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Medical Author:

Donna Bautista, DDS

Medical Editor:

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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In this Article

• Introduction
• What is a tooth fracture?
• What is a serious tooth fracture?
• What about a chipped tooth?
• What about a fracture of the enamel and dentin?
• What if I get my teeth knocked out?
• What is a displaced tooth?
• Prevention of dental injuries
• Dental Injuries At A Glance
• Find a local Doctor in your town
• Dental Injuries Index

Instead of being completely knocked out of the mouth, a tooth can be displaced. A displaced tooth may be pulled out and appear elongated, or be pushed in and appear shorter. A displaced tooth can also be pushed forward, backward, sideways, or rotated. While not an emergency, the sooner the dentist can splint or realign the tooth with orthodontic brackets and wires, the easier it can be brought back into proper alignment. Trauma significant enough to cause tooth displacement can also lead to pulp injury. Therefore, a displaced tooth should be evaluated periodically for several months to determine if a root canal procedure or tooth extraction is needed.

Prevention of dental injuries involves aligning protruding front teeth by dental braces and using face masks and mouthguards while participating in sports. Mouthguards have been shown to reduce trauma not only to teeth, gums, and the surrounding jaw bone but also to reduce injury to the temporomandibular joints (TMJ) and to reduce the intensity and number of head concussions. Mouthguards also reduce pressure and bone deformation of the skull when a force is directed to the chin.

Before the mandatory use of face masks and mouthguards for high school and college football players in l963, 50% of all football injuries involved the face and the mouth. Since the mandatory use of these protective devices, dental injuries in football players have almost been eliminated. It is now recommended that mouthguards be worn, not only for organized football, but also for unorganized football, baseball, basketball, racquetball, soccer, ice, field, and street hockey, wrestling, boxing, martial arts, volleyball, rollerblading, skating, skateboarding, and bicycling.

Mouthguards can be purchased in pharmacies and sports supply stores and molded at home. They can also be custom made by the dentist. Store-bought mouthguards are less expensive than custom-made ones. However, the store-bought ones may not fit the athlete's mouth, may become loose, may be uncomfortably bulky, and may interfere with speech or breathing. The ideal mouthguards are custom made by a dentist. An impression is made of the athlete's upper dental arch to make a mold of his/her teeth and gums. A custom mouthguard made of a vinyl acetate ethylene copolymer (a special plastic) is then fabricated from this mold in the dental office or by a dental laboratory. A well-fitting custom mouthguard is comfortable and will not interfere with breathing and speech.

• 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.

REFERENCE:

Andreasen, Jens O., et al. Traumatic Dental Injuries: A Manual. 2nd ed. Ames, IA: Blackwell, 2003.