be traumatized in many different ways. No one plans on having an accidental fall, a car
accident, or a sports injury but accidents happen. Any blow to the mouth can damage a
tooth. Most of these tooth injuries are merely cosmetic but some are true dental
emergencies. Tooth trauma can vary from minor chips to a knocked out tooth.
Here’s what you need to know about caring for your traumatized tooth.
tooth has three layers: enamel, the hard outer coating; dentin, the main part of the tooth; and
pulp, the fleshy nerve center. Many people who “chip” their teeth simply knock out a piece of
enamel. They may have a gap in their smile, but they aren’t likely to feel much
pain. If enough enamel breaks off, though, the dentin can be exposed. The
tooth still shouldn’t hurt too much, but it may be sensitive to cold. The worst breaks go all
the way to the pulp. This can cause extreme pain as well as bleeding from the
There are many possible treatments for broken and fractured teeth, depending on the
size of the break.
is only a minor chip on the outer part of the tooth (the enamel), we may be able to repair the damage with a
filling. Minor chips don’t always need treatment. Adding filling material may prevent it from getting worse or may
make the tooth look better. If the chip is small, the area can be lightly sanded to smooth out
any rough edges.
A more serious break can involve the enamel as well as the inner layer of the tooth
(dentin). Sometimes the damage can be repaired with a filling, but most often the tooth will
need a crown.
serious break or fracture is deep enough to expose the nerve tissue. These teeth will almost
always hurt and be sensitive. The broken part of the tooth will bleed.
Serious fractures often require root canal treatment to remove the exposed nerve. A crown will
be needed to protect the tooth.
tooth fracture involves the whole tooth, from chewing surface to the nerve chamber. In this type
of fracture, the two pieces of tooth have not come apart. The pieces remain in place, but the
crack gradually spreads. Pain from this type of fracture may be constant or may come and
go. Many people feel pain when they chew because as food is chewed pressure is applied to the
tooth. When the fractured tooth bites down on food, the crack in the tooth gets wider, but once
the pressure is released, the crack closes again. Treatment for a cracked tooth usually involves
a crown. If the fracture is severe,
root canal therapy may be indicated, or the tooth may even be
A tooth that is sensitive to changes in temperature or hurts while you are
is a warning sign that something is wrong and should be evaluated as soon as
injured tooth has been pushed out of its’ normal position (displaced) the tooth will need to be evaluated as soon
as possible, but are usually not true emergencies. Call our office to schedule an
appointment. Displaced teeth that interfere with biting, chewing or closing
of the mouth need to be repositioned quickly. These are more emergent. Call
our office at any time (the phones are always answered.) Some displaced teeth may have to be
repositioned in the socket. Displaced teeth often need to be splinted for a period of
involves binding a group of teeth together so that the biting forces are shared by a large number of teeth instead
of being born by the affected tooth. The affected tooth may also require root canal
A “knocked out” tooth, also know as an avulsed tooth, is possibly the most
traumatic of any single tooth injury. The tooth is forced from its normal position. Even worse, the tooth is
completely out of the socket. After an accident, the knocked out tooth has to be placed back into the socket with
an hour. If the tooth can be re-implanted within 15-30 minutes, there is a 90% chance of keeping that tooth for the
rest of your life. Here are some first aid techniques to consider:
· Handle the tooth by the chewing edge only.
· The tooth has to be rinsed off only using water or saliva. Do
not scrub the tooth.
· Making sure the tooth is facing the correct way; place the tooth back into
· In order for the tooth to be level with the adjacent teeth, use your thumb
to gently press the tooth up into the socket until it is in the right
· Bite down on gauze or a wet tea bag to stabilize the tooth.
· Call us right away (the phones are always answered).
If you are
unable to place the tooth back into the socket, call us right away or go to an emergency room.
Transporting the knocked out tooth is very important. Here are a few simple
· The tooth has to be moist. Do not let it dry out.
· Place the tooth in a container with a small amount of whole milk or saliva.
· If you do not have a container, you can carry the tooth between your lower lip and
gum, or under your tongue.
For knocked out primary (baby) teeth, there are usually no long term
problems unless the unerupted permanent teeth are damaged. Baby teeth usually
cannot be put back in. If you are not sure if it’s a baby or permanent tooth, use the guidelines
listed above and call for an appointment as soon as possible.
We may be
able to prevent a possible emergency by catching dental problems before they begin- saving you a lot of discomfort
and a potential emergency visit later.
by Bernadette and Jill, Chairside Assistants
August 25, 2009
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