Dealing with a Cracked Second Molar: Should You Extract the Remaining Half?

Biting down on food has fractured the second molar?

On December 5th, I cracked my lower left second molar while eating.
The dentist later extracted half of the tooth and mentioned that if it's inconvenient to chew, the remaining half could be removed as well.
Currently, there is half a cavity left, and I have been taking antibiotics and using mouthwash for disinfection.
I'm unsure if the wound will easily trap food, increasing the risk of infection, or if it would be better to extract the entire tooth.

Chen, 20~29 year old female. Ask Date: 2022/12/06

Dr. Zeng Guanghui reply Dentistry

It is recommended to completely extract the tooth.
Leaving half of the tooth can increase the risk of food debris accumulation and infection.
Dr.
Tseng Guang-Hui, Department of Dentistry, Nantou Hospital.

Reply Date: 2022/12/06

More Info

When dealing with a cracked second molar, particularly one that has been partially extracted, there are several considerations to keep in mind regarding the remaining tooth structure and the potential for infection or complications.

Firstly, it's essential to understand that leaving a portion of a tooth in place can sometimes be a viable option, especially if the remaining structure is stable and not causing any discomfort. However, there are risks associated with retaining a fractured tooth. One of the primary concerns is the potential for food particles to become trapped in the remaining cavity, which can lead to an increased risk of infection. If food does get lodged in the area, it can cause irritation, inflammation, and even lead to an abscess if bacteria proliferate.

The decision to extract the remaining half of the tooth should be based on several factors:
1. Stability of the Remaining Tooth: If the remaining portion of the tooth is stable and not causing pain or discomfort, it may be reasonable to leave it in place temporarily. However, if it is loose or if there is any pain associated with it, extraction may be the better option.

2. Hygiene and Maintenance: Maintaining proper oral hygiene is crucial. If you find it challenging to keep the area clean, or if you notice that food frequently gets stuck, this could be a sign that extraction is necessary. Regular rinsing with an antiseptic mouthwash can help reduce the risk of infection, but it is not a substitute for proper dental care.

3. Follow-Up Care: Regular follow-up appointments with your dentist are essential. They can monitor the healing process and assess whether the remaining tooth structure is causing any issues. If you experience increased pain, swelling, or signs of infection (such as pus or fever), you should contact your dentist immediately.

4. Long-Term Considerations: If the remaining half of the tooth is not viable for long-term use, your dentist may recommend extraction followed by restorative options, such as a dental implant or bridge, to maintain function and aesthetics.

5. Personal Comfort and Functionality: If you find that the remaining tooth is affecting your ability to chew or causing discomfort, it may be worth considering extraction sooner rather than later.

In summary, while it is possible to leave a portion of a cracked second molar in place, careful consideration of the factors mentioned above is necessary. If you are experiencing difficulties with hygiene, discomfort, or if the tooth is unstable, extraction may be the best course of action. Always consult with your dentist to discuss your specific situation and to determine the best treatment plan tailored to your needs.

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