Principles of treatment of broken molars with only roots left

This is an automatically translated article.

Posted by Doctor Lai Do Quyen - Department of Interspecialty - Vinmec Times City International General Hospital.

Molars, also known as molars, are the innermost group of teeth, which play the main role of chewing on the jaw. Due to the position deep inside, the shape of the teeth are large, with many crevices, difficult to clean, so they are most susceptible to decay. When the teeth are decayed, especially the molars, from the small cavities, they will spread, causing loss of many tooth structures, the teeth will gradually disappear, sometimes only the roots are left. Then the treatment will be much more complicated.

1.Construction of molars To make it easier for you to imagine, let's find out how the structure of a molar is.

A molar tooth consists of: the crown is the part above the gums that you see in the mouth and the root is the part below the gum and in the jawbone (alveolar bone), you cannot see. Each molar will have from 2 to 4 roots. The top of each root, where blood vessels and nerves enter the tooth, is called the apical (peduncle) region. The structure of the crown consists of layers: the outermost layer is enamel with very hard characteristics, the second layer is dentin, which is softer than enamel, and in the middle of the tooth is a hollow chamber in both the crown (pulp chamber) and the teeth. The roots of the tooth (the canals), which contain the blood vessels and nerves of each tooth, are called the pulp. The hard organization of the tooth consists of enamel and dentin.

2. How is the tooth decay broken, leaving only the root?

Tooth decay is a condition in which the hard organization of the tooth is attacked, gradually disappears and creates holes on the tooth surface. Tooth decay develops in stages. Mild caries when teeth appear tiny black marks and small holes appear on the tooth surface. The cavity is getting bigger and the toothache pain from less to more begins to appear. The fragments on the tooth surface get bigger and bigger as the tooth decay gets worse. The more severe the decay, the more damaged the tooth, so the more chipped. If not corrected early, tooth decay will attack all the enamel and dentin in the crown and expose the root.

3. Complications when deep molars are broken, only the roots remain

Cavity teeth are broken, leaving only the roots, causing many complications, severely affecting oral health, overall health and daily activities.
Cavities if not treated, the hard organization of the teeth will be destroyed more, making the teeth fragile, chipping only the roots. Then the teeth no longer have the function of chewing.
Cavities create cavities along with broken and chipped teeth, forming places to store food, causing bad breath. On the other hand, when a tooth is broken, chipped, the gums in between the teeth are easy to crawl into and fill the cavity. This part of the gums is easy to swell, easy to bleed due to rubbing when chewing, causing inflammation and that is also the cause of bad breath.

Cavities go deep down and into the tooth pulp, causing painful toothache due to infected pulp.
When the infected pulp spreads deep into the apical area, causing infection in the apical area. At this time, the tooth is painful, loose, the gums next to the tooth are broken and swollen, forming an abscess of the tooth apex.
Inflammation of the apex for a long time, the infection will spread to affect the surrounding teeth. Depending on how far the infection has spread, the adjacent teeth can be treated to keep or have to be extracted, causing many teeth to be lost.
The fovea of ​​infection from the tooth apex spreads, causing osteomyelitis, spreading to the soft tissues and adjacent tissues, creating a hard-to-control infection.
The infection spread, creating large cysts that destroy the jaw bone, causing the jaw bone to break, damage nerves, blood vessels,...

4. How to treat broken molars with only the roots left?

When a deep molar tooth is broken, only the root remains, which means that most of the hard organization of the tooth is lost, so the treatment will be quite complicated, requiring an experienced dentist to diagnose and have good technical skills. . The principle of treatment when a decayed molar tooth is broken, leaving only the root is to try to preserve the tooth as much as possible.
Depending on the condition of the root, depending on the degree of infection of the apex, the dentist will have appropriate treatment plans.
4.1 The roots are still good If the roots are still good, the infection in the apex does not spread, the dentist will conduct:
Clean the area around the roots, remove all the excess gums that fill the roots. The remaining root will be treated with root canal: remove all inflamed pulp in each root, clean the canal and seal the canal. Depending on how much hard tissue is left, the dentist will reconstruct the crown to make the tooth stronger when wearing the porcelain tooth on the outside. The last step is to make porcelain crowns on the outside to protect the inside teeth and to ensure chewing function and aesthetics.

Because molars have many roots, keeping a good root as a frame to wear the crown on is also an option for the dentist. Then the dentist will conduct:
Split the roots. Extraction of the root of the tooth cannot be kept. The retained root will be treated with root canal, create a post to regenerate the crown and make a cover or bridge to ensure sustainable chewing function. 4.2. If the root is too weak, the infection spreads and cannot be kept, the dentist will conduct:
Extract the root, scrape the infection in the apical area to avoid infection. more widespread, causing dangerous complications later. Making dentures to replace lost teeth to restore chewing function and aesthetics. The plan for dentures will be discussed thoroughly with you by your dentist because it is very important to have dentures after tooth loss. Deep molars are broken, leaving only the roots of the teeth, which is a severe caries condition, then there are infectious complications in the apical area. The treatment is complicated and expensive. However, you can prevent this terrible situation at an inexpensive cost by proactively booking an appointment with your dentist every 6 months.

At Vinmec Times City International General Hospital, you will be examined and thoroughly consulted by dentists with nearly 30 years of experience on dental problems as well as helping you plan the most suitable oral treatment plan. ensure the highest quality and efficiency.

Please dial HOTLINE for more information or register for an appointment HERE. Download MyVinmec app to make appointments faster and to manage your bookings easily.