Doctor's Answers (2)
a badly chipped/fractured tooth as you describe will be difficult to keep long term. If the nerve is exposed, root canal treatment will be required followed by crowning. The overall strength of the tooth will be poor and it may not last very long.
A more predictable treatment to consider will be extraction and placement of an implant. This is a titanium replacement for the root of the tooth that will support a porcelain crown. The lifetime of this is very good and it functions and looks just like a normal tooth.
Alternatives include a bridge which is a porcelain tooth attached to the adjacent teeth or a removable denture. Both these options are less costly but usually less desirable.
If you fracture a tooth then please visit the dentist immediately especially as it may be very painful and affect chewing/speaking. He/She will be able to relieve any pain and provide a temporary tooth. Definitive treatment times vary according to the procedure from days to months, but at no time will you be left without a tooth.
If only the root of the tooth is remaining, with very little or NO tooth structure protruding above the gum, then it can be very unpredictable to repair this tooth.
If there is a root remaining inside, then it needs to be assessed with an X-ray to check for possible causes of the fracture and infection.
In certain cases, a post core crown may still be possible if the remaining root structure below the gum is exposed with gum surgery. The root length and your lip line need to be assessed before this is done. This whole process can take a few months to complete and there will be a temporary crown placed while waiting for the gum to heal.
If the root is too short, then it may be better to explore other options such as a bridge that uses the neighbouring teeth as supports or an implant. If you are having a bridge made, the root may be removed or it may be submerged underneath the false tooth to maintain the the gum contour. If an implant is planned, the root is usually removed.
You may also choose to replace the missing tooth with a removable plastic denture. This is the cheapest and fastest option, as a new denture can be prepared within 1-2 weeks.
A new bridge may take 1-3 months to complete. An implant can take 3-6 months.
It is important to discuss all these options with your dentist to fully understand the pros and cons of each type of treatment.