Unfortunately, a simple filling does nothing to help strengthen the tooth or stop you from getting a broken tooth. A filling sits within the fracture (almost like a wedge in a log). It is only a matter of time for the crack to grow.

The ideal strategy for keeping your own tooth is to use restorations that reinforce the tooth, holding it together and making it strong. You thereby dramatically improve the chances of avoiding more extensive treatment. The longer we wait, the greater the chance that pain and loss can occur.

Insurance companies bet it all happens on someone else’s plan. Unfortunately, as a patient you are confronted with a choice. Do you invest in your own preservation or bet that when the tooth finally splits, it will be minor and the insurance company will then help out?

From almost 25 years of experience here is a close estimate of the risks:

• Teeth with angular cracks at the corners of a filling usually break off a corner or a half of the tooth to the gumline. These teeth are successfully treated with a build up and a type of crown. We see this almost every week.
• Teeth with a vertical crack eventually become occasionally tender to biting. If restored early enough, we avoid the additional need for a root canal about 80% of the time. We see this many times a month.
• If a cracked tooth always hurts upon biting, it probably needs a root canal, build-up and crown to save it. We see this a couple or few times a month. If the fracture runs deep there remains a small chance of fracture progression.
• If a large part of the tooth breaks away under the gumline, it becomes increasingly difficult and risky to treat and save the tooth. We see this a few times a year.
• If the tooth splits in half or far under the gumline, it needs to be extracted. Replacement, usually means a three tooth bridge or an implant. We see this several times a year.
• Every day we see prominent stress cracks growing under fillings we are removing. Crown type restorations save these teeth.

With each of the above situations, the increased treatment of a root canal and tooth build-up doubles the cost. If a tooth is lost and you have a bridge or implant, the cost is 3-4 times a single overlay or crown.

At Donaldson and Guenther, your personal best interest is our foremost concern. We repeatedly see patients and their teeth stay happier when appropriate treatment is done “in time” before something breaks or becomes painful. We understand dentistry is expensive. That is why we try to do the right thing – the first time. Nothing is more expensive and frustrating than needing more extensive treatment later because an insurance company encouraged people to gamble against themselves.

H. King

Dr. Kris; I just wanted you to know that when I moved to Sedona and went to a new dentist, he cataloged all the crowns in my mouth. When I saw the list, I had to add one they had not detected — my front incisor, that fractured and you crowned so many years ago! They thought it was real!!! Having read your notes on porcelain, I can’t help but wonder if you were using some of the newer techniques on me. I am certain, however, that my crown is an almost perfect copy of my original tooth. Thank you, and I miss you!