted. The existing bridge would then need to be replaced, possibly with a longer bridge that replaces two missing teeth.
Is Your Tooth Cracked?
Based on the information provided, we would want to confirm the diagnosis before proceeding with treatment. A crack in the root of a crowned tooth is possible, but a few details raise questions.
There are several reasons we would want a closer evaluation:
- There are no symptoms. A significant root crack often causes pain when biting or chewing, particularly on something hard.
- A crown helps hold a weakened or cracked tooth together and reduces the risk of the tooth splitting further.
- Although patients with an unusually strong bite can sometimes fracture teeth severely, a root fracture developing beneath an intact crown would not be the most typical finding.
Research has also shown that, under certain conditions, even a tooth fractured through the root may sometimes be stabilized, crowned, and retained. That does not mean every fractured tooth can be saved, but it reinforces the importance of confirming the extent and location of a suspected crack before extracting the tooth.
Why a Second Opinion May Be Helpful
Before removing an abutment tooth and replacing the bridge, we recommend getting an independent second opinion.
For the most objective evaluation, consider giving the second dentist as little information as possible about the first diagnosis. Rather than saying another dentist believes the tooth is cracked, simply explain that you would like a second opinion about the upper right area. This allows the dentist to examine the tooth and X-rays without being influenced by a previous diagnosis.
If the suspected crack was identified on an X-ray, having another dentist review that image may help determine whether the tooth is truly fractured and whether it can be saved.
Brian LeSage, DDS, an accredited fellow of cosmetic dentistry in Beverly Hills, sponsors this post. Read why his patients say he is the best cosmetic dentist in Beverly Hills.