What to do if a tooth is damaged?

December 25, 2015 | author : dentist, Gaiduk Igor

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Do you have a chipped, cracked, broken or misaligned tooth? What to do?

Assess the severity of the damage first

Trauma to the face can result in both a slight chipping of the tooth enamel (the outer layer of the tooth) and the loss of a tooth from the gums and/or fracture of the jawbone.

If, as a result of an injury to your face or head, you have a broken, chipped, or cracked tooth that causes bleeding from your nose or ears, loss of memory or consciousness, dizziness, confusion, heaviness in your head or ear pain, or your teeth do not close properly, immediately go to the emergency room for examination. You could damage the brain, temporomandibular joint, cause intracranial bleeding, break the jaw or other bones of the face. In this case, you need urgent medical attention. Most hospitals always have appropriate surgeons available to diagnose and treat your injuries.

Types of Tooth Damage

Fortunately, most dental injuries are not considered serious injuries. Broken (chipped, cracked) and loose teeth are classified into the following types (listed in order from mild to severe):

1. Damage to the crown (part of the tooth above the gum line).

1.1 Enamel.

a) A crack is the destruction of the enamel without breaking the structure of the tooth.

b) Tooth chipping - chipping or destruction of enamel with loss of the upper layer of the tooth structure.

1.2 Enamel and dentin - a crack and exposure of the outer and middle layers of the tooth.

1.3 Enamel, dentin and pulp - a crack and exposure of the outer, middle and inner layers of the tooth.

2. Damage to the root (part of the tooth below the gum line).

2.1 Horizontal - horizontal crack in the root of the tooth.

2.2 Vertical - a vertical crack in the root of the tooth.

3. Displacement of the tooth in the alveolus (the place in the oral cavity where the tooth is placed).

3.1 Contusion - the tooth absorbs the force of impact.

3.2 Displacement - the tooth is displaced relative to the alveolus.

3.3 Loss - the tooth falls out of the alveolus.

Damage, what to expect from it, and what to do?

Use the table below to classify damage, identify symptoms, determine if an emergency dental check-up is needed, how to relieve pain, and when and by whom to treat.

Damage	Appearance	Feel	Consequences	What can be done at home?	When to visit a doctor?	Emergency measures for treatment
Crack	Vertical or horizontal cracks in the enamel.	No	stress fractures.	Do not eat cold food and avoid hard pressure on the tooth.	At your next regular checkup.	Facet for the night.
Enamel damage	Slight chipping of the edge of the tooth.	Irregular shape and sharp edges of the tooth are felt.	Irritation of the lips or tongue.	Apply wax to the damaged area.	As soon as you have free time.	Enamel leveling and/or filling with light composite; in case of severe damage - the establishment of a facet.
Damage to enamel and dentin	Broken, chipped or cracked tooth with light and dark yellow/brown highlights.	They range from no pain to sensitivity to cold, air, sweet and hot foods.	Nerve damage or death from a dental infection.	Rinse your mouth with warm water, avoid high or low temperatures, rough foods, and use pain relievers if necessary.	In the absence of pain in the first 48 hours; if pain or tenderness bothers you, sooner.	Filling, crown placement.
Damage to enamel, dentin and pulp ( this case requires an urgent visit to the dentist )	Broken, chipped or cracked tooth with light, dark and red elements.	Moderate or severe pain.	Severe pain, infection, swelling.	Call your doctor right away, eat only soft or liquid foods, avoid extreme temperatures, and take anti-inflammatory and pain medications as directed by your doctor.	Visit a doctor as soon as possible; assistance must be received within 24 hours.	Depulpation, filling, installation of a crown, tooth extraction.
Horizontal or vertical damage to the roots ( this case requires an urgent visit to the dentist )	No	Constant, increasing pain; usually it arises from temperature and pressure on the tooth.	Severe pain, infection and swelling.	Eat soft foods, avoid extreme temperatures, take anti-inflammatory drugs.	See an endodontist or dentist as soon as possible.	Fixation of parts of the root, removal of part of the root.
Bruised tooth ( this case requires an urgent visit to the dentist )	The tooth looks normal; possible bleeding along the gum line.	When pressed, the tooth may deviate to the side, but it will not move completely.	Death of the dental nerve, depulpation, installation of a crown or facet.	Eat soft foods, do not chew on the side of the affected tooth, avoid extreme temperatures, take anti-inflammatory drugs.	Visit an endodontist or dentist within 24 hours.	Checking and monitoring the tooth and the surrounding area for damage to the nerve or other parts; possible splinting.
Tooth displacement: Subluxation extrusion Dislocation Intrusion (this case requires an urgent visit to the dentist)	The tooth may be crooked. In subluxations , the tooth wobbles but is not displaced; when pushed out , it sticks out; in dislocations is at an angle; and when intrusion it is deepened and looks shorter than the rest.	From normal sensitivity to numbness or pain; surrounding tissue may be damaged, so swelling and/or bleeding is likely.	Death of the dental nerve; possible damage to the alveoli of the tooth; ingrowth of a tooth into a bone.	Eat soft foods, do not chew on the side of the diseased tooth, avoid extreme temperatures; if there is swelling, use a cold compress; take anti-inflammatory drugs.	Contact your dentist immediately. Push-outs and dislocations must be eliminated within a few hours; other problems can be corrected in the first 24 hours.	Tooth reduction and/or splinting according to the diagnosis.
Traumatic dislocation ( this case requires an urgent visit to the dentist )	The tooth falls out completely.	Mostly pain; possible damage to the surrounding area, leading to severe bleeding and swelling.	Death of the dental nerve; possible tooth loss.	Apply a cold compress to the affected area on the face. Grasp the tooth only from the side of the crown. DO NOT TOUCH THE ROOTS . Gently wash it in saliva, milk, special or saline solution. If you are dealing with children or recalcitrant adults, place the tooth in the rinse solution. In other cases, you can put a tooth between the cheek and jaw. Try not to move the tooth. Milk teeth (which fall out in children) are not put back in, as this can harm the growing molars.	Visit a doctor within one hour. The faster the better. The chances of a successful treatment are higher if everything is done within 30 minutes.	Tooth placement and splinting; it is possible to visit a general practitioner for active tetanus toxoid immunization. After an hour or when the tooth dries, its installation is not recommended.

Can a tooth be saved?

If the trauma to the tooth is severe, you can ask your dentist about it before considering surgical extraction. The doctor should tell you if it is possible to fix or restore the tooth. He will also announce the approximate cost of restoring a tooth or teeth and the time it will take for all procedures. This will help you make a decision.

Is it worth saving a tooth?

The answer will not always be positive. Restoring a broken or chipped tooth can be very expensive. Unfortunately, failure to restore teeth can be even more expensive. Even if you can save the tooth, it is impossible to say with certainty whether it is worth it or not. To answer this question, you need to know the prognosis or expected consequences of the injury. Once your doctor has assessed the situation, he should discuss your options with you so that you can make an informed decision.

Reasons to save a tooth with good prognosis

Physically, our teeth are held in place by nearby teeth. When a tooth is removed, the nearest teeth move to a free position. This shift changes the bite and alignment of forces when chewing food. And you can break, chip or damage even more teeth as they are now subjected to more stress. When the teeth are strongly displaced to the free area, a space is created between them where food gets stuck. As a result, periodontitis can develop. It will be followed by loss of bone mass and teeth. The loss of multiple teeth can greatly affect the ability to chew food properly, leading to inadequate absorption of nutrients and digestive problems.

Socially and physiologically, the loss of teeth, especially a few, can make people look and feel older. When there are no front teeth, people smile less and hide their flaw. Even when the mouth is closed, the face may look sunken. The lower third of the face does become shorter when the back teeth are missing, which is quite noticeable in appearance. As a result, self-confidence suffers. If it's important to you to impress others, professionally or personally, then restore lost teeth and consider cosmetic dentures.

What if you cannot save a tooth and it needs to be removed?

One tooth can be restored with implants and bridges. If there are multiple teeth, a partial denture may be an option. In some situations, there are other ways. Your doctor should talk about all options after the examination.

What causes chipping, cracking and fractures of teeth?

The most common causes of tooth decay are:

Advanced tooth decay;
Depulpation of the tooth without the subsequent installation of a crown;
Teeth in which temporary fillings stand for a long time (mostly more than a month);
Accidents;
bruises;
Biting or chewing very hard food;
Use of teeth for inappropriate purposes;
Strong clenching of teeth;
Crooked teeth.

How can damage and injury to teeth be prevented?

See your dentist every six months to detect problems early and get treated before the filling or tooth structure starts to break down. This weakens the tooth and leads to damage.
Put a crown on the tooth after depulping as recommended by the doctor. During depulpation, the tooth loses its blood supply, making it brittle and prone to damage.
Replace temporary fillings with permanent ones as advised by your doctor. Temporary fillings wear out and leave the tooth unprotected, causing damage.
Use suitable protective equipment . In cars, do not forget about seat belts, when riding a bicycle, wear protective shields and a mouth guard.
Avoid dangerous situations where you can get hit.
Quit bad habits like chewing on bones and other solid foods.
Don't use your teeth to open bottles or break things.
If you clench your teeth at night, ask your dentist to make a night guard for you. The normal chewing bite force is 175 psi. During sleep, it can reach 300 psi or more, since there is no food in the mouth to take some of the pressure. And your defensive reflexes don't work here.
Aligned teeth are much less likely to cause damage or exert excessive pressure when chewing. The teeth that are in front of the rest are the most at risk, as they are the first to come into contact with objects. Find an orthodontist who will correct your overbite with traditional braces or invisible Invisalign.

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