June 2, 2015
One of the common problems we see as dentists is cracked teeth. Any tooth can fracture, just like driving a truck over pavement enough times can crack the pavement, but the most commo reason is from the weaknesses caused by drilling and filling teeth. Large amalgam fillings are like a lump of soft lead in a crystal glass, slowly creeping and expanding over the years until the tooth cracks apart.
While most cracks are horizontal and a cusp cracks of the tooth, a large number are vertical cracks extending into the nerve of the tooth and splitting the root in half.
It is best to replace any metal fillings if any sign of cracking is evident, but replacement with tooth coloured fillings may not be strong enough.
The tooth should be supported with a full coverage of porcelain, or the best alternative which is gold. The porcelain has a higher strength than plastic fillings but can still crack. The gold will wear at the same rate as your own teeth and will not break but there is a cosmetic compromise.
Talk to your dentist about which option is most suitable for you.
July 22, 2013
This patient started getting sharp pain every time they bit on this tooth. It had never been filled but it started to split This can happen from grinding (bruxing) at night, clenching, eating hard foods, or often old fillings have weakenbed the tooth. In this case the patient admitted a very stressful period over the previous 6 months and an awareness of heavy clenching.
You can see natural grooves and small enamel cracks in both teeth. The pain was localised to the second premolar by biting on a hard object.
After removing the enamel a verticle crack can be seen extending into the tooth. Without support this will continue down through the nerve and root of the tooth and the tooth will need to be removed. Below is an image of a tooth where this has already occured.
A porcelain shell like a helmet is made that can fit over the tooth and protect it. We use only Australian laboratories and don’t source crowns from overseas.
Thanks to Jade Dental Laboratory in Buderim ,Queensland, for this artistic creation.
The crown is glued onto the remaining tooth to seal the crack and reinforce the tooth.
I have used eMax for this crown. As it is cosmetic and translucent, I don’t have to agressively remove tooth structure all the way to the gumline like a traditional crown. This leaves the tooth much stronger in the long term.
You can see where the tooth was reduced on the side. Traditional crowns would mean removal of tooth all the way to the gumline.