Is a Broken Tooth an Emergency?
A dental trauma due to a shock is an injury to one or more teeth: bruised, cracked, broken or dislocated tooth(s). It could be a dental emergency (that could lead to an extraction if not addressed). Certain precautions make it possible to limit the risk of dental trauma, in adults as in children.
What is dental trauma?
A dental trauma is a lesion of one or more teeth, caused by a shock. Dental trauma most often affects the most exposed "front teeth" (incisors and upper canines in particular). Premolars and molars are more rarely affected. Indeed, they are better protected because they are located at the back of the mouth.
In addition, during a dental trauma, lesions can affect other parts of the mouth:
- the supporting elements of the tooth: bones and gums;
- oral mucous membranes: lips, cheeks;
- language and speaking.
Dental trauma particularly affects children and adolescents.
Nearly 30% of Americans will have suffered this type of accident before their sixteenth birthday. Young people are concerned for different reasons at two periods of life. The lack of coordination of movements and protective reflexes favors shocks against the edge of furniture or against hard or angular objects. When learning to walk, there are many falls. Traffic accidents are also commonly involved in tooth trauma and emergencies.
Dental trauma is common and has various causes:
- cycling, rollerblading or scootering,
- the games and blows exchanged during recreation,
- certain sports (team or contact sports),
- traffic accidents,
- fights, especially in adolescence
What are the lesions of the teeth after a dental trauma?
Depending on the nature of the trauma, the tooth is not affected in the same way.
Contusion
The contusion is the least violent trauma because it causes a simple shaking of the tooth, without apparent lesion, nor mobility of the tooth. However, this can be painful due to mild inflammation of the supporting tissues of the tooth, which usually heals in a few days.
However, the tooth must be monitored because following the shock a reaction can occur in the dental pulp in the days or weeks following the trauma. The tooth can lose its vitality, it changes color, turning gray and no longer reacts to thermal tests.
A crack in the dental crown corresponds to a crack in the enamel, without loss of dental tissue. It is difficult to visualize and locate. Generally imperceptible on radiography, it is sometimes accompanied by a slight sensitivity to cold. It can be manifested by a sharp pain, of short duration and inconstant occurring during chewing, more particularly during the release of the occlusal pressure.
Cracks can also affect the roots of the teeth. This type of crack, appearing in most cases on depulped teeth, is often discovered when a periodontal (gum) abscess appears.
The crown fracture
This fracture may only concern the dental crown (visible part of the tooth). It causes the loss of a piece of tooth of variable size depending on the nature of the shock: the tooth is broken.
This trauma can cause pain when exposed to cold or heat, and/or during chewing. The closer the fracture is to the pulp, the more intense the pain. When the pulp itself is exposed to the air, a small red dot in the middle of the tooth can be noticed with the naked eye. Any coronary fracture, whatever its level, can lead to a more or less short-term loss of pulp vitality.
Root fracture
Fractures of the roots of the tooth most often occur on the occasion of an impact at the level of the face. They can be:
- associated with a fracture of the tissue around the tooth,
- accompanied by trauma to adjacent or opposing teeth.
Root fractures are visible on X-rays, which locate the fracture line on the root. Depending on the level of the fracture, the coronal part of the tooth is more or less mobile. Root fractures can also be consecutive to crown cracks and extend over the entire length of the tooth. This type of fracture causes dull, permanent pain and results in mobility of the fractured tooth fragments.
Tooth trauma: what to do?
Depending on the dental trauma, it may be necessary to contact the emergency services or consult a dental surgeon as soon as possible. Gestures are essential before the consultation.
You should call emergency medical services:
- if the dental trauma was caused by a violent blow to the head;
- if the dental trauma occurs during a serious accident such as a traffic accident for example;
- if the victim has lost consciousness;
- if the victim vomited.