Keep the tooth or not?

[MountainMama]

My lower 2nd molar on the left has a crack. It started hurting a month ago, but the dentist did an x ray and said it was fine. He didn't even examine it. Two weeks ago, I had a cleaning, which seems to have aggravated it.

Now the aching is almost constant, but not terrible. Last week, one day I had a few shooting pains, but haven't since. I can actually feel the crack with my tongue and with my fingernail if I run it over the tooth. It runs from the top of the tooth (in the center, inner side of jaw) to the gum line (possibly farther down?).

The issue is that I had the 2nd molar above it extracted last year and not replaced. I originally wanted an implant, but can't afford it as I have other teeth that are priority.

Is it worth it to try to do a crown? Given my history the past 6 months, there is a risk of a crown prep causing irreversible pulpitis. I have so much anxiety about both options.

 

[FearfulInMA]

Ugh! I have similar luck with crowns and irreversible pulpitits. If it were me, I’d probably wait until I couldn’t stand it anymore and then have it extracted - save the money you’d spend on a crown and put it in an ‘implant fund’ for yourself. I’m sure others with better luck with crowns may say otherwise...

 

[MountainMama]

Ugh! I have similar luck with crowns and irreversible pulpitits. If it were me, I’d probably wait until I couldn’t stand it anymore and then have it extracted - save the money you’d spend on a crown and put it in an ‘implant fund’ for yourself. I’m sure others with better luck with crowns may say otherwise...

Yeah, my teeth seem to be very sensitive to any work. A tiny filling turned into irreversible pulpitis, as did a crown prep on a tooth with healthy pulp.

I don't know if it would be worth it to get an implant, since I am missing the tooth above it. Ideally, I would like to replace both, but as I am already getting 3 implants this year, I can't do that.

I am leaning towards just hanging on as long as possible.

 

[Dr. Daniel]

Hi,

If a tooth is painful, especially over a long period of time, your dentist should at least diagnose it.
I would not count on palpating with the nail nor the tongue to diagnose a crack. Surely you feel something but please remember that a crack is one of the most difficult diagnose for dentists, let alone for patients.
When you share with your dentist your complaint, I suggest you stay descriptive. Try not to suggest the diagnose of a crack because it can bias the dentist's judgement towards that diagnose. Let your dentist rechristen that conclusion (or a different one) on their own.

Hope it makes sense.

 

[MountainMama]

Hi,

If a tooth is painful, especially over a long period of time, your dentist should at least diagnose it.
I would not count on palpating with the nail nor the tongue to diagnose a crack. Surely you feel something but please remember that a crack is one of the most difficult diagnose for dentists, let alone for patients.
When you share with your dentist your complaint, I suggest you stay descriptive. Try not to suggest the diagnose of a crack because it can bias the dentist's judgement towards that diagnose. Let your dentist rechristen that conclusion (or a different one) on their own.

Hope it makes sense.

That does make sense. I will avoid saying anything except symptoms.
I am slightly frustrated with the dentist, though, because he diagnosed the tooth in front of that one (1st molar) as cracked when I first started having pain in my jaw, and said I needed a crown. I put it off after the crown prep on my other 1st molar on opposite side caused irreversible pulpitis. Now I am not convinced it is cracked, as it is sensitive to heat and cold (has an amalgam filling) but does not hurt when eating, and did not hurt when doing the test with the bite stick. It just seemed like they jumped to that conclusion with no other testing. No probing or anything.

Now I am wondering if it was the back molar all along. I have no idea how it would crack as there is no opposing tooth. At my cleaning, the hygienist said there was a large craze line right at the sensitive spot, and it hurt like crazy when she blasted it with a water jet at that spot. The one in front had no issues when cleaning. Nothing of concern showed up in the x rays. That 2nd molar has a composite filling in it, but has never given me issues before.