Tooth fracture

From one Tooth fracture one speaks when the tooth suffers a splintering or a break. This comes about through external influences, such as accidents during sports and leisure, but also through biting too hard. According to statistics, children and adolescents are more often affected than adults.

What is a tooth fracture?

From one Tooth fracture is usually spoken when the tooth breaks due to external influences. This mostly happens through accidents in leisure time or during sports, but also through blows to the jaw area and biting too hard - for example on a hard object.

With a tooth fracture, a distinction is made between different types of fracture: first of all, between the two types of tooth crown and tooth root fractures. With the former, a further distinction is made, namely between a pure fracture of the tooth enamel (called enamel-dentin fracture) or between an enamel-dentin fracture that exposes the nerve canal.

The latter type of fracture is considered to be one of the most painful tooth fractures, as the nerve is no longer adequately protected here and can be irritated and irritated.

causes

In the most common cases, the fracture of the tooth structure is caused by external factors. The best examples of this are accidents that happen during sports, while romping around (children and young people) or as a result of accidents with bicycles or cars.

The tooth fracture usually occurs when the substance of the tooth is so heavily stressed that it breaks due to a fall, an impact or a forceful impact on the jaw and tooth area (such as a blow). Of course, this can also happen by carelessly biting too hard. Common reasons for a Tooth fractureThat occurs when biting and chewing is a forceful bite on hard objects such as bones, shells of nuts and shellfish or hard fruit kernels.

Symptoms, ailments & signs

Problems caused by a tooth fracture manifest themselves depending on the location and course of the fracture. If the damage is under the gums, it will not be visible to outsiders for the time being. Superficial fractures do not initially cause any significant psychological stress.

Those affected may notice an overload-related stimulus when chewing solid food. In contrast, tears through the dentin cause considerable pain for patients. The underlying nerve canal is exposed through the fracture. Enamel cracks are symptomatic of normal and do not require therapy.

They reach to the surface of the dentin, where the damage usually stops. When the hump of the tooth is fractured, people develop a pronounced sensitivity to hot, sweet or cold foods. The gap runs through the enamel and dentin. In some cases, this even extends into the tooth pulp (tooth pulp).

Infractures only pass through tooth enamel and dentin and are considered difficult to diagnose. Sufferers experience considerable pain because of the opposing movement of the separated tooth sections while eating. The opening also offers germs from the oral cavity a convenient way of penetrating the inside of the tooth. As a consequence, there is a risk of inflammation of the nerve tissue and the tooth root.

In the long term, the tooth breaks due to mechanical stress. Without a crown or filling for stabilization, patients face complete tooth loss. Fragments of the loosened fragment in the gums provoke gum inflammation with associated bleeding. Root fractures often run through the entire tooth structure.

Longitudinal fractures of the root show a partial crack on the root canal wall, which grows steadily with permanent use of the injured tooth. Isolated root fractures are not necessarily associated with permanent symptoms immediately after their formation. Symptoms such as nerve pain or tooth dying can sometimes be delayed for up to several months.

Diagnosis & course

In most cases, the affected person notices the fracture of the tooth himself immediately. Often immediately after it has happened: for example, through a strong cracking, which the affected person can both hear and feel.

Often, in the first moment of the break, not only is the tooth itself stressed, but the surrounding gums are also irritated - for example by the strong pressure that is exerted on them. If only part of the tooth crown breaks away, most patients do not feel any pain at first, but are only irritated by the new shape of the tooth. However, this can have sharp edges, which is why you should always be careful if it breaks.

A tooth fracture can cut the tongue or the inside of the cheeks. If the nerve canal is affected, pain and hypersensitivity can occur. This is not the only reason why you should visit a dentist immediately if you have a tooth fracture.

Complications

A tooth fracture can result in the loss of the tooth. This can lead to further complications, especially in children and adolescents whose jaws have not yet fully grown. The premature loss of a tooth can then cause the misalignment of other teeth or a deformed jaw.

Complications can also result from injuries to the tooth itself, especially if these are also associated with lacerations on the face or lips. If the injuries are not treated on time or professionally, the risk of inflammation, swelling and abscesses increases. Inflammation can lead to severe damage and loss of not only the tooth, but also tissue surrounding the tooth such as alveolar bone and soft tissue.

In addition, such inflammations can spread and affect neighboring teeth, the gums or the oral mucosa. In the worst case, sepsis develops. Depending on the course of the injury, tetanus may also threaten if the patient has not been vaccinated against tetanus and the vaccination was not made up promptly.

In addition, tooth fractures are very often associated with injuries to the skull. If the patient falls on their head, there is a risk of concussion or more severe consequences such as a traumatic brain injury. In addition, if a front tooth is lost or damaged, patients often suffer very seriously from the aesthetic impairment, since a broken tooth is perceived as disfiguring. This is all the more true if the blemish cannot be remedied immediately, for example due to inflammation.

When should you go to the doctor?

If, after a fall, accident or violence in the area of ​​the face, a tooth splits off or a tooth is lost, a doctor's visit is necessary. Although there are no symptoms at the beginning, severe pain or other secondary illnesses can occur in the further course. In some cases, within a few hours, patients experience a state of unbearable pain. For this reason, a doctor should be consulted as soon as possible as soon as the first irregularities in the area of ​​the teeth appear.

A medical examination is necessary if the mouth has a bloody taste, swelling or impaired food intake. If abnormalities or inconsistencies can be noticed in the gums, it is also advisable to clarify the complaints. In some cases, splinters of the teeth got into the gums during the triggering event and can cause impairment there.

Over-sensitivity to various stimuli such as cold or heat is to be understood as a warning signal from the organism. If these changes occur suddenly, a doctor should be consulted. If there are any peculiarities when speaking, redness in the mouth or irregularities in existing dentures or braces, a doctor should be consulted. A doctor is also required in the event of headaches, swellings or deformities of the face and changes in the complexion of the face.

Treatment & Therapy

The dentist will first examine the fracture in detail and decide whether the nerve is affected and whether the tooth can be restored through reconstruction.

If possible, the dentist will try to restore the tooth with filling materials. Only if more than 70 percent of the tooth is destroyed or the tooth is split or broken down into the canal do you have to think about further reconstruction measures.

These could consist of a new and artificial tooth crown (denture), but in very unfavorable cases also include the fact that the broken tooth has to be removed. However, this is only very rarely the case - for example when the group is very difficult and cannot be dealt with.

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prevention

One Tooth fracture One can prevent it to a limited extent by trying to keep the tooth substance strong - through appropriate preventive measures at the dentist and through toothpastes and more, which strengthen the tooth substance. When doing risky sports you should also wear mouth and mouth protection. However, a tooth fracture cannot always be avoided. It is therefore important that you - if you have one - see a dentist as soon as possible.

Aftercare

Follow-up care for a tooth fracture is closely related to its cause. It makes a difference whether it is an external event such as a sports accident or a behavior-related fracture caused by chronic teeth grinding. If the cause is due to the patient's behavior, this must be resolved. Teeth grinding can be positively influenced by bite splints or psychotherapy.

In addition, aftercare also depends on the type of treatment by the dentist. Implants in particular must not be fully loaded during the healing phase. This can be achieved through softer food or the tendency to prefer to chew on the other side of the teeth. The duration of the healing phase is determined by the dentist.

Cooperation from the patient is essential here, also with regard to a check-up in the dental practice. If dentures are necessary after a tooth fracture, consistent oral hygiene is necessary. This is especially true after an implant has been inserted in order to avoid peri-implantitis, the bacterial inflammation around the implantation site.

In this context, professional tooth cleaning removes hard and soft plaque and also reaches places that the toothbrush can hardly reach. The dentist also offers special implant cleaning. After the tooth fracture, the patient can also achieve relief for the affected tooth by breaking up food into bite-sized pieces.

You can do that yourself

In the case of a tooth fracture, the possibilities for self-help are not aimed at changing the appearance of the teeth. This can only be improved by a doctor. It should be checked whether the causes of the tooth fracture can be changed. For example, the exercise of sports can be reduced that lead to violence in the facial area. The wearing of protective clothing should alternatively be optimized. This way the risk of further fractures is minimized.

At the same time, you should check your own behavior in everyday life. If the tooth fracture occurred as a result of an interpersonal physical conflict, your own behavior and reaction patterns should be changed. In this way, future provocations with possible violence can also be reduced to a minimum.

Daily dental care is an essential part of self-help. Daily teeth cleaning and cleaning of the interdental spaces have a significant influence on the oral flora. This prevents damage to the enamel and teeth.

When eating, it must be ensured that the food is adapted to the possibilities of the organism. Food that is too large or too solid can damage teeth. Wearing jewelry in the mouth area should also be avoided. The materials of rings or studs in the cheek or tongue can lead to irreversible problems with the teeth and cause fractures.