Can a Tooth Broken Below the Gumline Be Saved?

When a tooth breaks below the gumline, the chances of saving it are often slim. The structural support and potential for restoration are compromised, making it nearly impossible to prevent the tooth from becoming unrestorable. However, each case is unique, and your dentist can explore a range of options based on the severity of the break and your personal preferences. Here, we outline various alternatives and the factors that influence the best course of action.

Motivating Factors: Patient Preferences

What ultimately trumps all other considerations is the patient's desire and what they are willing to undergo. Your dentist will conduct a thorough evaluation to assess the extent of the damage and discuss the various options available. The decision is yours, and it's essential to have an open, honest conversation with your dental professional to make the best choice for your oral health and satisfaction.

Possible Alternatives

Extract and Leave Toothless

One straightforward option is simply to remove the tooth and leave that spot toothless. This approach provides immediate relief from any pain or discomfort associated with the break, but it may affect your chewing ability and biting force. Additionally, gaps in your teeth can impact your smile and overall oral aesthetics.

Extract and Removable Partial Denture

An alternative to being toothless is the placement of a removable partial denture. This involves creating a denture that can be taken out and put back in. This option is a good choice if you prefer to avoid a more invasive procedure or if you want a solution that can be easily adjusted as your dental needs change over time. However, it may take some time to get used to the feel and function of the denture.

Extract and Cemented Bridge

A cemented bridge is another option that involves the extraction of the broken tooth followed by the placement of a bridge. The bridge is typically made of porcelain and is anchored to the adjacent healthy teeth, providing a natural-looking and functional replacement. This option is usually more permanent than a removable partial denture but still requires successful dental work on both the healthy teeth and the implant site.

Extract and Implant Placement

If you decide that a removable or cemented bridge is not for you, you can opt for an implant placement. This is the most expensive and time-consuming option and typically takes between 5.5 to 7.7 months. After the implant is surgically placed, a dental crown is fitted on top to replace the missing tooth. With proper care, implants can provide long-lasting and natural-looking results. However, they require a detailed consultation with your dentist due to the high cost and complexity of the procedure.

Root Canal with Post and Crown Lengthening

A root canal with post and crown lengthening is another possibility, particularly for molars. This involves performing a root canal to remove the infected or inflamed pulp, then placing a post to hold a crown in place. Crown lengthening may be necessary if the crown of the tooth is too short or buried below the gumline. This method is often chosen for teeth that cannot be easily replaced with a bridge or implant.

Root Amputation with Crown Lengthening

For molars, a root amputation with crown lengthening can be a viable option. This involves cutting the tooth in half to remove the broken root and then performing crown lengthening to restore the remaining crown. This method can be more cost-effective than an implant and may be preferred if the tooth is partially broken and the damage can be contained.

Factors Influencing the Best Course of Action

The severity and depth of the crack, the availability and proficiency of dental equipment like soft tissue and hard tissue lasers, and the treating dentist's experience and surgical technique all play crucial roles in determining the best course of action. Some dentists may not have the necessary equipment to perform certain procedures, which may affect the options available to you. A consultation with a dentist who specializes in complex dental procedures is highly recommended to ensure the most effective and long-lasting solution.

Conclusion

While some procedures can attempt to save a tooth broken below the gumline, the success rate is often low, and the outcome can be unpredictable. This is where your personal preferences and the advice of a knowledgeable dental professional come into play. Whether it's extracting the tooth and using a bridge or implant, or attempting to save it with a root canal, the decision should be based on a thorough evaluation and a discussion with your dentist. Your dental health and overall satisfaction with your smile and bite are at the core of these choices.

Keywords: tooth restoration, gumline break, dental options