This is the third article in a series that we have prepared about First Aid for Dental Injuries. Previous articles discussed how to manage a tooth that has been ‘avulsed’ (completely knocked out) and a tooth that has been partially dislodged. You can read those articles by clicking on the links above.
In this article we will explain the first aid protocols for a tooth that has been broken, fractured, chipped or cracked following trauma to the mouth.
As always, we recommend that everything is done to prevent this type of injury. For example, during sports games and at training, the best protection is offered by the wearing of a well-fitted mouthguard. You can read more about mouthguards here.
About Broken Teeth
Injuries that result in broken teeth occur fairly commonly especially during childhood, and, incidentally, more often in boys than girls. Teeth are more likely to break if they are hit directly by a hard object such as a cricket bat or an elbow.
The extent of the injuries will be determined by the force and direction of impact. Teeth can be broken horizontally or obliquely (diagonally). The break can occur in any part of the tooth, from the tip of the crown right down to the root (under the gumline). If the root has been broken, this generally isn’t apparent until an x-ray is taken by the dentist. Because of the very real risk of root fracture, any tooth that has sustained a blow should be seen by a dentist as soon as possible.
Sometimes the break runs through the dentine (the hard structure below the outer enamel layer). In this case, the tooth is likely to become sensitive to cold, hot and sweet foods and beverages. The dentist will likely need to cover the dentine with a filling in order to stop the sensitivity and restore the natural shape of the tooth.
If the break exposes the pulp (nerve) of the tooth, bacterial contamination of the pulp will occur. This puts the pulp at risk of becoming inflamed or of dying (becoming “necrotic”). This scenario requires urgent management to improve the chances of full recovery.
Even if the pulp has not been exposed, a tooth that has been traumatically injured can develop internal injuries. As a result, the pulp can become inflamed or die (become necrotic). Root canal therapy may be required in such situations (for more information on root canal therapy, please click here). Pulp necrosis can occur many years after the initial injury, hence long-term, regular follow-up of traumatic injuries is important.
No matter what type of fracture has occurred, the patient should be seen by a dentist as soon as possible to increase the likelihood of successful recovery.
First Aid For A Broken Tooth
The first thing to do is to remain very calm and to encourage the injured to do the same. Check for other injuries, including concussion, and recognise that management of concussion should always take priority.
If you can find the broken pieces of tooth, please bring them with you to the dentist. Sometimes the dentist is able to reattach a fragment of broken tooth. Unlike the situation where a tooth has been knocked out of the mouth, the fragments can be transported wet or dry although it is preferably transported moist.
The wounded area should be cleaned as soon as possible. This can be achieved through a gentle rinse of warm water or saline. Cold liquid still works, but may irritate the tooth if the dentine or pulp have been exposed in the injury. This may cause the patient some distress.
It can be helpful to place a cold compress in the area while the patient is being transported to the dentist. This can reduce any swelling associated with soft tissue injury.
Download Our Dental First Aid Guide Here
We have developed a handy first aid guide for parents, coaches and all adults likely to be first on the scene of a dental injury. Please feel free to download and share!
If you have any questions about the management of a dental injury, please feel free to contact us on 03 5298 1020.