Dealing with a Broken Front Tooth: Options and Solutions

Q: Dealing with a Broken Front Tooth: Options and Solutions

Hello： Both physicians have thoroughly informed you of the treatment options as well as the potential side effects and complications. <br>Therefore, the decision on which treatment method to choose and the responsibility for any resulting side effects or complications ultimately

Broken front tooth?

I have a question regarding my front teeth.
One of my front teeth broke about two years ago due to biting into ice, losing a third of it, and I had a veneer placed on it.
At that time, I also had a veneer placed on the adjacent front tooth (so two front teeth with veneers).
This past August, I accidentally broke the same front tooth again while eating ice, this time losing two-thirds of it.
I consulted a dentist, who mentioned that the root canals of my two front teeth are very small, and they couldn't locate the root canal due to the fracture.
They suggested using a microscope for root canal treatment.
The dentist said that my tooth broke due to the pressure from biting ice.
After the microscope root canal treatment, I would need a crown.
I'm concerned whether the crown will put pressure on the veneer and cause it to come off as well.
The dentist indicated that if the tooth breaks again, it shouldn't affect the veneer.
However, the dentist performing the microscope root canal treatment suggested first checking if a crown can be placed without it falling off before incurring the cost of the microscope root canal.
I consulted another dentist who mentioned a 70% success rate and warned that improper use after treatment could lead to it falling out within two years.
They also mentioned that dental implants for front teeth may not look good and that we should first assess whether there is enough bone for the implant.
I'm seeking advice on how to resolve my dental issues, as it has been nearly two months, and I'm unsure what to do.

Sha Sha, 30~39 year old female. Ask Date: 2021/11/05

Dr. Lin Jiayong reply Dentistry

Hello: Both physicians have thoroughly informed you of the treatment options as well as the potential side effects and complications.
Therefore, the decision on which treatment method to choose and the responsibility for any resulting side effects or complications ultimately rests with you.
Sincerely, Dr.
Lin Chia-Yung, Department of Dentistry, Taichung Hospital, Ministry of Health and Welfare.

Reply Date: 2021/11/05

More Info

Dealing with a broken front tooth can be a challenging situation, especially when previous treatments have not provided lasting solutions. Based on your description, it sounds like you have already undergone some dental work, including veneers, and now face a more severe fracture of your front tooth. Here’s a comprehensive overview of your options and considerations moving forward.

Understanding Your Situation
You mentioned that your front tooth has been broken twice, with the most recent incident resulting in a significant loss of tooth structure (two-thirds of the tooth). The fact that your dentist has indicated that the root canal is difficult to locate due to the small size of the canals adds complexity to your situation. This is not uncommon, as some teeth, particularly incisors, can have intricate root canal systems that are challenging to navigate.

Options for Treatment
1. Root Canal Treatment: If the tooth is still salvageable, a root canal treatment may be necessary. This involves removing the nerve and pulp of the tooth, cleaning out the canals, and then sealing them. Given the difficulty in locating the canals, your dentist may refer you to an endodontist (a specialist in root canal treatments) who can use advanced techniques, such as a dental microscope, to find and treat the canals effectively.

2. Crown Placement: After a successful root canal, a crown is typically placed over the tooth to restore its function and appearance. Crowns can provide strength and protection, especially for teeth that have undergone significant structural loss. Your concern about the crown potentially affecting the adjacent veneer is valid; however, a skilled dentist can usually work around this to ensure that both teeth remain intact.

3. Veneer Replacement: If the crown placement affects the existing veneer, you may need to replace the veneer on the adjacent tooth. This is something to discuss with your dentist, as they can provide options that maintain the aesthetic appearance of your smile.

4. Extraction and Implant: If the tooth cannot be saved, extraction may be necessary. While you mentioned concerns about the aesthetics of dental implants, modern implants can be very natural-looking and functional. The success of an implant largely depends on the quality of the bone in the jaw, so a thorough evaluation will be needed to determine if you are a candidate for this procedure.

5. Temporary Solutions: While you are deciding on the best course of action, your dentist may provide a temporary solution, such as a temporary crown or a flipper (a removable partial denture) to maintain aesthetics and function.

Considerations
- Success Rates: You mentioned a 70% success rate for the root canal treatment. It’s essential to have a candid discussion with your dentist about the risks and benefits of each option. Understanding the potential for complications can help you make an informed decision.

- Long-term Planning: Consider the long-term implications of each treatment option. For instance, while a root canal and crown may preserve your natural tooth, an implant may offer a more durable solution in the long run, especially if the tooth has a history of fractures.

- Aesthetic Concerns: If aesthetics are a significant concern for you, discuss this with your dentist. They can provide options that will ensure your smile remains attractive, whether through crowns, veneers, or implants.

Conclusion
Navigating the treatment of a broken front tooth requires careful consideration of your options and open communication with your dental provider. It’s crucial to weigh the benefits and risks of each treatment, especially given your previous experiences with dental work. Seeking a second opinion from a specialist, such as an endodontist or a prosthodontist, may also provide additional insights and options tailored to your specific needs. Ultimately, the goal is to restore both function and aesthetics to your smile while ensuring the longevity of your dental health.

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