Wednesday, January 26, 2005

Cracked Tooth Syndrome

Rarely a day goes by without a consultant receiving at least one claim requesting a crown or onlay for a tooth described as having "cracked tooth syndrome". Accompanying the claim is usually an x-ray showing a tooth (usually posterior) with an moderately-sized existing restoration (composite or amalgam) and a intra-oral photo showing a tooth with craze lines.. There appears to be no reason to place an indirect restoration outside of the fact that the tooth has "cracked tooth syndrome". So how can you demonstrate to the consultant that that tooth indeed requires that restoration? Show that you used due diligence to arrive at this diagnosis. Send in a copy of the patient's chart demonstrating that you followed the usual course which usually includes the results of stick biting tests, removing the existing restoration to look for internal fractures, placing a temporary restoration for a period of time to see if the restoration was the problem, etc.

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