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Question:
Crown on lower tooth: I have had a crown on my lower molar for several years. Part of it recently chipped off. My dentist smoothed the rough area and wants to put a new crown on.

There are no cracks and it doesn't bother me at all, although the dentist had a "watch" on it due to age. He suggested that since it was not shaped properly, food might slough off and get under it, causing gum problems.

Is this a legitimate issue and do I really need a new crown or can I wait until it bothers me? ...Visitor from KS

Answer:
Those are great questions however, without seeing the case, I can only give you generalities.

Porcelain crowns fracture with a great deal of frequency. A fracture of the exterior porcelain surface does not condemn the crown to replacement unless it is a cosmetic problem or results in significant food impaction.

The latter will result in periodontal compromise to the gum tissue and underlying bone and it is not worth trying to squeeze a few more years out of the crown.

If however, it is not a cosmetic issue, the fractured part does not drive your tongue nuts, and the external remaining anatomy is such that you can still keep your gum area clean then postponing replacement until the crown fails because of recurrent decay is not a bad option.

Positively, you do not want to wait until it hurts.

By then you have created a bigger and more expensive problem probably involving a root canal, further structural compromise to your tooth, and threatening its' long term prognosis. Good luck!

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