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Can root canal or extraction alleviate sensitivity due to hair fracture in molar tooth?

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Dentist, Prosthodontics
Practicing since : 1995
Answered : 77 Questions
Hello. I am a 55 year old male. My dentist replaced an upper right molar filling because I felt sensitivity when biting down. He said he found that there is a "hair line fracture" in the tooth. He hopes the new filling would take care of it, but he said he can't tell how XXXXXXX it is. Now I feel the same sensitivity when I bite on it. It's not pain, just sensitivity. Is the ultimate solution to this going to have to be a root canal if it gets painful, and how would that alleviate the hair fracture in the molar, as opposed to extraction? Also, he put in a crown on another molar because the replacement filling didn't cover the entire large area, but I notice it's a little sensitive to cold. Is this normal, and what would be the ultimate fate of such a tooth even if the crown is good? I have another molar that is an implant, and I find I always have to use a toothpick to clear out food after eating. Is this normal? Thank you.
Posted Thu, 26 Apr 2012 in Dental Health
Answered by Dr. Ramesh B. Hegde 9 hours later
Thanks for the query.

It is the right decision to change the restoration when there is complaint of sensitivity in pre-existing restoration.

I do not know what is the material used for new restoration. If the new restoration is of only composite resin then there is possibility of getting sensitivity again, as the procedure is technique sensitive and demands absolute dry area while doing restoration.

Usually when composite resin is preferred as restoration of choice, the base of the restoration is done by another material called glass ionomer. When it is done with glass ionomer as base [called as Sand-witch technique] the chances of getting sensitivity is almost nil. If the material chosen is Silver amalgam for the new restoration, even this also should be based with another insulating restoration.

If all precautions are taken to prevent sensitivity, then dentist has to look out for areas of attrition on biting surfaces or abrasion on the sides of tooth. The hairline crack which you have mentioned can also give the feeling of sensitivity if it is XXXXXXX

If sensitivity is due to hairline crack then better to take a chance by undergoing root canal treatment. During the procedure of root canal treatment the dentist will assess the prognosis of tooth with crack line, if he suggests for extraction then only you can go extraction of the tooth. The root canal treatment as such is not a painful procedure because it can be done by giving local anaesthesia injection.

For the mild sensitivity with another crowned tooth, try using anti-sensitive mouthwashes. Mouthwash has to used twice daily after brushing for 15-20 days, after the mouthwash do not take any food/liquid for 30 minute.

For the implanted molar, it is better to use interdental brushes for maintaining the hygiene rather than toothpick.

Hope i have answered your query. If you have any further queries you are most well-come.
Above answer was peer-reviewed by
Follow-up: Can root canal or extraction alleviate sensitivity due to hair fracture in molar tooth? 2 hours later
Thank you. Unfortunately I do not know the details of technical materials used in the replaced fillings except that they were not mercury.
The sensitivity of the tooth with the hairline fracture is not terrible yet. Just a little when I bite on it.It has been this way for many years. Would this indicate that the crack is not worsening over the years? And what causes a hairline fracture? At what stage would it need a root canal or even extraction?
For the crown tooth the sensitivity to cold is minor. I had the crown about two months ago..
Would mouthwash still help or is the problem significant? Is it common after a crown?
Thank you.
Follow-up: Can root canal or extraction alleviate sensitivity due to hair fracture in molar tooth? 48 minutes later
I also have one remaining impacted wisdom tooth after the rest were removed many years ago. It doesn't cause me any trouble, so could it continue to remain there under my upper right gum?
Answered by Dr. Ramesh B. Hegde 4 hours later
Thanks for the details you have revealed and further queries.

Since you are sure of the new restoration does not contain mercury, then it cannot be silver amalgam restoration. Most probably it is the Composite resin Restoration. If sensitivity persists and no other reasons in the region for precipitating the sensitivity, then restoration has to be redone with all precautions.

Such sensitivity is not an indicator for the crack progression. Such crack usually breaks the tooth into parts if it is progressing.

The most common cause for crack to occur is unusual force on the tooth, for eg: If accidentally bite on a small stone or an attempt to open the cap of sealed bottle.

The causative factors can worsen the existing crack also, therefore it advised to avoid eating hard food from the affected tooth.

Since the sensitivity of the crowned tooth is mild you need not go for mouthwash, regular brushing with fluoride toothpaste is sufficient. The sensitivity problem does not appear to be significant; few people do develop such sensitivity, if it becomes unbearable then crown has to be removed and x-ray may have to be taken for further evaluation.
Your wisdom tooth in the upper right jaw can remain there because it has not given any problem in all these days. It is most unlikely that it can trouble you in the future.

Hope I have answered your query. Please do write back if you have further queries.

Above answer was peer-reviewed by
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