A broken or fractured tooth is a break in the hard structure, ranging from a tiny chip to a deep break that exposes the nerve. Understanding the damage is necessary for determining the proper next steps and ensuring the best outcome. This guidance helps assess the situation and establish whether the injury requires immediate professional care.
Criteria for an Immediate Dental Emergency
A true immediate dental emergency involves a risk of life-threatening complications or a time-sensitive need to save the tooth. Immediate attention is required for severe, uncontrollable bleeding that does not stop with pressure, or pain unmanageable with over-the-counter medication.
A completely knocked-out tooth (avulsion) is a time-sensitive emergency, as successful re-implantation decreases sharply after 30 to 60 minutes. Immediate medical attention is also necessary for a suspected jaw fracture. Symptoms include a change in how the teeth fit together, inability to fully open the mouth, or numbness in the chin or lower lip.
If the injury involves facial or jaw trauma, or signs of a spreading infection like rapid facial swelling, an emergency room visit may be necessary. For all other severe fractures, contact an emergency dentist immediately to prevent infection and save the tooth.
Essential Immediate Care Steps
While waiting for professional care, take immediate steps to manage discomfort and protect the injured tooth. Rinse the mouth gently with warm water to clean the area of debris and blood. A mild saltwater solution can soothe irritation and reduce the risk of infection.
If there is bleeding, apply firm pressure using clean gauze or a cloth for 10 to 15 minutes. Manage swelling by applying a cold compress or ice pack wrapped in a towel to the outside of the face in 15-minute intervals. Over-the-counter pain relievers like acetaminophen or ibuprofen can help, but avoid aspirin if bleeding is present, as it thins the blood.
If the broken piece is found, handle it gently only by the crown, avoiding the root. Keep the fragment moist by placing it in milk, sterile saline solution, or the individual’s own saliva. This preservation increases the likelihood that the dentist can reattach the original piece.
Classifying Tooth Fractures and Necessary Treatment
Treatment for a broken tooth depends on the depth of the fracture into the tooth’s structure. A minor chip affecting only the enamel may be painless and can be addressed by polishing the rough edge or using dental bonding. When the fracture extends into the underlying dentin, the tooth often becomes sensitive to temperature changes, requiring a more involved restoration, typically involving a protective material and restoration with a filling or a dental crown.
A severe break reaching the pulp (the soft tissue containing the nerve and blood vessels) is characterized by intense, persistent pain, sometimes showing a pinkish tint or bleeding. This damage requires root canal therapy to remove the infected pulp before the tooth is sealed and protected with a crown.
A split tooth, where a crack runs vertically, may necessitate extraction if the split extends deep below the gum line. The goal of treatment is to alleviate discomfort, restore function, and prevent the spread of bacteria into the jawbone. Timely intervention minimizes the risk of complications like infection or abscess formation.