Tooth-broken-You should do it immediately

introduction

It is not uncommon for patients to suddenly find that a tooth has broken off. See matching: Canine aborted. Nevertheless, a dentist must be consulted as soon as possible. The dentist may be able to fix the broken tooth ( or the tooth piece ) or replace it with a suitable filling material.

It is recommended in case of a demolition to keep the piece of the tooth and bring it to the treatment appointment. If the broken piece of tooth has been swallowed or lost, the only option is a new tooth filling or an overcap. The incisors are often affected by falls.

If the defect is not clearly visible, most sufferers feel the broken edges with their tongues: they perceive that the tooth no longer feels as if they were otherwise.

Illustration tooth canceled

Figure tooth canceled: immediate action and treatment

Tooth broken off
tooth fragment

  1. Tooth fragment
    broken tooth
    or tooth piece
    Do not clean!
  2. Storage -
    Glass of milk,
    sterile saline,
    wet storage!
  3. Ideal is one
    tooth box
    (Pharmacy)
  4. As soon as possible
    Visit a dentist
    (up to 24 hours)
  5. Attached tooth fragment
    (special gluing technique,
    Plastic cement)

causes

A tooth can break off for a variety of reasons:

This happens most often by far in connection with an accident in which very strong forces act on the tooth substance.

Sports accidents lead to the list of possible causes. Many sufferers report that when drinking from a heavy glass bottle they slipped off their lips and the bottle crashed into the tooth. Furthermore, many patients present themselves in the dental office where a spoon has hit the tooth too hard or has bitten on a hard object (bone or candy).

In addition, root-filled teeth are particularly often affected. This is due to the fact that during the root canal treatment both the nerve branches and the blood vessels have to be removed from the inside of the tooth.

Sooner or later, this leads to a shortage of the tooth substance, which then becomes porous and unstable. For root-dissected teeth the same risk applies.

Furthermore, many broken teeth are teeth that had to be supplied with a lot of restorative material due to an extensive carious defect (caries).

The dentin ( dentin ) is one of the hardest, most resistant materials ever and can therefore withstand particularly high forces. If, however, a lot of dentin has to be removed and replaced by an artificial material in the course of a carious defect, the resistance of the affected tooth automatically decreases and it tends to break off much more easily.

Cause caries

Tooth decay can often cause a piece of the tooth to break off. This can happen in two ways.

On the one hand, the tooth can be cariously severely damaged. The outer tooth hard substance is attacked in this case, perhaps the bacteria have penetrated even into the interior of the tooth. As a result of this attack, the tooth is no longer so firm, as the stability-conferring substances have weakened or disappeared. Now it can happen that a piece of the tooth breaks off during chewing.

Another case is when a tooth, which in its past was exposed to strong carious influences, was treated with fillings. The caries has been removed and the areas have been filled with a special material. But even at these repairs it can lead to tooth rupture, since the site was added later and thus represents a weaker point in the tooth, as if everything consists of a natural material, such as enamel. If the caries has progressed so far that a root canal treatment has been carried out, it is not uncommon to break off the tooth, because such a tooth is more unstable and susceptible to breakage due to the absence of the feeding vessels.

Tooth breaks off after root canal treatment

After a root canal treatment, a tooth becomes brittle because all the afferent vessels (blood and nerve vessels) have been removed from the dental pulp. The fact that the tooth is no longer alive and is supplied with nutrients, it can break more easily. The dental guideline advises that root canal treated teeth should be rapidly crowned after completed root canal treatment to protect them from fractures. Because if he is only fractured, he can break so deep that he is no longer worth preserving and must be drawn.

This diagnostic decision is made by the dentist for the site where the tooth is fractured. The boundary represents the enamel-cement boundary, which marks the transition between tooth crown and tooth root. If the tooth is not broken below this limit and the tooth can still be tolerated in its biological width, this can still be treated.

After canceling a root-filled tooth, the treatment therapy consists of supplying the broken-off part as quickly as possible so that further parts of the tooth do not break off. The tooth is built up in advance with plastic or cement and thus the broken point replaced by a filler. Thereafter, the tooth must be supplied with a crown as quickly as possible. Furthermore, a pin is often inserted in the root-filled tooth, which protects the tooth from peeling forces. This pin can be a glass fiber pin or made of cast metal.

The crown structure, which is cemented, then the crown shape is prepared and finally the crown attached to it. The broken tooth usually causes no pain after root canal treatment, because it is not vital and no longer feels any stimuli. Pain is more likely to occur through the surrounding tissue, which may be irritated by the fracture.

What to do?

No matter which way you lost your tooth, whether it was broken off, loosened or knocked out, in any case it is advisable to see a dentist or a dental clinic as soon as possible. Dental clinics provide emergency services at later times or on weekends or holidays, or a dentist is on call.

The broken tooth or the missing piece of the tooth should be collected and brought to the appointment. It is best to store it in a glass of milk, in a sterile saline solution or in a special tooth rescue box. Tooth rescue boxes contain special nutrients for the tooth, which can extend its extraoral (outside the mouth) life up to 48 hours and are available for purchase in pharmacies. Within 30 minutes, the tooth should be treated with one of the three options.

When rearranging, make sure that they only touch the tooth on the crown. Attempting to reinstate the tooth itself is not recommended as it can destroy the fine fibers of the root. The treating dentist is thus given the chance to replace the broken piece or the tooth.

First aid

People who have a tooth broken off can greatly facilitate the work of the treating dentist through ideal behavior. First and foremost, the patient should be careful to collect the dental fragment, if possible, and bring it to the clinic.

Unfortunately, this is not always possible because the broken piece of a tooth can be very small and / or quickly swallowed. Then the broken piece has to be conserved. For example, storage in alcoholic liquids is suitable.

In the event of tooth breakage during the weekend, holidays or holidays, a dental emergency service or hospital should be consulted as soon as possible. The faster a treatment, the more likely the tooth can be restored by adhering the fragment.

However, if the patient waits too long to visit a dentist, often only an artificial restorative, crown or partial crown can be used to save the tooth.

Which home remedies help?

There are no home remedies that can help with a fractured tooth. Chamomile tea or chewing on cloves only helps with irritation of the gums, which can often accompany a fall and a traumatized tooth. However, if the tooth has become unstable and broken off by a tooth decay, for example, no home remedy can cure the caries or fill the existing hole.

What to do if the nerve is exposed?

If the tooth is broken off so that the nerve and vascular chamber is exposed, the only option is usually to treat it with a root canal treatment. If the tooth has broken off and the pulp mark and the vessels therein are not contaminated by bacteria, theoretically it is possible to try to cover the nerve chamber.

However, since the pulp has already come into contact with saliva in almost all cases and is bacteriös infected, this therapeutic approach is not considered. After successful root canal treatment and successful root filling, there is an increased risk of fractures and the tooth should be over-crowned quickly to protect it.

What is behind a black coloring of the tooth?

A dark tooth discoloration is due to a death of the vessels, which lie within the medullary cavity of the tooth. The nutrient supply through the vessels ensures that the tooth does not lose its water reservoir and remains resilient. If this condition is no longer present due to a bacterial infection or a fracture and the vessels devital, the tooth becomes brittle and turns dark gray to black.

The tooth turns black when blood remains in the interior of the dental cavity, this blood breaks down into iron, which is black and lodged in the enamel. Also, a non-optimally flushed canal in a root canal treatment may cause a discolored tooth on completion if blood is left in the canal. In a fracture, these discolorations are increasingly apparent as the brightest layer, the enamel, breaks off and the discolored, discolored layer comes to light. If the fractured tooth is not treated, it can also cause tooth decay, causing black discoloration and "fouling".

glue

If a tooth is broken, it may be re-glued by the dentist. The prerequisite for this type of treatment, however, is that the affected patient finds the fragment, preserves it and gives it to the treating dentist.

Many patients report, however, that the broken tooth could not be found or even swallowed. In addition, a patient with a broken tooth should consult a dentist as soon as possible. The probability of being able to re-attach the broken tooth fragment decreases enormously after just a few days.

If possible, a broken tooth fragment should be stored in a glass of milk or a special nutrient solution. Meanwhile, there are also special tooth rescue boxes that can be purchased in the pharmacy.

With appropriate preservation, the tooth fragment can be glued to the tooth stump in the jaw for about 24 hours. For bonding the tooth, the dentist usually uses a plastic adhesive that has to be cured by polymerization. After attaching the tooth, however, it should be spared for hours to allow the adhesive to cure completely. In addition, it must be remembered that a dental fragment can only be glued on if the medullary cavity has not been opened. In this case, the tooth nerve usually needs to be removed and the root supplied with an artificial restorative material.

As a rule, the aborted tooth is set up after the root canal treatment by means of plastic-containing materials. In the case of large losses of substance, the production of a crown or partial crown may become necessary.

breaking points

Molar teeth break more frequently than incisors because of the higher stress. Incisors, however, break more likely due to a dental disease.

In general, there are no places where teeth prefer to break off. In some cases, the tooth breaks down as a whole. One speaks then in the dentistry of a complete dental abort. Basically, the tooth crown is completely separated from the tooth root lying in the jawbone. In such cases, it is extremely difficult to maintain the tooth, as the pulp and rootlets in it are damaged.

The drug of choice is then a root canal treatment or removal of the root stump. A tooth can also break off completely on just one side.

If the root fibers have been damaged only slightly or not at all, the fragment can be glued on. However, it does not always succeed in saving an affected tooth.

With broken teeth corners or small fragments, the treatment is a lot easier. Usually, the fragment is simply glued or, in the case of fragment loss, replaced with a plastic restorative.

In the majority of cases where a tooth is broken off, it is already filled teeth. Usually no piece of the natural tooth substance breaks off, but only a piece of the filling material. This is the ideal starting point for the treating dentist, because the defect can then be easily and quickly remedied by laying a new filling.

Generally, parts of the molars or premolars will be more likely to break off. This is due to the significantly higher load during the chewing process. Biting on a hard candy or bone can already lead to tooth rupture.

Incisors, on the other hand, rarely break off as a result of an accident, but rather due to a dental disease. This is one of the reasons to identify a treatment appointment with the dentist as soon as possible and to clarify which type of disease is present in the affected tooth. The spread of the disease to other teeth should urgently be avoided. In addition, the unaesthetic appearance of a broken incisor drives most patients to the dental office quite quickly.

In fact, as soon as a tooth is broken, careful oral hygiene is becoming increasingly difficult. Fracture edges have the smallest indentations, which are almost unreachable by the bristles of a toothbrush: a carious defect is often the result.

Usually, a broken incisor can be obtained without any problems and supplied with a plastic filling material, a crown or partial crown.

Chipped molar tooth

To the molars one counts the premolars and the molars. These are, in contrast to the incisors, intended for crushing the food and can easily break.

Very large chewing forces act on the teeth when chewing, so that when biting on a hard candy or on a bone with a high probability of tooth breakage can occur. This is even more easily done if the teeth are root canal-treated or carious, because then their substance is weakened. Usually you do not see such changes due to the posterior position in the mouth itself.

With a broken molar, a quick visit to the dentist should be sought so that the existing fracture site is closed as quickly as possible. It may have sharp edges and be easily attacked by bacteria. Here, too, a break may not be visible, so you should be on the safe side to play it safe and seek professional medical advice. Frequently, something does not have to be broken off the tooth, but an older filling can be affected, which generally become more susceptible to breakage over time.

Chipped incisor

After a fall or trauma most of the incisors fractured due to the anatomical position. After an accident, it is advisable to consult a doctor or the hospital as soon as possible in order to be able to exclude or care for a craniocerebral trauma. If the craniocerebral trauma is excluded, the dentist should be consulted so that the further treatment of the incisor can be clarified.

If the tooth is not only fractured, but also loose, it must be splinted so that the separated fibers can regenerate and solidify the tooth. Depending on the size, the broken piece can be filled with plastic, with the pulp mark open, root canal treatment and a subsequent crown can be supplied.

Broken canine

If the canine breaks off, almost the same applies as for an incisor. After clarification of craniocerebral trauma, a dentist should be consulted quickly to treat the fractured tooth. Depending on the size of the defect, the lesion can be filled, root-filled when the pulp is opened, crowned over or, if a very deep defect is found, the tooth can be pulled.

Pain

Toothache usually results from nerve irritation or damage caused by mechanical injury or tooth decay.

A broken tooth does not necessarily cause any pain. In most cases, it is even the case that the affected patient does not experience any problems due to tooth-substance loss. In the case of a broken tooth that causes no pain, it is not always necessary to visit a dentist in a timely manner. However, it should be noted that there is an increased risk of caries formation along the breaklines.

This fact is due to the fact that the broken edges are usually not completely flat, but have depressions and for this reason there accumulate more food debris. As a result, a breeding ground for bacteria and other pathogens develops along the breaklines. Furthermore, it can be observed that a broken tooth reacts more sensitively to thermal stimuli (hot / cold) over time.

The immediate search for a dental emergency service is recommended only for a broken in the course of an accident (front) tooth. In some cases, a broken tooth can cause severe pain and / or bite problems.

This pain is usually the symptom of nerve irritation or damage. Pain on a tooth that has broken off can either be due to direct mechanical injury to the nerve or as a consequence of a carious defect near the fractured edge. Pain on a broken tooth is generally not permanently relieved without dental treatment. Painkillers such as acetaminophen or ibuprofen can usually only temporarily suppress the symptoms.

The method of first choice for a painful aborted tooth is the removal of the affected tooth root and the closing of the root canal by a suitable filling material.

What costs can arise?

The costs of providing a broken tooth are not always covered by the statutory health insurance. In many cases, the affected patient has to pay at least a partial amount of the dentist's bill himself.

For example, if the tooth is broken off during school sports, an accident report should be sent to the responsible insurance company. In such accidents, the school insurance companies are often required to pay.

Furthermore, the cost of treating a broken tooth depends on the extent of the necessary measures. If the tooth fragment merely has to be glued on, the costs are in the two-digit range. When opening the root cavity, however, an extensive root canal treatment with removal of the tooth root must be performed.

The costs of root canal treatment are borne by the statutory health insurance only if certain conditions are met.
These conditions are:

  • The tooth must be classified as worth preserving
  • The tooth is part of a complete row of teeth without gaps
  • The root canal treatment and the subsequent gluing of the tooth can be used to prevent the row of teeth from being shortened backwards
  • By the measure, an already existing dentures can be obtained

In general, the chances of reimbursement of this treatment for anterior teeth are much higher.
For patients who have healthy teeth without tooth loss, the costs are usually borne without any problems. Furthermore, the price of the treatment of a broken tooth, if the fragment can not be glued, depending on the type of care desired by the patient (crown, partial crown, etc.).

Teeth break during pregnancy

Painkillers, X-rays or anesthesia should be avoided during pregnancy in case of dental treatment.

If, for various reasons, a piece of the tooth breaks off during pregnancy, there is no need to panic.
As described above, the broken tooth should be properly lifted and a dentist should be consulted as soon as possible.
He will then treat the tooth, but to what extent depends on the individual situation.

Of course, there are certain things to consider in the treatment, such as the use of painkillers, anesthetic or the use of an X-ray machine. However, most of these obstacles can be avoided, so that nothing stands in the way of a treatment of the tooth.

The simple reincarnation of a broken piece of teeth is, among other things, no problem. Larger, predictable interventions, such as pulling a wisdom tooth, should, however, be carried out before or after pregnancy if there is no emergency situation.

It should not be forgotten, however, that when treating a broken tooth or the circumstances surrounding it, it can be very stressful for the mother and child, so care should be taken.

If the tooth is broken off by a fall or a more severe blow, it should be made sure that it was not there to other injuries or the unborn child could have been harmed.

When is a filling necessary?

A filling after a tooth fracture can have multiple causes. If caries is underlying the fragment, it must be removed by the dentist and the defect should be filled. If the tooth is fractured by mechanical damage, such as a fall or a blow, the lesion does not necessarily have to be replaced with plastic. If the lesion is minimal, the dentist can also smooth the edge and fluoridate the tooth, which is quite sufficient.

From a certain size of the fracture, however, this must be supplied with a filling. In the anterior region, a filling may also be necessary for aesthetic reasons, since the patient otherwise does not want to show himself in public.

When is a provisional necessary?

A temporary restoration is necessary if, after a fall or a trauma, the anterior teeth are damaged, so that the aesthetics must be restored. In these cases, a temporary restoration is made to temporarily restore the patient to legal capacity until the final restoration is completed.

Furthermore, a provisional is made when a fractured tooth is ground for a crown or inlay to protect it until completion, as it is more susceptible to thermal, mechanical and chemical irritation by the abraded enamel layer.

When is a crown necessary?

If a tooth breaks off, it may be possible that it can only be supplied by a crown. This variant occurs when a large part of the tooth is broken off, so that only 20- 25% of the tooth crown substance is preserved. If one tried to build this tooth with plastic, the chewing surface would consist of two-thirds of the filling material, which can not restore the chewing stability of the tooth. The tooth could no longer withstand the chewing load, as it does not get any stability from the plastic.

Thus, he would fracture again after a short time, because the defect is just too large to absorb the chewing force through plastic. It can happen that the tooth breaks down even more deeply or even the whole tooth crown fractures and the tooth is worse in the worst case no longer worth preserving. The caustics can only be given by the tooth is protected from the outside by a crown.

Furthermore, a crown is necessary after a tooth has received a completed root canal treatment. After the root canal treatment, the dead tooth becomes brittle and breaks off more easily because it is no longer supplied by vessels. To counteract this scenario or to protect the tooth after a crown fracture, it should be over-crowned quickly.

Tooth broken off at the child

Children enjoy romping around outside, playing with other children, and are less likely to appreciate potential dangers, which is why accidents often occur that affect their teeth. In most cases, the front incisors are affected.

In the situation in question, the affected should keep calm and look for the lost tooth, which can then be stored in a glass of milk or a special tooth box until shortly after a visit to the dentist. If the tooth is not equal, the oral cavity should then be screened to prevent ingestion or slippage into the trachea.

The tooth found should also not be disinfected or tried to clean clean, so as not to hurt the fine structures. If it is heavy, you can bite on a cloth and cool from the outside.

The faster the tooth can be re-used by the dentist (replanting), the higher the likelihood that it will grow again. Outside of a tooth rescue box, the chance of survival of the tooth is about 30 minutes. The cement-forming cementoblasts must survive to make successful insertion possible.

Should a tooth not be re-inserted and a gap created, the adjacent teeth will begin to wander and tilt to close this gap. This can lead to changes in the causal system with long lasting consequences. With mature teeth and permanent teeth then a suitable dentures is made and used.

If the tooth that has been knocked out is still a deciduous tooth, it will not be reimplanted again and the resulting gap will be provisionally treated, for example with a plastic tooth, until the development of the remaining teeth has been completed and a definitive restoration can be used. Alternatively, there are fixed or removable placeholders such as a brace, to which a tooth is fixed. Thus, the surrounded teeth do not tip into this gap and the space is preserved for the regrowing permanent tooth, so that there are no problems in the teeth later. In addition to chewing, this also ensures the development of correct language formation.

HELP...I Broke My Tooth (December 2019).


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