How Long Can You Delay Extraction of a Cracked Tooth?

In the late 90s, I got a gold crown on an upper left molar. In 2008, my dentist at the time did a root canal on that tooth. Last month I started feeling a dull ache in the tooth. My dentist said my gums around the tooth were inflamed, so she prescribed oral penicillin and referred me to an endodontist who examined the tooth with a surgical microscope. She said the tooth cracked, and she recommended extracting it. She doesn’t think a root canal will help the tooth.

Now that I’m taking the penicillin, the infection in my gums is gone. I’m hesitant about getting the tooth extracted because I do not feel any pain. I’m thinking about canceling my extraction appointment with the endodontist and waiting to see if I feel symptoms again. Maybe this referral is a way for my dentist to make more money because I’ll need an implant and crown if the tooth is extracted. How long can I delay an extraction? Thank you, Breigh from NJ

Breigh,

You are taking a significant risk by waiting until you have symptoms again.

Reasons not to Delay Tooth Extraction

A dentist or endodontist can use an implant to replace an unsavable cracked tooth

Reasons not to delay tooth extraction include:

• Infection – Penicillin controls your infection, but it does not remove it. If you stop taking the medication, your gums will swell again after a few days. If you delay treatment until you feel symptoms again, the infection will be so advanced that it can neutralize the local anesthetic and make the extraction painful. At that point, your dentist will likely ask you to resume the penicillin to control the infection. If you continue in the cycle, you will still need a tooth extraction at some point.
• Last-minute extractions – An extraction exposes a large area of bone and tissue. There is a small risk that any bacteria present can spread to your tissues and bloodstream. The risks are lower if the endodontist extracts the tooth while you do not have symptoms and the infection is still under control.
• Cracked tooth – Keep in mind that your tooth broke. Endodontists are specialists at preserving teeth and determining whether a tooth is too damaged to save.

It does not seem that your dentist and endodontist are recommending extraction to make money on a dental implant and crown. Although you can seek a second opinion from another dentist, we strongly advise you not to put it off until you feel symptoms again and need an urgent appointment.

Elgin, Illinois dentist Dr. Steve Sirin sponsors this post.