Though human teeth are strong, they can chip, break or fracture, in various situations . These can be a fall with your face towards the ground, a punch in a fight , a hit by a cricket or a golf ball etc. As soon as there has been an incident of broken tooth, one should take an appointment with the dentist. Before that there are few steps the person can take himself , ie till he gets to the dentist .
If a portion of the tooth has broken off , take the broken portion and put it in a container which has milk. Get this container with the broken tooth portion, to the dentist, at the time of your appointment . The dentist may be able to re-attach the broken tooth back . Please don’t try to fix the broken portion onto the original tooth in your mouth on your own.
Till you get to see the dentist, best to do warm saline rinses to ward off infection . Take a glass of luke warm water , put a teaspoon of normal salt and rinse your mouth with it, focussing on the injured tooth. If there is pain best to take an over the counter painkiller ie ibuprofen. Avoid eating with the broken tooth before seeing the dentist . If there is a sharp edge of the broken tooth, best to cover it with a piece of wax , to prevent injury to the soft tissues of the mouth like lips, tongue, cheek etc. There are various treatments the dentist can do to treat your chipped or broken tooth . If the chip is minor, the dentist may just contour and polish it. This is a short one sitting procedure. If the chip is a little more, a tooth coloured filling or restoration may be done by the dentist . This is also a one sitting procedure and takes about half an hour .
If the tooth has broken to a larger extent, there can be two options .
If there is no pain then the dentist will just put a crown /cap on the broken tooth . The all ceramic/ porcelain crown/ cap is very life like. It matches so well with the natural teeth that no one can make out the difference between natural or artificial tooth. If there is pain in the broken tooth , there may be a nerve involved . This means that the tooth is broken at the level of the nerve . The dentist confirms this with an X-ray .
If the nerve is exposed or involved the dentist will first do a root canal treatment to remove the infected nerve and then put a crown on it. These days, the root canal treatment is done in one sitting and is a painless procedure , under local anaesthesia .
In some cases the tooth is broken so much that only one third of the tooth remains and two third is broken. In such cases , a root canal , post and core and then a crown is required on the fractured tooth .
If the tooth is broken to a very large extent ie only one fifth or one sixth of the whole amount is left in the mouth, then it may need to be extracted. The dentist will make a decision. If post and core is not possible or a good sound margin on the tooth is not available for the crown then the tooth had to be removed / extracted . If there is a crack or fracture line going through the crown and root of the tooth , then also it might need an extraction.
The dentist can take a call ie if the extraction and placing the implant can be done in the same sitting . These days immediate implants are routine procedures provided the case selection is ok .
Posted By – Dr. Suprriya B. Bhatia