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Molly Maloof, MD

Director of Clinical Content
@DoctorBase

My upper front tooth with a very old root canal, post and full crown porcelain on silver broke from its stronghold.

30 yrs ago my upper front tooth had a root canal & full crown of porcelain over silver. 2 weeks ago I bit into a apple & I heard a crack inside that rooted canal. After examining I realize the tooth moves fwd & backward, & 45 degrees to the L & R. But wont let me pull it out using reasonable force, WHY? I have no Ins. or extra money. What can I describe to a DDS that means fast fix? Can the tooth can be pulled out, washed, dried then re-cemented to last awhile if careful?
Poster
  • Female | 52 years old
  • Complaint duration: 14 days
  • Medications: none
  • Conditions: no

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Featured Answer

4 UpVoted this answer
A crack heard from biting down onto a root canal post and crowned tooth is a big problem. First thing you need is an x-ray, a periodontal probing and a clinical examination.Most likely, it is a catastrophic crack. You need to decide the options that will save you money in the long run and prevent you from worrying about the status of this tooth. In 2014, you will most likely to gain more from an implant and a restored crown rather than a bridge or a removeable partial. Trying to recement a failing a post and crown will only lead to more recementations, gum problem, bone loss, etc.
4 UpVoted this answer
Just like most of the comments, my advise will be to have a limited exam, take some X-rays. Have a dentist give you a professional advise. Seems like a tooth that is non restorable.

Have the tooth extracted and wait until financially you could have it replaced.
Rodolfo A. Olmos
3 UpVoted this answer
This is the most common perspective a human been has to their teeth, i call it the esthetic perspective. We see our smile and what we see in the mirror is what is most important. If our reason for going to the dentist is "that we never take out our face and put it in a cup (wearing a denture)" then we must see this from the engineering perspective.

- When we try this perspective we start from the joint (tmj) it's just like scissors, if you are going to cut an electric cable with scissors you don't cut it with the tip of the scissors, you shove it all the way back into the joint and lean on it. The closer we are to the joint the greater the force your jaw is able to exert.

-Teeth are not all the same, all back teeth are the same and all front teeth are the same, all back teeth are the columns and studs that keep the building sanding and square. All front teeth are the doors and windows that "hang" off the front of the house but are not weight bearing structures. (that means they cannot bear weight or they will break)

-We don't have a hundred teeth back there, there are only four supporting structures to each side, two are columns and two are studs each has an upper and a lower half. Many people get their first toothache and they choose to have the tooth extracted because you can't see it. (esthetic perspective) New definition an extraction is an amputation.

- Columns or molars are about two and a half times the size of a stud or premolar, so if that first extraction was your second molar which is next to the hinge you just lost almost 50% of your ability to grind food on that side.(chewing power) Just one extraction. Opposing tooth is neutralized, can't clap with one hand.

-Out of habit or fear or lowest fee, demolishing the house seems to be the most convenient way to deal with the inconvenience. Until one good day we realized that teeth are not figurines on a mantle, they are the blades of the grinding machine which enables you to eat. And without them nothing is the same, you don't look like yourself and you can't eat. The complete loss of form and function is not something which makes humans feel better. The bone that holds a tooth shrinks from 30-70% in the first 12 months, after this the human face only shrinks.

-How many teeth are missing in the back? To be a functioning unit you need a tooth that faces and engages another tooth completely.

1- teeth are amazingly hard to grab, i would use a dental slide hammer. After a complete exam and radiographs, it might be just a piece of cement. I do not advocate for someone who has never done this to try.

2-if you have termites in your house and the thing looks like its going to hit the ground at any second, what would you have to tell the contractor that would mean a fast fix? after an exam there might be no fast fix, other than an immediate denture.

3- if the tooth is still complete, the crown and post are still complete and the difference between first contact and complete closure can be cleared with an aggressive adjustment (grinding the back of the crown) maybe.

Test- push the crown back in until it feels like it went home, keeping your index finger on it holding it in place. Now bite down on your back teeth until they all touch like when you are chewing comfortably. Now you see your bite broke the tooth not the apple, and the distance from where the tooth was to where your bite wants to put it is how much needs to be cut out for it to fit where it used to be. This is a changing structure. The area of dentistry called occlusion seeks to create a stable structure. No change through time.
3 UpVoted this answer
Your front tooth seems to have a major problem, I would suspect that some of the tooth inside of the crown broke so the crown moves as it is only being held on by the post in the root canal. Depending on how deep the break is, a dentist might be able to remove the broken part and bond it together. Sometimes we can replace the post in the root canal and fabricate a new crown. It all depends on where the fracture lies.
2 UpVoted this answer
I would recommend seeing a dentist as soon as possible. That much movement can be indicative of a severe fracture. A tooth cannot be extracted and recemented . The post and core may be recoverable depending of how far along the root the fracture has occurred. Your dentist will recommend the best option. It may involve removing the tooth and placing a temporary "false" tooth.
Timothy Agapas
2 UpVoted this answer
It's dangerous to attempt surgery on yourself. Where are you going to go if there are conplications-fractures-infections? Because of competent dental care you got 30 years of service from a badly damaged tooth. See a fully qualified Dentist for help, even if you have to pay for it yourself. The treatment scenario you described is dangerous and extremely risky. See a Pro.
Arnold J. Malerman
1 UpVoted this answer
Sounds like you have fractured the root at or below the margin of the crown. It may be possible to save the crown with a post and core you should be prepared to pay $300-500. to fix it properly.
1 UpVoted this answer
You will need to see a dentist for proper examination and radiograhs. It sounds like there could be a root fracture, in which case the tooth would have to be extracted. Options for relacement would be implant, bridge or various types of dentures. Prices vary, but if you are vacationing in the Caribbean, you will amazed at the price of dentistry.
J. Abe  Smith
1 UpVoted this answer
Sounds like the post has debonded. If the tooth is not fractured there is a chance that it can be recemented. If the tooth is fractured then you are probably looking at an extraction followed by a bridge, implant or partial.
Mike Huggins
1 UpVoted this answer
Sadly from what you described, it does not sound like there is a "fast fix," but it all depends on what fractured and how severe it is. I recommend you see a dentist ASAP to get an accurate diagnosis of your predicament. You could be looking at an implant and crown, bridge, partial, or temporary partial.