Dr. David Kagan's Blog

I had a cracked lower second molar, which, when the broken piece was removed I was directed to go to an Endodontic specialist. I have now started a root canal for that tooth. It has been brought to my attention that the broken segment of the tooth is partially below the gumline and there is some concern about whether I should go ahead with the root canal and then getting post and crown to attempt to save the tooth or to just extract the tooth and have a dental implant and permanent tooth put in place. Besides the spiraling costs to be considered, I have no way to determine what to do. Please advise.

Thank you,
-Stan from New York

Stan,
There is no way we can tell from this distance if your tooth will hold up or not. But let me try to be helpful.

If a tooth is broken below the gumline, yes, it does cause some concerns about whether the tooth will hold up. But often a dentist can do a crown lengthening procedure and the result will hold up just fine.

And then another thing that may be going on is defensive dentistry. The dentist wants to be sure you are fully warned about every possible thing that could go wrong, in order to protect himself or herself legally, and sometimes this causes more worry than is necessary.

I would just go back to your family dentist who sent you to the endodontist and ask the question: what are the long-term prospects for this tooth, and what would you recommend? Then make a decision based on what you’re told.

In general, it is better to try to save your own natural tooth when you can.