Dentistry Book


Tooth Fracture

Aka: Tooth Fracture, Fractured Teeth, Dental Fracture, Broken Tooth
  1. See Also
    1. Tooth Avulsion
    2. Tooth Luxation
    3. Dental Trauma
  2. Definitions
    1. Tooth Fracture
      1. Broken Tooth affecting any portion of tooth (root or crown)
  3. Symptoms
    1. Pain at affected tooth
  4. Types
    1. Root Fracture
      1. Difficult to diagnose without dental expertise and imaging
      2. Typically treated as Tooth Luxation
    2. Tooth splinter line or crack line
      1. Asymptomatic in most cases
      2. Amenable to cosmetic restoration
      3. Longterm risk of future affected tooth problems
    3. Crown Fracture
      1. Enamel Fracture (Ellis Type 1)
        1. Remaining tooth white or opaque
        2. Painless to air and water
        3. Amenable to cosmetic restoration
      2. Dentin extension (Ellis Type 2)
        1. Remaining tooth demonstrates brown or yellow coloration
        2. Sensitive to air and water, as well as hot and cold
        3. Apply Calcium hydroxide to the Fracture site
        4. Dental referral for permanent restoration
      3. Pulpal space extension (Ellis Type 3)
        1. Remaining tooth is pink, red or bleeding
        2. Rinse the tooth with saline to isolate the bleeding source (tooth vs Gingiva)
        3. Apply Calcium hydroxide to the Fracture site
        4. Treat with antibiotics (Penicillin VK) and NSAIDs
        5. Referral to dentist within 24 hours
          1. Root canal needed in some cases
  5. Management: General
    1. Keep tooth fragments hydrated
    2. See a dentist as soon as possible (typically within 24 hours, especially Ellis Type 3 pulpal space extensions)
  6. Management: Tooth Fracture Dressing
    1. Dressing may reduce pain and reduce infection risk
      1. However, dressing may not prevent pulp necrosis or infection
    2. Technique
      1. Moisten exposed dentin and pulp, while keeping remaining tooth dry
        1. Apply a damp gauze to surface
      2. Mix together dental cement (e.g. Calcium hydroxide)
        1. Combine 1-2 mm each of catalyst and base on a mixing pad
        2. Mix for 15 seconds until consistent color
        3. Alternatives: Light-Cured Composites are typically used by dentists
      3. Apply a thin layer (0.5 mm thick) onto exposed dentin and pulp surface
      4. Keep the region dry for at least 60 seconds
        1. Lip and Tongue held away from surface
        2. Local gauze roll can absorb Saliva
      5. Confirm cement hardened
        1. Light pressure to cement should not leave an indent
    3. References
      1. Warrington (2022) Crit Dec Emerg Med 36(5): 15
  7. References
    1. Broderick and Deak (2015) Crit Dec Emerg Med 29(1): 2-8
    2. Claudius, Behar and Trahini in Herbert (2015) EM:Rap 15(5): 5-7

Tooth Fractures (C0040441)

Definition (NCI) Broken tooth affecting any portion of tooth: root fracture, crown-root, broken tooth (crown fracture), chipped tooth. A crown fracture can involve the pulp. Tooth fracture sequelae range in severity from cosmetic defects to tooth death. Involvement of the pulp is a more important indicator of severity of tooth fracture than is the amount of the tooth affected.
Definition (MSH) Break or rupture of a tooth or tooth root.
Concepts Injury or Poisoning (T037)
MSH D014082
ICD10 S02.5
SnomedCT 157372007, 269353002, 36202009
English Fractures, Tooth, Fracture, Tooth, Tooth Fracture, Crack, Fracture of Tooth, Tooth Fractures, chipped tooth (symptom), chipped tooth, broken tooth, broken tooth (diagnosis), open wound of a tooth (broken), tooth fracture (physical finding), tooth fracture, Tooth Fractures [Disease/Finding], chip tooth, teeth broken, fracture tooth, tooth chipped, fractured tooth, tooth fractured, tooth fractures, broken teeth, Teeth broken, TOOTH FRACTURE, FRACTURE, TOOTH, Tooth fracture, Fracture of tooth, Broken teeth, Broken tooth, Chipped tooth, BT - Broken tooth, Fracture of tooth (disorder), Fractured tooth, broken; tooth, fracture; tooth, teeth; broken, tooth; fracture, fracture of tooth or teeth, Fracture;tooth/teeth
Italian Frattura dentaria, Dente scheggiato, Fratture del dente
Japanese 歯牙破折, シガハセツ, 欠け歯, カケハ
Swedish Tandfrakturer
Czech zuby - fraktury, Zlomenina zubu, Odštípnutý zub
Finnish Hammasmurtumat
German Zahnfraktur, Abgebrochener Zahn, Zahnabbruch, Zahnfrakturen
Korean 치아의 파절
Polish Złamania zęba
Hungarian Fogtörés, Letört fog
Dutch afgebroken tand, fractuur; tand, gebroken; tand, tanden; fractuur, tanden; gebroken, tandbreuk, Fracturen, tand-, Fractuur van tand, Fractuur, tand-, Tandfracturen, Tandfractuur
French Dent ébréchée, Fracture dentaire, Fractures de dents, Fractures dentaires, Fractures des dents
Portuguese Dente lascado, Fractura dentária, Fraturas dos Dentes
Spanish Diente astillado, fractura de diente (trastorno), fractura de diente, fractura de pieza dental, fractura dental, Fractura dental, Fracturas de los Dientes
Norwegian Tannfrakturer, Tannbrudd, Brudd i tann
Derived from the NIH UMLS (Unified Medical Language System)

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