When a child falls or generally is rough-housing, sometimes, they fracture a tooth. Ugh, why does it have to the be the front teeth, the ones everyone sees? Almost every Monday, we receive a call from a parent with a child or teenager that fell over the weekend and chipped, broke, or otherwise fractured a tooth. Teeth can sustain a lot of force, but a sharp hard force concentrated in one spot can cause a fracture or “broken tooth”. Now, baby teeth often have multiple small chips on the edges or facets from “normal” wear and tear. Of course, a fracture in a permanent tooth can be cause for concern.
Class 1–Chips or fractures in the outer enamel layer only
Class 2–Fractures into the dentin layer
Class 3–Fractures into the pulp of the tooth
Class 4–Fractures onto the root often vertical fractures
What to do?
Class 1–Well, they may look bad, but are usually not sensitive. If it is very small, we often just smooth off the edge. It is very difficult to do a very thin filling on the edge of a tooth. You can, but it will chip off again in a heartbeat. If the chip is larger, you often have to do a composite filling (bonding). It’s the same material we use for white fillings. It is “bonded” onto the tooth -sort of like gluing something onto a flat wall.
Treatment is sometimes different for a baby tooth. Often parents want whatever it takes to “save” a baby tooth that is not of any real consequence other than appearance. We are much more likely to just remove a severely damaged baby tooth rather than do a “baby tooth root canal”. The main objective is protecting the developing permanent tooth. Small fillings in front baby teeth are more difficult to retain without doing a crown. Having said this, we still try and “fix” fractured baby teeth if we can. The age of the patient can dictate what you are able to do (or not). A chip in the tooth of a two year old may be handled differently than that of a 5 year old. Behavioral considerations, the need for sedation, and how much root is left on the baby tooth will influence the ultimate decision.
There is more on the blog on trauma (and I know you want more info on this one):