Dental Injuries

  • Medical Author:
    Donna S. Bautista, DDS

    Dr. Donna S. Bautista, DDS, completed her undergraduate studies at the University of California, San Diego with a bachelor of arts in biochemistry and cell biology. During her time at UC San Diego, she was involved in basic research including studying processes related to DNA transcription in the field of molecular biology. Upon graduation, she went on to attend dental school at the University of California, San Francisco. In addition to her formal dental training, she provided dental care for underserved communities in the Bay Area through clinics and health fairs. She also worked toward mentoring high school students interested in the field of dentistry.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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How is a tooth fracture treated?

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 tooth and/or 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 portion of the tooth that is visible in the mouth is called the crown and is only a part of the entire tooth structure. The remaining portion of the tooth is buried in the bone and is called the root. Different tests are performed in the mouth to determine if a tooth fracture is present. In some instances, dental X-rays can help to diagnose, locate, and measure the extent of tooth fractures.

What are treatment options for a serious tooth fracture?

A serious fracture is one that exposes both the dentin and the pulp tissue and should be treated promptly. Serious fractures may make the tooth displaced and loose, and cause the gums to 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 infection after the exposure of the pulp to the oral environment, a root canal procedure may need to be performed during the first visit. Alternatively, the dentist may elect to only apply a sedative dressing on the splinted tooth to help calm the tooth pain. The tooth will then be reevaluated in two to four weeks to determine if a root canal procedure is necessary. If the tooth appears to have recovered and is stable in the mouth, the splint is removed at that time and a filling or crown is placed to restore the fractured tooth. The tooth may still require periodic monitoring over time (months to a year) to determine if any further treatment will be needed.

The most serious injuries involve vertical, diagonal, or horizontal fractures of the tooth roots. In most instances, a fracture of the tooth root leaves the injured tooth very loose and unable to be restored with dental work, thus necessitating tooth extraction. The extracted tooth is often replaced with a removable plate containing a false tooth as a temporary measure until a more definite plan for tooth replacement is made. There are some specific instances where teeth with horizontal fractures near the tip of the root may not need extraction. Root canal treatment for the injured tooth may be required in the future if symptoms of pulp death and tooth infection appear. Periodic dental X-rays of the fractured tooth are performed to monitor it closely.

Medically Reviewed by a Doctor on 1/25/2016

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