WHAT DO I HAVE TO DO IF A TOOTH HAS BROKEN?Before a fracture of a tooth it is of special interest to go to the dental clinic to prevent major injuries and obtain a good prognosis. The treatment of dental fractures can vary depending on several factors such as the time that has passed, the tooth involved or the type of dental fracture. Once the dental practice is visited, a patient’s medical history is made with all the data of interest, the patient is explored in detail, emphasizing the affected area. Usually some complementary tests such as radiography are performed, to see the involvement of the root, or dental vitality tests to know how the dental pulp is. In children it is important to observe and take x-rays to see if the germ of the definitive tooth has been affected or not.
Dental fractures can be traumatized in several ways, such as the location of the fracture. Thus, fractures can only affect enamel, the fracture can be larger involving the entire crown with or without dental pulp involvement. In more advanced situations there are root fractures or coronoradicular fractures. Finally, dislocation or avulsion of the tooth can occur.
Once the fracture is diagnosed and the type of treatment it varies depending on age and dentition, temporary or definitive.
The treatment to be carried out can vary from a simple polishing of the enamel or a reconstruction of the affected tooth to an endodontics of the affected tooth and a subsequent placement of a dental incrustation or crown, or in more severe cases in which the tooth is compromised. It may be the treatment of choice. In case of enamel involvement, small cracks or bills may appear on it. To treat this affectation, the treatment consists in polishing the surface of the affected enamel and in this way being able to regularize the cutting edges.
If the fracture does not affect only the enamel but also the dentin is involved in the coronal part but the pulp is not affected, the treatment of choice consists in filling or restoring the tooth (depending on the amount of tissue affected) with resin Composed by adhesive techniques. Sometimes, in these types of fractures the tooth pulp is affected with an increased sensitivity or a negative vitality, so in most of these cases the indicated treatment is the performance of a root canal with a subsequent restoration to protect the tooth, either with the placement of an inlay or a dental crown.
When deciding whether there is pulp exposure in coronal dental fractures, conservative treatment may vary from a pulpotomy (removal of the pulp chamber of the tooth) or a pulpectomy (removal of the entire dental pulp). Dental fractures in which both the crown and the root of the tooth are affected, depending on the degree of involvement, a crown lengthening can be performed to expose the base of the fracture and reconstruct the tooth or if the dental involvement is very apical extraction of the affected tooth is the most favorable indication of treatment.
Occasionally, dislocations or avulsions of the teeth may occur. Dental dislocations are injuries that can affect the dental pulp and the periodontal ligament. Avulsions refer to the complete separation of the tooth from its socket. The prognosis and the treatment of this type of affectations can vary depending on many factors, some of the treatment can be the splinting of the tooth once placed in its socket or exodontics to the tooth and prosthetically rehabilitating the dental loss. In more severe cases a fracture of the alveolar process may appear. The treatment of these affectations is more complex and needs the evaluation and intervention by a specialist in surgery or maxillofacial.
It is of special interest that after performing the most appropriate treatment for each type of dental fracture, the control appointments scheduled by the dentist are scheduled. Periodic visits are usually carried out especially in the first three months after the dental fracture. In these controls, clinical and radiological examinations are performed to assess the prognosis of the tooth, its vitality and observe the evolution of the affected area.