TOOTH FRACTURES AND OTHER INJURIES

TOOTH INJURY and TOOTH FRACTURES:

Luckily, most TOOTH INJURIES and TOOTH FRACTURES are NOT life threatening. On the other hand, some may think that losing one of their front teeth is the END of their LIFE!!

And unfortunately, those front two teeth are probably the most common recipients of DENTAL INJURIES. That’s what they get for being in front, right?

(For more on TOOTH INJURY and DENTAL INFECTIONS , click link.)




PRIMARY TEETH are not treated the same as PERMANENT TEETH. If a primary tooth is knocked loose, it will not be SPLINTED. It will either be left to fall out on its own, or EXTRACTED.

If primary teeth are lost prematurely, often times the permanent tooth will be delayed in its eruption, meaning it will erupt later than it normally would.

And second,

ANY TOOTH THAT SUSTAINS A TOOTH INJURY, MAY NEED A ROOT CANAL IN THE FUTURE. The nerve is a delicate structure, and can be damaged from any sort of tooth fracture of injury.


TOOTH FRACTURES:

If a tooth gets chipped or fractured, often times a simple tooth colored filling can be placed in order to build the tooth back up to the correct size. If the tooth fracture is quite large or there is not much tooth structure left, a CROWN may be needed. If the tooth fracture is sufficiently deep into the nerve, a ROOT CANAL may be needed. And if the root of the tooth has fractured VERTICALLY, the tooth will need to be EXTRACTED .

COMMON CAUSES OF TOOTH FRACTURES:

  • Root Canal Treated without Crown Placement
  • Piercings
  • Decay, Weakening the Tooth
  • Trauma
  • Grinding, Bruxing, Clenching
  • Malocclusion
  • Large Fillings


DISPLACED TEETH:

When a tooth is displaced from its original position, the tooth needs to be replaced into its correct position, and may need to be SPLINTED for several weeks. If the tooth cannot be manually replaced into proper position, ORTHODONTICS may be needed to achieve that movement.

Any tooth that is displaced, may eventually need to have ROOT CANAL therapy done in order to remove the nerve of the tooth. Often times when a tooth injury occurs, the nerve gets damaged, and sometimes takes weeks or months before it’s death is evident

Below is a dental xray of a tooth that was displaced out of the socket.

After anesthetizing the patient, the tooth was pushed back into proper position.  The tooth will still most likely need a root canal, but at least is back in place.

AVULSED TEETH:

If a tooth gets completely knocked out of its socket, the best thing to do is to put it back in. If it is REIMPLANTED within the FIRST 30 MINUTES, the chances of it being accepted by the body is decent. After 2 hours, the probability of it surviving in the mouth is very poor. Between 30-120 minutes, it is still possible, but the longer you wait, the worse the chances.

If you can't get the tooth back into the socket, you can keep it in milk, saliva, or have the person keep it in his or her mouth off to the side until you can be seen by a dentist.

It is very important not to scrub the sides of the tooth

If the tooth is REIMPLANTED successfully, it will need to be SPLINTED into place, and will eventually need a ROOT CANAL. If the tooth got knocked out of the socket completely, you can be sure the NERVE was separated in the process.


RESTORING MISSING TEETH:

If a tooth is not restorable after a tooth fracture and is ultimately lost, most likely either a TOOTH IMPLANT or BRIDGE will be needed to restore the space. Both are very viable options, and both have their pros and cons. Please visit their respective pages for further discussion about both procedures. 





MANDIBLE FRACTURES (BROKEN JAW):

In the event that you do have a MANDIBLE FRACTURE, your jaw will need to be FIXED with ARCH BARS at the least. These are wired to all of your teeth and help to hold the jaw in proper position. Along with the ARCH BARS on both upper and lower teeth, MOST of the time the jaws will be WIRED SHUT (INTERMAXILLARY FIXATION).

This can be done under LOCAL ANESTHESIA in a normal dental office, but most of the time is done under GENERAL ANESTHESIA (you will be put to sleep0 in an OPERATING ROOM.

If the ARCH BARS are not sufficient, you may need to have METAL PLATES placed, which are SCREWED into your jaw. These also help to fix the MANDIBLE in the correct position. These are left in the bone indefinitely and do not need to be removed (unless they cause problems later, which is rare), so every dentist you see in the future will know that your jaw was once broken.

MANDIBLE FRACTURES can be treated by either PLASTIC SURGEONS or ORAL SURGEONS. Either is capable, but ORAL SURGEONS have had much more extensive training in how the teeth should come together. Keep in mind, your jaw will heal however it is set, so if it is set incorrectly, your BITE/OCCLUSION will be off forever. This is why it is important that your surgeon has a good working knowledge of OCCLUSION.

After the surgery, you will be wired shut for 6 WEEKS, and will need to sustain yourself on a liquid diet and blended food. 

After the 6 weeks, the wires will most likely be removed (under local anesthetic in a dental office), and you should be able to once again function normally.

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