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Posts for: March, 2015

Our adult patient asks: "What kind of treatment is needed when the crown of a tooth fractures?"

Did you know that there are many different types of tooth fractures?

One of the most common types of fractures is a fracture in which part of the crown has been broken off. This is most often caused by some type of trauma. It can also occur in teeth that have been weakened by untreated decay.

The most favorable type of crown fracture is one in which the missing piece of tooth exposes only the enamel (outermost layer of the tooth) and the dentin (layer under the enamel). The other important feature is that the root is completely formed in an adult tooth. If the missing piece of tooth is not close to the pulp (the innermost part of the tooth; containing the nerve, blood vessels, and other living cells), then usually a filling will be all that is needed to solve the problem.

But, if the pulp is exposed, or nearly exposed, from the fracture, a toothache may occur, or the pulp tissue inside may die. In either of these cases, a root canal treatment will likely be needed.

Sometimes the pulp tissue inside the tooth dies over a long period of time after the original trauma occurred. It  can be painless. A change in color of the crown of the tooth is often an indication that the pulp is dead. Your endodontist wil generally test the tooth to see if it is alive. If not, a root canal treatment is usually needed.

A different kind of procedure may be needed when the crown is fractured (exposing the enamel and dentin) down onto the root surface, below the gum level. Depending on how deep the fracture has penetrated, somtimes a procedure called "crown lenthening" can be done to help salvage the tooth. This procedure is done by our periodontist. The procedure effectively lowers the gum and bone to expose more tooth structure, so that the tooth can be treated wtih a root canal and ultimately restored by your general dentist.


More about fractured teeth next month!