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 about a chipped tooth?
A minor tooth fracture involves chipping of the enamel only. The tooth is not displaced, and there is no bleeding from the gums. The only symptom of such minor chipping may be sharp or rough tooth edges irritating the cheek and tongue. The injured tooth itself may not even be painful or sensitive to food or temperature. The risk of pulp injury is small, and treatment is not urgent. A small amount of orthodontic wax or sugarless gum can be placed over the rough edge until the dentist can be reached. Definitive treatment usually involves placing a dental filling, a porcelain or gold crown, or a "cap" to protect the pulp of the tooth and to restore normal tooth contour.
What about a fracture of the enamel and dentin?
A deeper fracture can involve both the enamel and the dentin of a tooth. The tooth is still not displaced and the gums are not bleeding. These deeper fractures may be sensitive to cold temperature or food. Prolonged exposure of dentin to oral bacteria can cause the death of the inner pulp tissue. Death of pulp tissue can lead to serious tooth infection and abscess. Therefore, fractures involving the dentin should be treated promptly (within days of the injury). Treatment involves placing a sedative dressing over the exposed dentin, followed by a dental filling, a porcelain or gold crown, or a "cap" to protect the pulp of the tooth. A follow up X-ray in three to six months may be needed to be sure that the pulp has not died.
If the fracture has already significantly injured the pulp, then treatment involves either extracting the dying tooth or performing a root canal procedure to prevent serious tooth infection. The root canal procedure is done to save the dying tooth from infection and extraction. This procedure involves removing all the dying pulp tissue and replacing it with an inert material in order to keep infection out.
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