Teeth are frequently in harm’s way; by one estimate, a quarter of all 12-year-olds have injured their permanent teeth. Of course, the fact that dental injuries are common is no comfort when they happen to you—or your child. Fortunately, modern dental treatment can make your smile look great again—especially if you get prompt and appropriate care. That’s why it is important to know what to do when you break a tooth.
If a tooth has been damaged by a traumatic blow to the head, it’s a good idea to get checked out at an emergency room or urgent care center—particularly if there’s any dizziness, disorientation or loss of consciousness. If the injury is confined to the tooth or teeth, you may be able to wait until the next day (or longer for a tiny chip) to see a dentist. Here are some common types of tooth injuries and methods for repairing them:
The appropriate treatment for a chipped tooth will depend on how much of the tooth has broken off. A small chip isn’t generally an emergency; it can often be repaired with dental bonding, which involves layering on a durable, tooth-colored material to restore the tooth’s shape. This is a relatively simple procedure that can be completed in one dental appointment. Because the bonding material has the same shade and transparency as natural teeth, it creates a beautiful repair. It is possible, however, that the bonding material will wear away over time and have to be replaced eventually. Minor chips can also be repaired with a porcelain veneer, which covers the entire front surface of the tooth instead of just the chipped area.
The repair of larger chips is more involved. A large chip that has not exposed or damaged the tooth’s pulp (nerve tissue) may need a veneer or crown (cap). This will likely take two visits, as your dentist needs to shape the remaining tooth structure to receive either a veneer or a crown, and then have the permanent restoration fabricated in a dental laboratory. The dentist will send you home with a temporary restoration (veneer or crown), and will call you back in when the permanent restoration is ready to be placed on your tooth.
A large chip that has exposed or damaged the tooth pulp will probably be painful, and may require immediate care; it will almost certainly need a crown, along with root canal treatment. This procedure involves removing exposed or infected pulp tissue from within the tooth and then sealing its central inner space (pulp chamber) and the narrow “canals” that branch from it down through the roots. Although it sounds complicated, root canal treatment is actually a routine dental procedure typically carried out under local anesthesia; it doesn’t feel much different than having a cavity filled, though it may take longer. Root canals can be performed by a general dentist or a specialist called an endodontist.
Sometimes teeth break because they have been weakened by untreated tooth decay, or because old dental work is failing. Repairing this may involve any of the procedures mentioned above. If the tooth has broken off at the gum line, it will probably have to be extracted. But your smile can still be restored beautifully with a permanent dental implant or natural-tooth bridge.
A crack can begin from the chewing surface or the root of a tooth, and may cause severe pain or just intermittent discomfort. But because even a small crack can open a pathway to infection, it’s important to see a dentist—whether or not you are in pain. The dentist will x-ray the tooth to determine the extent of the damage and the appropriate course of action.
A crack that is entirely above the gum line and does not expose the tooth’s pulp is the easiest to treat. Depending on the size of the crack, the tooth may be restored with a tooth-colored filling material, a veneer or a crown. If the crack exposes the pulp, a root canal treatment and a crown may be able to save it.
A tooth with a crack that extends beneath the gum line and into the roots cannot always be saved. A tooth that is actually fractured into two pieces will have to be extracted and replaced. Sometimes it’s possible for you to receive a dental implant on the same day the broken tooth is removed—sparing you the need to schedule a second surgical appointment.
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