|
Dental Injuries
FRACTURE OF ENAMEL & 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 an anesthetizing cream 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 3-6 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 used to save the dying tooth from extraction. This procedure involves removing all the dying pulp tissue and replacing it with an inert material.
SERIOUS TOOTH FRACTURE
A serious fracture that exposes both the dentin and the pulp tissue should be treated promptly. The tooth may be displaced and loose, and the gums may bleed. To prevent the loose tooth from falling out completely, the dentist can splint the loose tooth by bonding it to the adjacent teeth to help stabilize it while the underlying bone and gums heal. Because of the high risk of pulp death, a root canal procedure is commonly performed during the first visit. Alternatively, the dentist may elect to only apply a anesthetizing dressing on the splinted tooth. The tooth will then be reevaluated in 2-4 weeks for root canal procedure followed by a dental filling or crown. The splint is also removed at that time.
The most serious injuries involve vertical, diagonal or horizontal fractures of the tooth roots. In most instances, fracture of the tooth root leaves the injured tooth very loose, thus necessitating tooth extraction. The extracted tooth is replaced with a removable plate containing a false tooth. Rarely, certain teeth with horizontal fractures near the tip of the root may not need extraction. However, root canal treatment for the injured tooth may be required in the future if symptoms of pulp death and tooth infection appear. Therefore, periodic x- rays of the fractured tooth are performed.
Back to complete list
|
