Molar Broken at the Gumline

Dr. Hall:

Is there any way to restore a molar which has been broken at the gum line other than extraction and implant or bridge?

—Lucie from California

Lucie:

If a molar is broken at the gumline, the dentist can always do a root canal treatment, put dental posts in and do a dental crown without having to resort to a tooth extraction. Unless there is something else wrong with it. Maybe there is a crack or something else. If you’re suspicious that your dentist is too eager to extract it, ask for a second opinion somewhere. Different dentists have different attitudes about extracting teeth. There are many who seem to give up on a tooth too easily, but others will try hard to save them.

Saving the broken tooth is more trouble, takes a higher level of skill, may be less profitable, and exposes the dentist to some risk because the attempt at saving the tooth might not hold up. But my experience is that when I would be honest with the patient about any risk of failure, if such was the case, most people would opt for having me try to save a tooth. That is also what I would try to do if it were my tooth.

A molar broken at the gumline is easier to restore than a front tooth, because there are several roots to the molar, and the dentist can put in a couple of posts at different angles, which would anchor the buildup and the crown pretty securely. With a front tooth, it’s more round and with a single post there will be rotational forces that work to dislodge the post. But sometimes even a front tooth badly broken off can still be restored.

I hope this is helpful.

—Dr. David Hall