Dental Injuries (cont.)
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- Dental injury facts
- What is a tooth fracture?
- What is a serious tooth fracture?
- What about a chipped tooth?
- What about a fracture of the enamel and dentin?
- What if I get my teeth knocked out?
- What is a displaced tooth?
- Prevention of dental injuries
- Find a local Doctor in your town
What is a tooth fracture?
Tooth fractures can range from minor (involving chipping of the outer tooth layers called enamel and dentin) to severe (involving vertical, diagonal, or horizontal fractures of the root). Enamel and dentin are the two outer protective layers of the tooth. The enamel is the outermost white hard surface. The dentin is a yellow layer lying just beneath the enamel. Enamel and dentin both serve to protect the inner living tooth tissue called the pulp. The visible one-third of the tooth is called the crown, while the remaining two-thirds of the tooth buried in the bone is called the root. Dental X-rays are necessary in most instances to diagnose, locate, and measure the extent of tooth fracture.
What is a serious tooth fracture?
A serious fracture is one that exposes both the dentin and the pulp tissue and should be treated promptly. The tooth may be displaced and loose, and the gums may bleed. To prevent the loose tooth from falling out completely, the dentist can splint the loose tooth by bonding it to the adjacent teeth to help stabilize it while the underlying bone and gums heal. Because of the high risk of pulp death, a root canal procedure may need to be performed during the first visit. Alternatively, the dentist may elect to only apply a sedative dressing on the splinted tooth to help calm the tooth pain. The tooth will then be reevaluated in two to four weeks for root canal procedure followed by a dental filling or crown. The splint is also removed at that time.
The most serious injuries involve vertical, diagonal, or horizontal fractures of the tooth roots. In most instances, fracture of the tooth root leaves the injured tooth very loose, thus necessitating tooth extraction. The extracted tooth is replaced with a removable plate containing a false tooth. Teeth with horizontal fractures near the tip of the root may not need extraction. However, root canal treatment for the injured tooth may be required in the future if symptoms of pulp death and tooth infection appear. Therefore, periodic X-rays of the fractured tooth are performed.
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