Is this broken tooth safe to leave as is?

[Jethro]

The side of my tooth broke away a few days ago, revealing the filling and unprotected centre. My dentist gave me three options. 1. Its OK to leave as it is. 2. Add a filling to the existing filling. 3. Remove the old filling and fit a new one. I was amazed when she said it was OK to leave as it was, even though it was not causing any pain.
Is she correct in saying its OK to leave as is? (I'm a UK NHS patient)

 

[apl789]

no. Get it seen to asap.

 

[Jethro]

I thought so, fairly obvious really but wanted a second opinion. I went to see another NHS dentist and they put some temporary white fill material to stop bacteria getting in (see photo). I wonder why my regular dentist didn't think of doing that. They said if a full crown was fitted the remaining tooth would soon crumble, so I would be better off with a partial metal crown or alternatively a white filling. I think I will go with the white filling.

 

[Busybee]

I am surprised any dentist would want to leave it as it is. Strange they cannot crown it but then different dentists have different approaches and they have seen your underlying tooth structure so we can't really comment. You should be able to have a partial crown. Gold is probably best but not sure if the NHS do it. Whatever you choose get it done by a good dentist. They can probably make a filling of the whole area or the white filling but it wouldn't be as strong as a gold onlay and might break away in the future. Depends on the skill of the dentist.

 

[Jethro]

My regular dentist was favouring her first option, to the point it felt like she was recommending leaving as it was. Only when she could see I thought it odd did she then mention the other two options. And don't forget she still let me walk away saying it will be OK if I kept it clean and did not offer a protective filling to keep out the bacteria that would develop, as clearly it was a food trap. Others here and on another forum have said it needs sorting asap as the remaining filling will most likely come out and take the attached piece of tooth with it.

The second dentist gave two options and said it needed a partial crown (something my regular dentist never mentioned), as a full crown would cause the remaining tooth to crumble, but then said I would have to go private if I wanted a white filling. However a white filling has been offered free on the NHS at my regular dentist. Clearly she knew she had to do something to replace the piece of missing tooth and thankfully fitted a temporary filling to protect it while I made up my mind. For patients it is a horrible mine field at times.

 

[Busybee]

If you leave as is the surrounding teeth will suffer as it's weak and doesn't protect the remaining tooth structure. If it were my tooth I'd go for a partial crown. I'd get someone good to do the work as the filling you have doesn't look high quality. You don't want to lose that tooth, go to a decent dentist and have it done well.

 

[Jethro]

How do you find a decent dentist?

 

[Busybee]

Personal recommendation is the best route. If you are going to the NHS then the NHS choices site has reviews. You can also check the care quality commission site to see if there has been a satisfactory inspection, although that does not mean that the dentist's work is guaranteed as high quality, just that they have ticked the boxes of maintaining health and safety rules. Check their general dental council registration. NHS dentists don't have as much flexibility because of the way the contract works. They rush too much and with a problem like yours you need someone to take their time and get it right in order to save the tooth.

 

[Jethro]

UPDATE:
Here is a photo of the current progress on fitting a new white crown.
The temporary filling has been removed along with the old filling and other half of my tooth.
A white protective material has been fitted covering whats left of the original tooth. A new crown is being made and I have an appointment to fit it this week. The only painful bit was the injection to the inside of the roof of my mouth.

I forgot to mention my new dentist also discovered some of the filling has come away from whats left of a rear molar. You can just about see this in the photo. Now I think about it, I remember loosing bits form that molar before the broken tooth. I'm guessing my old dentist must have also missed this as she never said anything about it. Yet another reason to change dentist.

 

[Jethro]

Following my new dentists discovery of the missing filling in a bottom rear molar, I think the tooth is called UL6 shown at the top in the photo below.

My new dentist asked me to request my dental records which have also been sent to me. They show that in March 2017 she noted the UL6 tooth was defective and broken, yet no treatment was offered or carried out. In December I had an emergency appointment to look at the broken UL4 tooth with missing buccal cusp, which of course was the main subject of this post. I find it very strange why she did not also mention that the filling in UL6 was completely missing, she must have noticed as after all its only one tooth away. I think I should stress that I may be old and gittish, but I am punctual, polite and very clean, so there is absolutely no reason for any decent dentist to not do a proper job.

 

[Busybee]

Unfortunately not all dentists are of the same standard. That's why half spend most of their time fixing errors others have made.