A minor broken tooth (fracture) involves chipping of the enamel only.
A deeper fracture can involve both the enamel and the dentin of a tooth.
Death of pulp tissue can lead to serious tooth infection and abscess.
A serious fracture that exposes both the dentin and the pulp tissue should be treated promptly.
The most important variable affecting the success of reimplantation of a tooth that is knocked out is the amount of time that the tooth is out of its socket.
Care should be taken to handle the knocked-out tooth only by its crown and not by its root.
Prevention of dental injuries involves aligning protruding front teeth by dental braces and using face masks and mouthguards while participating in sports.
Trauma to the face or teeth can result from auto accidents, falls, and injury from sports such as football, hockey, soccer, volleyball, basketball, and baseball, etc. Patients suffering significant head, neck or facial trauma should be evaluated and treated in hospital emergency rooms. Such trauma may involve bleeding from the nose or ears, concussion, dizziness, lapse of memory, disorientation, severe headache and earache, or breaking (fracture) of the skull and/or jaws. Most hospitals have on their staff oral surgeons who can treat fractures of the upper or lower jaw and perform emergency tooth removal (dental extractions) and reconstruction of the dental arches.
Wear and tear of cavities and chewing hard objects such as pencils, ice cubes, nuts, and hard candies, can also lead to tooth fractures. Dental accidents without associated head and neck trauma can be evaluated and treated in a dental office. Such dental injuries include broken (fractured) teeth, teeth totally knocked out of the mouth, or teeth displaced by unexpected external forces. These dental accidents may be associated with swelling of the gum and oral tissue. Cold packs or ice cubes placed either inside the mouth directly above the injured tooth, or outside on the cheeks or lips, can reduce pain and swelling before the patient reaches the dentist.
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 1/3 of the tooth is called the crown, while the remaining 2/3 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.
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.
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