Do You Always Need to Extract a Tooth with a Root Fracture?

Is it necessary to extract a tooth if the root is fractured?

Hello, doctor.
I accidentally fell while riding my bike and broke my right front tooth.
An X-ray showed a vertical crack along the root of the tooth.
Does this situation definitely require extraction? Is it still possible to get a crown? Thank you!

Yumi Wen, 20~29 year old female. Ask Date: 2016/09/15

Dr. Zeng Guanghui reply Dentistry

If there is a vertical crack that has reached the tooth root, extraction may be the better option.
It is advisable to consult a dentist for further evaluation.

Reply Date: 2016/09/15

More Info

When it comes to a root fracture in a tooth, the decision to extract the tooth or attempt to save it through other means depends on several factors, including the location and extent of the fracture, the health of the surrounding tissues, and the presence of any infection.

In your case, since you mentioned that your right front tooth has a vertical crack visible on an X-ray, it is essential to evaluate the severity of the fracture. Vertical root fractures can be particularly challenging because they often extend below the gum line and may not be visible during a clinical examination. If the fracture is confined to the root and does not involve the crown of the tooth, there may still be a chance to save the tooth, especially if the fracture is not causing significant pain or infection.

If the fracture is located above the bone level and the tooth is still stable, a dentist may consider placing a crown (or dental cap) over the tooth to restore its function and appearance. However, if the fracture extends below the bone level or if there is significant mobility or infection, extraction may be the only viable option.
In cases where the tooth is extracted, there are several restorative options available afterward, including dental implants or bridges, which can effectively replace the missing tooth. Dental implants are often preferred due to their durability and the fact that they do not require altering adjacent teeth.

It's also important to consider the potential for complications. If the fractured tooth is left untreated and becomes infected, it could lead to more severe issues, including abscess formation, which can cause pain and swelling. In such cases, extraction may become necessary to prevent further complications.

In summary, while not every root fracture necessitates extraction, the decision should be made based on a thorough evaluation by a dental professional. If you are experiencing pain or discomfort, or if there are signs of infection, it is crucial to seek prompt dental care. Your dentist may recommend imaging studies, such as X-rays, to assess the extent of the fracture and determine the best course of action.
Ultimately, the goal is to preserve your natural teeth whenever possible, but sometimes extraction is the best option for your overall oral health. If you have concerns about the treatment options available to you, discussing them with your dentist can help clarify the best path forward based on your specific situation.

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