Clinical Case: Why crowns are recommended for teeth with large fillings.

It can happen at any time – chewing on a hard nut or candy, biting into a carrot, or even sinking your teeth into a soft pizza! At least once a week, I see a patient in my office who has broken a tooth or filling. Those who are lucky are able to have the teeth fixed with a simple filling. However, sometimes broken teeth cannot be saved and the only choice is to extract the tooth.

This patient presented to the clinic as an emergency. She had crunched down on a crouton and felt a “snap” in one of her teeth.  Notice the large size of the fillings.

Fractured Outer Cusp

When I examined the tooth, I found that the outer cusp of the second premolar had been fractured.  The patient was frozen so that I could examine the tooth without causing her discomfort.  As can be seen in the above photo, the cusp could move freely from the tooth itself – it had broken clear off the tooth and was only being held in by the attachments to the gums.

Broken Cusp Removed

The broken cusp was removed to assess the damage and restorability of the tooth.  Unfortunately, this tooth could not be saved for a few reasons: Continue reading Clinical Case: Why crowns are recommended for teeth with large fillings.