Last spring I had to make a decision about my relatively new lawnmower; spend a good chunk of money to get it fixed or trade it in for a newer, shinier model.  I chose to spend less money and save my old mower.  We’ve had some fine times together.  Had I known then, the lack of rain we were going to get, I probably could have just done without a mower at all.  Hindsight is so twenty‐twenty.

Dental patients are often faced with a similar, but far more personal situation.  What do you do with a broken tooth?  Do you spend the time and resources to save it or do you have it removed and spend your resources replacing it?  Let’s look at the facts.

First off, not all broken teeth are restorable.  Gum disease, large cracks or fractures of tooth roots, infections, and/or huge cavities can all make this discussion moot.  We can perform a lot of surgical miracles, but some broken or decayed teeth are doomed to see the light of day.  That is why prevention (taking care of things before they hurt or break) is so important when it comes to your teeth.

Let us assume, for this discussion, that your tooth is salvageable with a root canal and a new lab made crown or cap.  There are generally two alternatives to this type of treatment.  The first being to do nothing and live the rest of your life with an infected, rotting tooth.  Rarely, is this treatment accepted by patients.  The second alternative would be to have the tooth extracted (removed) and look at replacing it with some form of prosthetic tooth.  Implants, bridges, and partials are all different options one might then face, but that is a subject for a whole other article.

Okay, so we have decided that something needs to be done to our imaginary broken tooth:  root canal and crown versus extraction and replacement.  There is no right or wrong answer here, just pros and cons to both.  Saving a tooth generally means more time and money up front with the major advantage being keeping what God designed for you to talk and chew with.  Your teeth have nerves all around them that cannot be replaced with implants or bridges.  The only advantage to removing our broken tooth would be short term.  It costs less to extract.  The problem is that the long term costs of replacement far outweigh the short term savings.  Granted, there is the option of not replacing the tooth at all, but then you run into a whole other set of problems.  Loss of function, shifting of teeth, gum disease, and esthetics all become an issue when a tooth is lost and not replaced.  Losing several of your back teeth can also cause your bite to close down and lead to headaches, jaw pain, and TMD.  The good news is that, with modern pain medication and anesthetics, either option should get you out of pain, for good.

Hopefully, regular dental visits can prevent the need to ever reference this article.  If not, I hope this helps.

Until next time, keep smiling.

‐Questions or comments can be sent to Drs. Parrish at ParrishDental@aol.com.