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1 13th September 19:54
mxsmanic
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Default I think I have a cracked molar, what can I do?


In answer to the obvious question, I haven't been to the dentist because
I can't pay for it at the moment. In the meantime, I need some
opinions.

This first molar has been hurting a lot when I bite down on it. Certain
types of biting cause a sudden, severe pain that is similar to what one
feels when a tooth is moved in its socket (as by something jammed
between teeth, etc.). There is no pain on release. Sensitivity to
temperature extremes is minimal. There is no continuing pain outside of
the biting pain.

This tooth has a deep and extensive filling that has been there for some
years.

Examination of the tooth (to my unprofessional eyes) revealed what
appears to be thin cracks on either side of the rear cusp on the tongue
side of the tooth. I have the impression (but not the verification)
that the seemingly isolated cusp is slightly mobile. It looks the same
as the rest of the tooth.

Today, while eating some potato chips (carefully) I felt the usual pain
on biting. I baby this tooth to help avoid further damage. While
eating, at some point, the pain virtually ceased--and now I feel some
sort of roughness on the inside (tongue side) of the tooth with my
tongue. Examination of the tooth shows that the cusp appears to be
slightly separated from the filling, and from the rest of the tooth.
I'm not sure, though. I have no tools to examine it closely, and I
wouldn't know how to examine it in detail anyway.

So ... I'm pretty sure this tooth is cracked. My layman's guess is that
the interior rear cusp is separating from the rest of the tooth. What
do you all think?

I hope in particular that the crack is limited to the top of the tooth
and this cusp. I do not mind getting root c**** and/or a crown if
necessary, but I wish to avoid extraction at all costs, as I've already
lost the same molar on the opposite side (at the time, because I could
only afford extraction, but not root c****), and I don't want to lose
this one.

What do you think? Does this sound like the type of crack that would
not require extraction and could be repaired with a crown and possibly a
root c****? Does it even sound like my armchair diagnosis of a crack is
correct?

FWIW, the other molar (that I had extracted years ago) probably
underwent a similar transformation: deep filling, filling broke, cusp
eventually broke off (I saw this). It could have been saved if I had
had the money, but when it got too bad to endure, I was broke, so
extraction was the only option.

Next question: Since I have no money now, how long can I expect this
tooth to hold? Can I do anything in the meantime to minimize further
damage? If it is truly just the cusp breaking off, is there a risk of a
crack extending into the root developing? If so, how can I minimize
that risk while I wait until I can afford dental work? Is there a
chance that it will at least stabilize for some indefinite period while
I try to find cash to get it fixed?

I really do not want to lose another tooth, so this is important. I
don't know when I'll have enough money for dental work again; right now
I can't even afford exams, much less restoration or endo treatments.

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2 13th September 19:54
paul
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Default I think I have a cracked molar, what can I do?


If its broken down onto the root it may not be restorable. If it is
restorable, it sounds like it needs rct/core/crown and possibly crown
lengthening surgery.

I have to say that a couple of years ago the problem was undoubtedly a
simple thing to fix and much,much cheaper. After this episode I suggest you
find something in your budget (cable, cell phone, a couple of dinners out
per month , or go back to dial-up) to eliminate so that you can have regular
dental care instead of crisis oriented care. I can't understand why people
say "It could have been saved if I had had the money, but when it got too
bad to endure, I was broke, so extraction was the only option". The point is
to go at the least sign of a problem. Don't wait until its "too bad to
endure". At that point its just too late.
Sometimes people come in, usually with well kept teeth, and ask me to check
a tooth that has started bothering them 2 days ago. I check it and can find
nothing wrong. They often say sorry they bothered me and just wanted to make
sure it wasn't a cavity. I tell them that they definitely did the right
thing by having it checked instead of waiting and that is why we are here.
DON'T WAIT!

I usually try not to lecture folks, but Mxsmaniac seems way to intelligent
and informed to watch and observe a problem develop over YEARS and now have
this terrible dental problem to deal with.
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3 13th September 19:54
mxsmanic
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Default I think I have a cracked molar, what can I do?


Paul writes:


I had no money then, either. My last check-up and cleaning was three
years ago, I think.


That wouldn't help, since I have no income. I can't even pay the rent
at the moment.


I can't afford either of these right now. I'm just hoping there is some
way to minimize the deterioration of the tooth.

I touched the corner that seemed to be cracked this morning--and it
moved. I think it is broken and just the gum or something is holding it
in place. I'm not sure what to do about it. It doesn't seem to hurt
very much, although the area around it seems a bit sore. The filling
seems to be intact but separated from the cusp by perhaps the width of a
sheet of paper (I can see that there is some separation). I'm resisting
a temptation to play with it just to see how broken it is.

Is there a way to tell the extent of the crack from the symptoms?

Extraction is ten times cheaper than root c****, that's why. That's why
I had an extraction twenty years ago. Extraction was $75; root c****
would have been close to $1000.

Right now I have $140 in my checking account. I don't think that would
pay for even an extraction, but in any case, I don't want this tooth
extracted. And if only the cusp has broken off, from what I've read, an
extraction is hardly necessary (?).

I went to the dentist every six months until I ran out of money.

You must have a very wealthy clientele. At one point in the past, I was
able to do that. I can't now.

I don't know what other options I have, unless I can find some money.

The problem hasn't developed over years and years. It has developed
since the last time I was able to afford dental care. Since I haven't
been able to afford care since I first noticed it (about a month ago), I
haven't had it looked at. Simple economics. And dental care is
probably the _least_ of my problems right now, although it does hurt at
the moment and I know it's going to preoccupy my thoughts now (which I
can scarcely afford).

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4 13th September 19:54
paul
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Default I think I have a cracked molar, what can I do?


One time this guy came to my office, crying in pain. He told the front
office he had $60.00. Being the old softy I am I got it out for what he had.
You may say $60.00 is alot but overhead in a dental office is typically
60%-75%.
But you are saying you have zero income? Hmm...is there a charity funded
clinic anywhere near you? I know in Atlanta we have at least one where
indigent folks can have care for $1.00

How do you have internet access?
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5 13th September 19:54
mxsmanic
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Default I think I have a cracked molar, what can I do?


Paul writes:

I've earned several hundred euro since the beginning of the
year--roughly the equivalent of one month's rent. I've earned about
220 this month. My rent is 615.

It's better to wait for someone I can trust, especially for endodontic
work or (if there's no way to avoid it) extraction. Too many things can
go wrong if it isn't done right. My current dentist does excellent
restoration and endodotic work; I just can't afford him now.

I pay the ISP yearly; it's paid up until next July. The telephone bill
is 40 per month. One root c**** and crown would cost more than I pay
in a year for telephone and Internet access.

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6 13th September 19:54
down
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Default I think I have a cracked molar, what can I do?


<sound advice snipped>

Hey its not just the money, often its the FEAR of that ****ing drill in
the hands of an idiot that can't perform good ****gesia! :-/

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madiba
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7 13th September 19:54
down
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Default I think I have a cracked molar, what can I do?


The cracked piece will fall out eventually. If the worst comes to the
worst and it has to go (dont do RC**** work on a useless/rotten tooth
stump, thats money down the drain) then remember when you have money
again you can get an implant. So don't leave rotten bits of root in the
jaw to mess up your chances of getting one in the future.

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madiba
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8 13th September 19:55
mxsmanic
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Default I think I have a cracked molar, what can I do?


madiba writes:

The cusp wiggles if I touch it (and hurts, although not as much as I'd
expect). Does it seem probable that only the cusp is cracked, and not
the root? If only the upper cusp part is cracked, the tooth can be
saved, right?


I had heard that implants didn't work very well. What is the current
status?

Also, why does a crack down into the root necessitate extraction? Isn't
there any way to fill the root c****s and epoxy it together or
something?


What are the risks of not extracting a tooth that's cracked down into
the root?

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9 13th September 19:55
mxsmanic
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Default I think I have a cracked molar, what can I do?


madiba writes:


Actually, my current dentist seems to be an expert on that. My previous
root c**** was totally pain free; I fell asleep in his chair. So I'm
not worried about that in the least, and if I had a bucket of money in
the bank, I'd make an appointment today to get this all fixed.

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10 13th September 19:57
down
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Default I think I have a cracked molar, what can I do?


Like the rest of dentistry, you need to find someone with experience.
I'm thinking about two implants for myself at the moment. The chances of
implants lasting long are better on the lower jaw, BTW.


Lets leave these questions to the dentists
--
madiba
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