Teeth

Tooth Fracture

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Tooth Fracture, Fractured Teeth

  • Definition
  1. Broken tooth affecting any portion of tooth (root or crown)
  • Symptoms
  1. Pain at affected tooth
  • 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
  • Management
  1. Keep tooth fragments hydrated
  2. See a dentist as soon as possible (typically within 24 hours, especially Ellis Type 3 pulpal space extensions)
  • 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