A good deal of us know what it is like to have gone through the unfortunate experience of breaking our teeth, whether it was as a young child chipping a baby tooth while falling off a swing set, or as an adult, having them knocked out in a traffic accident.  Dental injuries to the teeth commonly occur with falls, assaults, sports activities, child abuse, and multiple traumas such as an auto collision.  Whatever the case, breaking a teeth, be it a light chip or a deep fracture, should not be taken lightly.

When teeth are knocked out, especially if the tooth(s) are permanent ones, seek emergency care immediately.  The sooner you get care, the higher the probability the tooth can be saved.

If a tooth is completely knocked out, it should be quickly rinsed off with water, but never scrubbed. The tooth should be held by the crown (top), not the root, to minimize damage to the ligaments.   The best situation is for the tooth to be put back into the socket.  If that is not possible, it may also be placed between the cheek and gum line of either the person who lost the tooth or any willing adult.  This is because the mouth is the best place for the tooth because it protects the root by keeping it moist and provides protection against bacteria.  If this is also not possible, the tooth can be maintained and transported in to the doctor or dentist in saline, milk, or saliva. 

Do NOT transport the tooth dry, as this will cause permanent damage to the tooth nerve endings within minutes.  Transporting the tooth in water is also not recommended.

If bleeding from the socket is seen, rinse the mouth out with water.  Place a wad of tissue or gauze on the socket and apply pressure down on it (bite) to stop the bleeding.  For loosened, pushed in, or broken teeth, avoid eating or drinking anything.  If the tooth is broken in pieces, retrieve any remaining parts and transport them in one of the suggested solutions.

Toothache and jaw pain are the most common symptoms of dental injuries.  Some people may complain of pain with chewing or with temperature changes.  Although a tooth may have broken off, loosened, fallen out, or been pushed into the gum line, other less common symptoms may be seen.

• Isolated bleeding from the mouth
• Cuts surrounding the lips and cheeks
• Facial swelling
• A change in the tooth’s color

When seeing a doctor, an examination of the face, neck, mouth will be performed, and the teeth follow.  The doctor or dentist will look for damage to the jaw, salivary ducts, and nerves, as well as to account for all missing teeth.  A panoramic x-ray may also be taken to detect dental injuries.  This thorough image allows for a good structural evaluation of the teeth, jaw, and soft tissue structures

The Ellis classification is normally used to grade or describe tooth fractures. The higher the number (classification), the more serious the fracture is.  Broken teeth are managed according to their Ellis classification.

• An Ellis I fracture solely involves the enamel. This is the proverbial "chipped tooth." It is usually painless and more a cosmetic problem than anything else.  Common treatments include using white filling for bonding, installing veneers or crowns.                                                                                                                   
• An Ellis II fracture extends through the enamel and stops at the dentin. Usually the tooth is sensitive to cold.  In an Ellis III fracture, the injury extends through all 3 layers, exposing the pulp. Typically you will have extreme pain, often accompanied with mild bleeding from the tooth itself.  For these more serious fractures, it is not uncommon for the affected tooth(s) to be extracted.  Treatment for these missing teeth involve a variety of dental options from bridges to dental implants to dentures. 

Whatever the case may be, cosmetic and reconstructive dentistry has evolved to the point where most dental problems can be treated successfully.  To find out more about available dental options to treat broken teeth, browse through our comprehensive website. 

If you have any questions or concerns, please do not hesitate to contact one of our networks of specialists. 

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