Teeth can be traumatized due to a number of causes including accidental falls, motor accidents, blow during fights, sports activities etc. Children and more so boys during the growing period are more prone for such injuries.
Trauma to the oral structures can range from fractures involving the tooth crown, root or both to injury affecting the supporting structures or surrounding tissues or even complete dislodgement of the tooth from its socket. They may also be accompanied by injury of the tissue surrounding the teeth including the gums, bone supporting the teeth and the jaw bones.
Not all fractures of the teeth may be considered as a dental emergency. Fractures can occur in a number of places in the teeth. Fractures that involve only the enamel or enamel and dentin may not pose much problems for the health and recovery of the teeth. These are called uncomplicated fractures. Complicated fractures of the teeth are those where the pulp tissue is exposed to the exterior. These fractures are to be treated as an emergency and may require endodontic treatment
Very minor chipping involving only the tip of the crown can be treated by reshaping the teeth followed by polishing. In case of slightly larger fractures involving the enamel and dentin, composite fillings can be given to replace the broken part.
Fractures can occur at the neck of the tooth leading to the entire crown being lost. In these types of fractures the remaining root can be treated endodontically and a post inserted into it which can support an artificial crown.
Trauma to the teeth can be transmitted to the supporting structures, which get damaged. This can cause mobility of the teeth. Such mobile teeth may require splinting for a specified period of time till the supporting tissues heal and the tooth becomes stable. Visit Dental Emergencies Section for further details
Splinting is a procedure where the teeth are supported in its position for a period of time. This is done to teeth that are traumatized or teeth whose supporting structures are affected by disease, which prevents them from supporting the teeth. Splinting 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.
Teeth that are traumatized can be displaced from their position. This displacement can be in any direction depending upon the type and direction of trauma. The displacement can be into the bone (i.e. the tooth is driven into the bone) or can be displaced partially out of the socket. Such displaced teeth may have to be repositioned in the socket and splinted for a specified period of time. These teeth may also require endodontic therapy.
A tooth that is subjected to trauma shows injury and inflammation of the underlying supporting tissues. This causes the teeth to be tender and also dislodge slightly out of the bone. These extruded teeth are tender on biting.
Fractured pieces of the crown can be reattached using composite cements. So it is advisable to retain the fractured piece and take it with you when you consult the dentist.
If the nerve and blood supply to the tooth gets damaged or destroyed the pulp of the tooth dies. The dead pulp can discolor the teeth, which can look brownish to black in colour. Usually the pulp recovers after mild injuries and there is no change in color. However, if the pulp gets damaged then gradually the colour of the tooth changes over a period of time. Endodontic treatment of the teeth can revert back the tooth colour and function. Some tooth may require additional procedures like bleaching of the teeth or whitening of the teeth if discoloration is severe and persistent.
Yes, if the tooth is intact it can be placed back into the socket. However, the outcome of the treatment depends on how quickly the tooth is put back in its place. Prolonged time out of the mouth and drying of the tooth will have poor prognosis. Until a dentist is approached the tooth should be carried in the patients mouth or externally in a cup of milk or sterile water or normal saline. The tooth should never be allowed to dry. In these emergencies the success of treatment depends on how quickly the tooth is put back inside. So it is advisable to contact your dentist immediately.