Panaromic x-rays. Can someone look into it and say the issues. Any cracks?


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Hi,

I am attaching my panaromic x-ray image. I have fillings on few tooth. 13,14,15,19. And on 19th I did replace it with a new filling last week. This panaromic taken before the filling replacement.

I have some discomfort on tooth 19 and my dentist said that I need crown to cover it up because he guess there might be a crack underneath. I would like to know if you see any cracks on this x-ray?

What can we identify using panaromic x-rays? This is the first time I have taken that. Please look into it and share your opinion.

My current dentist say I need crown on 19. I see a new dentist a couple of months back and she suggested root canal for 15. Is both necessary now? Can we identify using panaromic x-ray?
Thank you.
NATARAJAN^GIRIJA_MN04_MP01_026.JPG
 
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MattKW

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Are you sure you mean 19 (lower left 1st molar). I can't see obvious decay on the OPG, but granted they're not the usual film to diagnose decay.
Anyway, cracks are not diagnosed on Xrays. Do you have standard small dental Xrays taken after your recent treatment? These are usually called bitewings.
 
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Are you sure you mean 19 (lower left 1st molar). I can't see obvious decay on the OPG, but granted they're not the usual film to diagnose decay.
Anyway, cracks are not diagnosed on Xrays. Do you have standard small dental Xrays taken after your recent treatment? These are usually called bitewings.
Thank you so much for your reply @MattKW. Appreciate it.
What is OPG mean?
I have x-rays taken after few months of my first filling. I had the filling replaced 2 weeks back and I didn't take any x-rays in these 2 weeks.
I am attaching the x-ray taken before this refilling.
And I had a very very small decay on 19 and have a very shallow filling on surface O.
1933-7605d9428f8b709876066431821bbc1a.jpg
1932-4fd566bc966c059906a471a9988c0117.jpg
1931-df497f4d3b1c5b4f82a6eff97137e4aa.jpg
 

honestdoc

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Why did your new dentist suggest you need a root canal treatment on #15? A test that I use for possible fracture is a "tooth sleuth" bite stick. I place it on each of your 4 cusps on the #19 (usually the 5th cusp is too small to isolate). During the bite test, if you have pain upon releasing, the cusp may have an internal fracture. If you have pain only when biting down, you may be grinding and clenching.
 
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Why did your new dentist suggest you need a root canal treatment on #15? A test that I use for possible fracture is a "tooth sleuth" bite stick. I place it on each of your 4 cusps on the #19 (usually the 5th cusp is too small to isolate). During the bite test, if you have pain upon releasing, the cusp may have an internal fracture. If you have pain only when biting down, you may be grinding and clenching.
Thank you so much for your inputs @honestdoc. Appreciate it.
The another dentist told me about the root canal because she said that the filling sometimes not work in the back molars and they prefer root canal. And she said that might be the reason I am getting the pain and discomfort near the lower left (18 and 19).
But now I refilled the filling with my old dentist 2 weeks back. And now I have sensitivity to hard and crunchy foods when I chew and some dull ache in that tooth which comes on and off.

And about the bite stick, my dentist checked something like a hard plastic stick(not sure if it's bite stick) and told me to bite on it for few times. And i don't feel any pain with that. He didn't say anything after the bite check. He just said we can try crown on this tooth as we already tried refilling.
And told me to check if I am grinding or clenching in the night.
I think I should go for a new dentist and see. I am just olanniny to wait for few more weeks if it subside on its own. The pain actually increased after the recent visit to my dentist (I went on Monday for bite check). The pain comes for few seconds and goes off.
 
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Are you sure you mean 19 (lower left 1st molar). I can't see obvious decay on the OPG, but granted they're not the usual film to diagnose decay.
Anyway, cracks are not diagnosed on Xrays. Do you have standard small dental Xrays taken after your recent treatment? These are usually called bitewings.
What is OPG mean?
 
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Why did your new dentist suggest you need a root canal treatment on #15? A test that I use for possible fracture is a "tooth sleuth" bite stick. I place it on each of your 4 cusps on the #19 (usually the 5th cusp is too small to isolate). During the bite test, if you have pain upon releasing, the cusp may have an internal fracture. If you have pain only when biting down, you may be grinding and clenching.
Whether the minor cracks are reversible?
 

honestdoc

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Cracks unfortunately are not reversible. It can be very difficult to determine the extent of the crack. I worked on a colleague who I prepped a tooth for a crown and placed a temporary crown for about 3 months. His symptoms disappeared and we placed the final crown. He didn't have any issues afterwards. If cracks are deeper/more extensive, extraction would be the most predictable option.
 
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Cracks unfortunately are not reversible. It can be very difficult to determine the extent of the crack. I worked on a colleague who I prepped a tooth for a crown and placed a temporary crown for about 3 months. His symptoms disappeared and we placed the final crown. He didn't have any issues afterwards. If cracks are deeper/more extensive, extraction would be the most predictable option.
Thank you so much for your reply @honestdoc. Appreciate it.
The extraction really scares me. I really don't know if I have crack and that's the reason for these issues. I also suspect that the crack being formed when the dentist drilled and filled. Because, he didn't say anything about the cracks before my procedure. Is that possible that fillings can create cracks?
I don't want to do extraction. Let me see another dentist in few weeks. What symptoms should I check if I have crack?
The symptoms I have right now are, sensitivity while chewing down hard and crunchy foods. And dull or some pinch needle like pain comes on and off.
I know these questions should be the asked to the dentist in person. But just asking here if I can have some inputs myself on hand.
 

honestdoc

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Try to go to the drug store and find a dental night guard and use it during sleep. It can be very difficult to identify cracks. As mentioned above, when you bite into a tooth sleuth and you feel pain letting go of your bite, that may indicate an internal fracture. I had a tooth that was very sens to biting and after wearing a night guard for 5 years, the pain gradually disappeared.
 
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Try to go to the drug store and find a dental night guard and use it during sleep. It can be very difficult to identify cracks. As mentioned above, when you bite into a tooth sleuth and you feel pain letting go of your bite, that may indicate an internal fracture. I had a tooth that was very sens to biting and after wearing a night guard for 5 years, the pain gradually disappeared.
Thank you so much for your reply. Appreciate it.
 

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