The hygienist noticed a crack in my lower right second molar during my dental cleaning two months ago. My first molar has a veneer on it. My dentist referred me to an endodontist to see the depth of the crack, but the endodontist just recommended a crown. My dentist tried to mend the tooth, and now I cannot chew on the right side of my mouth. The tooth is sensitive, and the dentist says that until it calms down, I must wait before I start braces. Should I ask for an onlay or a crown, or is it time for a second opinion? Will the work damage my veneer? – Thanks. Eduardo from Austin
Dr. Tostado would need to examine your tooth to see its condition. An accurate diagnosis depends on several factors, including:
- Location of the crack
- Vertical or horizontal crack
- Crack depth
Should You Get an Onlay or a Crown?
Whether a dentist recommends an onlay or a crown depends on the extent of tooth damage and whether the dentist offers onlays. Sometimes, an onlay can restore a tooth and preserve more healthy tooth structure than a crown.
What Is an Onlay?
An onlay is a custom-fitting ceramic that a dentist applies only to the damaged portion of your tooth. An onlay covers one or more tooth cusps or peaks on the biting surface of your tooth. Gold, porcelain, and hardened composite are types of onlays. A porcelain onlay is not strong enough to hold a cracked tooth together. Sometimes, it is necessary to cover the entire surface. Not all dentists have the training required to offer onlays.
Although an onlay may temporarily hold a cracked tooth together, a dental crown is a long-term solution. If your dentist has advanced cosmetic dentistry training, listen to their recommendation after examining your tooth. Your pain could be persisting because the crack needs further repair. If your dentist recommends a crown, you should consider it. Repeated attempts to repair the tooth can make it weaker and break in half eventually. A skilled cosmetic dentist has the necessary tools to restore your tooth without damaging your porcelain veneer.
Wait until your dentist resolves the issue before beginning treatment with braces. Still, if you are unsure about your dentist’s treatment advice, you can get a second opinion.
Dr. Gilberto Tostado, a San Antonio, Texas cosmetic dentist, sponsors this post.