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Dental and Oral Health Center

Fractured Rear Molar

09/14/2009

Question:

I recently had a root canal, a post inserted and a crown on a rear molar. Shortly afterwards, I began feeling the tooth and was told it sounded like a fracture. It has now progressed to pain. Of the three procedures, my uneducated guess is that the one that could have caused the fracture is the insertion of the post. Any thoughts on what could have caused this tooth to fracture so soon and what are my options??

Answer:

The tooth is more likely to be cracked than fractured. The crack could have existed before the root canal and in fact precipitated the need for a root canal. Some of these cracks are very difficult to detect and therefore diificult to differentiate from a tooth that has no crack but needs a root canal. It is also possible that the root canal coud have worsened the crack or it could have been worsened by the placement of the post. 

It is diificult to determine why the tooth cracked or fractured. Usually, if the tooth is fractured due to the post, it breaks near the end of the post and happens after the post is placed. If it was cracked before all of the treatment was delivered, the pain usually never goes completely away when the treatment is completed. 

If the tooth is in fact fractured or even cracked, it is not savable. The pain will not go away no matter what treatment is provided. The tooth must be removed. Make sure that the endodontist and the general dentist agree that the tooth is cracked or fractured before it is extracted. 

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Response by:

D Stanley Sharples, DDS
Clinical Assistant Professor of Primary Care Dentistry
College of Dentistry
The Ohio State University