Injured Tooth: What Should I Do?

How Do I Know if I Need Treatment?
As with any trauma to the mouth, you should consult with your dentist immediately to determine if treatment is required. The dentist will examine the affected area and may take X-rays.
If you are in pain from a broken, cracked or chipped tooth, you may want to take an over-the-counter pain reliever. If possible, keep any part of the tooth that has broken off and take this with you to the dentist.
If a tooth is completely knocked out of the mouth by an injury, take the tooth to your dentist as soon as possible. It may be possible for your tooth to be placed back into your mouth, a procedure called reimplantation.

How Does a Dentist Treat a: 
Chipped tooth —If there is no pain and the chip is small, it’s up to you to decide if, when and how the tooth should be repaired. Depending on the size of the chip, it can be smoothed or cosmetically corrected. Other options include veneers, crowns and fillings. Ask your dentist to explain these options. If a filling or artificial tooth becomes chipped, it should be replaced.
Cracked or broken tooth —Cracked and broken teeth should be repaired as soon as possible to prevent further damage. Root canal therapy or tooth extraction may be necessary. If a crack affects the enamel and dentin of the tooth, a crown is frequently the best treatment. Keep in mind that cracks are not always visible, even on X-rays. Symptoms may involve pain while chewing and Sensitivity to cold and possibly hot foods and liquids, as well as air, which may over time become more pronounced.
Tooth knocked out —The key to successfully reattaching a tooth is to get it reimplanted in the socket as soon as possible. With each minute that passes, more of the cells on the root of the tooth die. If possible, rinse the tooth with water only, then reimplant the tooth at the site and hurry to a dentist as quickly as possible. The tooth should be picked up by the crown only and must not be allowed to dry. The best chance for success is reimplantation within the first 30 minutes, with chances still good for up to two hours. It may be necessary for your dentist to do a Root canal treatment one to two weeks after the tooth has been stabilized.
Permanently lost teeth, whether they’ve been removed by a dentist or accidentally knocked out, should be replaced. This is to avoid problems such as difficulty chewing and speaking, a shifting of position among remaining teeth, temporomandibular joint (TMJ) disorders caused by chewing on the side with more teeth, and a weakening of the jawbone. Options for replacing lost teeth include bridges, dentures and implants. 
Broken jaw —If you suspect you or someone else has a broken jaw, do not move it. The jaw should be secured in place with a handkerchief, necktie or towel tied around the jaw and over the top of the head. Cold compresses should be used to reduce swelling, if present. Go immediately to a hospital emergency room, or call your dentist.

	Chipped front tooth
	Chipped tooth after repair
	“Permanent tooth knocked out”
	Carefully reinsert knocked out tooth and visit your dentist immediately

 

Sports Safety: Avoiding Tooth and Mouth Injuries

A few years ago, a dental newsletter published what seemed like an unusual story. A boy snagged his teeth on a basketball net while doing a slam-dunk.

A freakish accident? Not quite. After the article appeared, nearly 40 dentists wrote in with their own stories. They all told of would-be Michael Jordans who sacrificed their front teeth in pursuit of the perfect dunk.

In older children and adults, sports injuries are common. Dentists estimate that between 13% and 39% of dental injuries occur while playing sports.

About 80% of all dental injuries affect at least one of the front teeth. Damage to the tongue or cheek is common, too.

Basic Protection

Even if a tooth has been knocked out, it often can be saved if you get to a dentist quickly enough. Minor chips and cracks can be repaired. Dentists use tooth-colored materials that are nearly as strong as the original tooth. However, even “minor” injuries can cause serious and costly damage. If you enjoy sports or other high-risk activities, protect yourself. The use of mouth guards among football players, for example, is believed to prevent about 200,000 mouth injuries a year.

Depending on the sport, two types of protection are available:

• Helmets — A helmet is a must for activities that involve speed or impact. These include football, hockey, skating and bike riding. The helmet should fit correctly. It should also be appropriate for the sport you are playing.
• Mouth guards — Wearing a mouth guard is one of the best ways to prevent injury to your teeth, tongue and lips. A custom-fit mouth guard from your dentist is recommended. This type of mouth guard usually fits better than a ready-made one (found in sporting-goods stores). That means it may protect your teeth better.

What are Sports Mouth Guards ?

What Are Sports Guards and Mouth Guards?
Sports guards, mouth guards and mouth protectors are different names for the same thing: a device worn over your teeth that protects them from blows to the face and head. Mouth guards are an important piece of athletic equipment for anyone participating in a sport that involves falls, body contact or flying equipment. This includes football, basketball, baseball, soccer, hockey, skateboarding, gymnastics, mountain biking — any activity that might result in an injury to the mouth.

Mouth guards typically cover the upper teeth, and are designed to protect against broken teeth, cut lips and other damage to your mouth. If you wear braces or other fixed dental appliances (such as a bridge) on your lower jaw, your dentist may suggest a mouth protector for these teeth as well.

What Are the Different Types of Mouth Guards?
No matter which type of mouth guard you choose, it should be resilient, tear-resistant and comfortable. It should also fit properly and not restrict your speech or breathing. The three types of mouth guards are:

• Custom-made mouth guards — These are individually designed and made in your dentist’s office or a professional dental laboratory. Not surprisingly, they are likely to provide the most comfortable fit and best protection. Your dentist makes an impression of your teeth and then constructs the mouth guard over a model of them. Because they fit and feel better, most athletes prefer customized mouth guards. However, they are also the most expensive.
• Boil and bite mouth guards — These come in a pre-formed shape that can be altered by boiling the mouth guard in water, then biting into the warm plastic for a customized fit. They can be bought at many sporting goods stores, and may offer a better fit than stock mouth protectors. Follow the directions carefully to avoid winding up with a poor-fitting mouth guard.
• Stock mouth guards — These are inexpensive and come pre-formed, ready to wear. Unfortunately, they often don’t fit very well. They can be bulky and may make breathing and talking difficult.

How Long Should Mouth Guards Last?
Mouth guards should ideally be replaced after each season because they can wear down over time, making them less effective. Replacement is especially important for adolescents because their mouths continue to grow and teeth continue to develop into adulthood. Many athletes who play several sports have new mouth guards made when they go for their six-month dental checkup.

Knocked-Out Tooth (Avulsed Tooth)

What You Can Do
What Your Dentist Will Do

Dentists refer to a knocked-out tooth as an “avulsed” tooth. This is one of the most serious dental emergencies for permanent teeth. However, the damage can be fixed. If you act quickly, there’s a good chance the tooth can be saved.

What You Can Do

When a tooth has been knocked out, the nerves, blood vessels and supporting tissues are damaged, too. The nerves and blood vessels can’t be repaired. That is why all avulsed teeth will need a root canal. However, the bone can reattach to the root of the tooth once it’s put back into place.

The odds of saving a tooth are highest in young children, but adult teeth can be saved as well. Only permanent teeth should be re-implanted.

It is important to get to the dentist as quickly as possible after a tooth has been knocked out. It is also important to avoid damaging the tooth even more.

Follow these suggestions to improve the chances of saving your tooth:

• Handle the tooth carefully. Try not to touch the root (the part of the tooth that was under the gum). It can be damaged easily.
• If the tooth is dirty, hold it by the upper part (the crown) and rinse it with milk. If you don’t have any milk, rinse it with water. Don’t wipe it off with a washcloth, shirt or other fabric. This could damage the tooth.
• Keep the tooth moist. Drop it into a glass of milk. If you can’t do this, place the tooth in your mouth, between the cheek and gum. A young child may not be able to safely “store” the tooth in his or her mouth without swallowing it. Instead, have the child spit into a cup. Place the tooth in the cup with the saliva. If nothing else is available, place the tooth in a cup of water. The most important thing is to keep the tooth moist.
• Try slipping the tooth back into its socket. In many cases, it will slip right in. Make sure it’s facing the right way. Don’t try to force it into the socket. If it doesn’t go back into place easily and without pressure, then just keep it moist (in milk, saliva or water) and get to the dentist as soon as you can.

If the tooth is intact (not broken in pieces), it is always a good idea to try to save it.

What Your Dentist Will Do

Putting the tooth back in place sometimes can be simple. Other times it can be complicated, such as when the tooth or bone is broken. Your dentist will use water to flush debris from the socket. Then he or she will slip the tooth back into place. It is most important to re-implant the tooth as soon as possible. Ideally, this should occur within the hour of the accident.

The dentist may perform a root canal right away, or may wait. The best course to take will depend upon how long the tooth was out of the mouth and other factors. In any case, the dentist will splint the avulsed tooth to the teeth on either side with a soft wire and/or composite material. This will be used to hold the tooth in place for several days. Your dentist will decide how long the splint should remain.

If the bone around the tooth was not fractured, the root usually will reattach firmly to the bone in about three to four weeks. More damage to the area may require six to eight weeks of repair time.

Your dentist should examine the tooth again in three to six months. Unless there are signs of infection, the next visit will occur at your yearly checkup. The dentist will follow up for the next two to three years to ensure that the tooth re-implanted successfully.