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Medical Forum / General / Dentistry / March 2007Early detection of tooth fracture.
I had a tooth fracture (lower left middle molar) last year that was not diagnosed until after 6 weeks. Initial symptoms were pain and then abscess developed. Diagnosis was not made until after the tooth was visibly cracked several weeks later. In retrospect, I remember a "zapping" type of feeling when biting down on This was about 2 weeks before the diagnosis was made. I'm thinking that this was when the tooth fully cracked. Few days ago, I felt a similar pain (not quite as severe and not so much of a "zap" feeling but more of a general pain feeling) for a few seconds when biting down on a soft food. And I felt it again again today. It is on the lower right side but I can't narrow it down to a specific tooth -- maybe the first or second molar. I don't feel any ongoing pain Should I go to the general dentist? or periodontist? What kind of tests can they do to diagnose if it is a fracture? Can anything else cause these symptoms? > I had a tooth fracture (lower left middle molar) last year that was > not diagnosed until after 6 weeks. [quoted text clipped - 19 lines] > > Can anything else cause these symptoms? Sometimes not easy to do. I do have a nice, exceptionally low-tech instrument called a "tooth slooth" (their spelling) that is useful for isolating any particular areas of fracture. However, it is sometimes still difficult to do until some other evidence appears (such as infection). I would start off with my general dentist. If you are in fact fracturing multiple teeth you should evaluate why this is happening--large restorations, habits, clenching and grinding, etc. Steve On Mar 12, 5:51 am, Steven Bornfeld <dentaltwinm...@earthlink.net> wrote: > mr_ravi_pa...@yahoo.com wrote: > > I had a tooth fracture (lower left middle molar) last year that was [quoted text clipped - 32 lines] > > - Show quoted text - i went to the general dentist. the x-rays showed no sign of cavities. he recommended that i have a cleaning with the hygenist. he said that sometimes buildup (think he said calculus) can cause pain when chewing down -- similar symptoms to fractures. i had read that dentists use hot/cold sensitivity tests to identify fractures. so i asked if there were any tests like that but he said no. maybe some dentists are more skilled and experienced in the practices of identifying dractures? he said that if it is a fracture, it will soon become evident (within 2 months). in the meantime, i have scheduled cleaning appointment. and so far, i have not yet experienced the pain when chewing since 10 days. i forgot to ask about the grinding. i don't know if i grind or not -- maybe i do while sleeping.. is there a test to determine that? If you have visible calculus build-up, the first step should probably be to get your teeth completely clean no matter what is wrong. (Unless you are in severe pain.)  Signature/ Amatus / > On Mar 12, 5:51 am, Steven Bornfeld <dentaltwinm...@earthlink.net> > wrote: [quoted text clipped - 61 lines] > > is there a test to determine that? > On Mar 12, 5:51 am, Steven Bornfeld <dentaltwinm...@earthlink.net> > wrote: [quoted text clipped - 52 lines] > > is there a test to determine that? If the pain went away, it is most likely you don't have a fracture. Other than some kind of test like an electromyograph (I don't know any dentists who set patients up for that), you look for signs of wear, abfraction of the teeth, soreness of the perioral musculature that indicate overuse, and the complaints of your bed partner. ;-) Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 > Few days ago, I felt a similar pain (not quite as severe and not so > much of a "zap" feeling but more of a general pain feeling) for a few [quoted text clipped - 8 lines] > > Can anything else cause these symptoms? Cracked teeth can be difficult problems. By the time you reach middle age, most people have several molars restored with 'fillings'. The teeth have had structure damaged from the decay and other structure cut to remove the decay. They are never as strong as a natural tooth that has never needed treatment. Add a couple of decades of use and abuse, and teeth can easily develop cracks. With magnification, most molars with 'fillings' have visible crack/craze lines in several locations. Some of these may never develop into a significant problem, but others continue to spread deeper into the tooth causing sensitivity. Depending upon the actual direction that the crack takes, it can lead to a root canal, a piece of tooth fracturing, or actual loss of the tooth. But just looking at these lines doesn't tell the dentist that a tooth is cracked enough to cause symptoms or need a different restoration immediately. According to the textbooks, any molar with a filling over 1/3 of the occlusal width should be treated with a crown or onlay. Most patients don't want to spend the money to do this, and most dentists don't "enforce" this 'rule'. We place lots of restorations that are stretching the limits of the materials and remaining tooth structure. The 'safe' way to treat these problems is to place a crown or onlay when a restoration is replacing a large amount of tooth structure. When a tooth with a large filling begins to get sensitive to biting, it could be too late for an easy fix. In this situation, I discuss the possibilities with the patient. Adjusting the occlusion might help the situation temporarily. A crown or onlay might solve the problem for years, but the tooth may still end up needing a root canal (and a small chance that it will be beyond help). Some people crack teeth that have never had any decay and teeth with small restorations. Evidence of clenching should not be dismissed and I recommend an NTI in these cases. D >> Few days ago, I felt a similar pain (not quite as severe and not so >> much of a "zap" feeling but more of a general pain feeling) for a few [quoted text clipped - 50 lines] > > D Why doesn't the mouth's natural restoration of the enamel patch the cracks when they are tiny? Complex answer would take a few pages. Simple answer is that such a process cannot repair a crack. Signature/ Amatus /> > Why doesn't the mouth's natural restoration of the enamel patch the cracks > when they are tiny? Microscopic remineralization of decalcified enamel is possible. It is not a process that can 'weld' over/across a stress related defect. D > Complex answer would take a few pages. Simple answer is that such a process > cannot repair a crack. >> Some people crack teeth that have never had any decay and teeth with >> small restorations. Evidence of clenching should not be dismissed [quoted text clipped - 4 lines] >Why doesn't the mouth's natural restoration of the enamel patch the cracks >when they are tiny? That's funny. |
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