Hi Dawnrainbow,

It sounds like the tooth may have been fractured prior putting in the filling which often happens when a cavity is deep mainly because the tooth becomes weak from the infection caused by the cavity. After putting in the deep filling, the tooth was not only traumatized from the drilling (which occurs any time a tooth is drilled into) but the fractured portion of the tooth gave way from the pressure of the filling. That would account for a large portion of the tooth breaking off.

Based on your description, there is very little crown to root ratio left of this tooth. Meaning the upper portion of the tooth above the gum line is basically gone. The only thing above the gum line is the new crown which is basically cemented on to very little solid tooth structure. The roots of the tooth have been root canaled which causes further trauma, additional bacteria and inflammation to occur. Unfortunately, this tooth is very unhealthy and laden with bacteria. There is no restorative dental procedure to fix or repair the tooth structure that is missing or cure the infection that is brewing inside of this tooth. The pain you felt with the temp crown and now feel with the permanent crown is due to the fact that there is bacteria and inflammation building up in the tooth as well as the surrounding ligament and bone. Removing the crown may temporarily subside the symptoms as it would allow the bacteria to be exposed to the air which would reduce the amount of pressure on the inflammation. However, this tooth is going to continue to deteriorate irrelevant of being covered or not because not only is the tooth sick but the surrounding tissue and bone are also involved with the bacteria and inflammation.

Antibiotics may temporarily subside some of the pain but the meds cannot reach the infection inside of the hundreds of microscopic canals called dentin tubules or in the ligament or jaw bone where the bacteria is spreading to. The only way to attempt to remove the infection is to remove the source which is the tooth. The longer you retain this tooth, the more widespread the infection can become.

The cavity was the problem and the dentist attempted to conservatively restore it. Obviously that did not work because the cavity was too deep and the tooth was probably fractured. It can be hard to diagnose a fractured tooth as the fracture can be microscopic and not clinically or radio graphically visible. Because you just had the root canal and crown done, if you have the tooth removed soon, then you are entitled to a reimbursement of most of the $$ you spent on the root canal and the crown. If you wait, then you will be less likely to be reimbursed because you chose to live with the pain. I know that sounds a bit harsh but that's the way it is.....

Also, it is important for you to know that this tooth is very fragile and so is the surrounding bone. It is best to see an oral surgeon for the extraction because they are much more knowledgeable and experienced than general dentists in removing teeth in this condition.

I'm sorry to deliver this news to you.... I know it can be a bit scary especially when you are in pain and you have already been through so much. By any chance did either dentist give you the option of extracting this tooth or did they just tell you to have a root canal? The reason I ask is because you should have been offered both options.

Please check in with us when you can.
Bryanna