Hi Dr Hall,
I just had a front right central incisor break at the gumline after getting a root canal treatment. My dentist has used a metal screw post for the temporary crown. I have a continuous dull feeling in nasal cavity area but no pain. Is the screw a good idea for this type of problem as I cannot afford a bridge?
Frank from Pietermaritzburg, South Africa
(see Dr. Hall’s answer below)
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These screw posts generally are pretty solid as far as staying in the tooth, but they are risky. They exert a lot of stress on the root. The risk is that the root will split from the pressure. Is that happening in your case and is that why you have this dull feeling in the nasal cavity (which would be where the end of the root of this central incisor would be)? That could be, but I would wait it out.
But a front tooth that has broken off at the gumline is a tough situation. Many dentists would consider the tooth to be unrestorable. There are rotational forces on a front tooth that over time can loosen the crown and/or the post. My advice would be to go ahead with the crown, cross your fingers, and hope this post and crown last a long time. My guess would be that they would fail at some point.
If you can’t afford an implant or a bridge, the budget option for replacing a single front tooth would be a flipper partial. That may be where you end up.
In retrospect, it would have been good if your dentist had placed a simple post in your tooth after the root canal treatment, before the tooth broke off.
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About David A. Hall
Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.