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Therapy Why a Periodontist? Fractured Teeth

Teeth are remarkably strong, but they can chip, fracture or break. Teeth usually break as a result of trauma from biting down on something hard, for example, or from an injury to the face. Cavities that have weakened the tooth also can cause chipping or fractures.

When a tooth cracks or fractures, it may or may not hurt. You may not notice the damage immediately. Minor tooth fractures are unlikely to cause symptoms. Deeper fractures can be painful because the damage may extend to the nerve inside the tooth. Pain from fractures may be constant or may come and go. Many people feel pain when they chew because as they chew they apply pressure to the tooth. As the fractured tooth bites down on the food, the crack in the tooth gets wider, but once the pressure is released, the crack closes again.

Larger fractures may cause a portion of the tooth to break off.

What You Can Do
There is no way to treat fractured teeth at home. You need to see your dentist whenever a tooth is sensitive to changes in temperature or if it hurts while you're eating. Pain that's constant is a serious warning sign because it may mean that a fracture has damaged the nerve and live tissues inside the tooth.

In the meantime:
Save the pieces. If the break was relatively clean, your dentist may be able to cement the tooth back together as a temporary measure.
Rinse your mouth well with warm water. If you were able to save the tooth fragment(s), rinse them under running water.
If an area is bleeding, apply a piece of gauze to the area for about 10 minutes or until the bleeding stops.
Apply a cold compress to the cheek or lips over the broken tooth. This will help reduce swelling and relieve pain.
If you can't get to your dentist right away, cover the broken surface of the tooth that is in your mouth with temporary dental cement, available in pharmacies.
Take an over-the-counter pain reliever.

There are many possible treatments for broken teeth, depending on the severity of the break.

A more serious break will involve the enamel as well as the inner layer of the tooth (the dentin). In some cases, the damage can be repaired with a filling, but often the tooth will need a crown.

The most serious breaks are those that damage the nerve. In addition to making and placing a crown, your dentist probably will need to do root canal treatment to remove the damaged nerve and blood vessels.

Some fractures will require periodontal surgery (crown lengthening) before a crown can be placed. If the fracture is below the gum line, close to, or below the bone holding the tooth in the jaw, periodontal surgery is necessary to remove some bone to create enough room to place the crown over the root properly. If the tooth has a split root, it is often painful because the tissues surrounding the root may be inflamed or infected. In most cases, the tooth will have to be removed.
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