Tag Archives: Chipped tooth

Tooth Trauma (Part IV of IV)

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When a front tooth has been chipped, there are a few options on restoring the tooth. If the chip is small enough, the area can be repaired by bonding tooth colored filling material to the enamel. I have many cases where that repair has lasted over ten plus years.

Porcelain Crown

Large defects are better repaired by covering with a porcelain crown. The porcelain is extremely durable and color-stable and can last decades. With children, when a majority of these injuries occur, it is better to do a tooth colored filling, even with large fractures. The main reason is that at least a millimeter and a half of tooth enamel needs to be removed from the tooth in order to get a good cosmetic result and in a child, the nerve in the center of the tooth is extremely large. Taking 1.5 mm of enamel in a patient of that age group can be enough to either expose the nerve or injure it enough that root canal treatment would be needed later on. Also, in a child, the tooth continues to erupt out of the gums, so as the child matures, the edge of the crown can become exposed which can be very unsightly. When a tooth colored filling is done to repair a fracture, it is expected that it will have to be repaired or redone many times during the patient’s lifetime.

Tooth Trauma (Part III of IV)

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If a tooth has been displaced in a traumatic accident, as long as the x-ray doesn’t show any root fractures, then the dentist can usually move the tooth back into its original position. Then, the tooth is usually splinted to the adjacent teeth during the healing period. This is done by attaching a wire to the front teeth with composite. Composite is the tooth colored filling material routinely used to fill cavities.
When one of the teeth has been chipped, the primary focus tends to be on that tooth. However, in a traumatic injury to the mouth, it is not unusual to have multiple teeth having been injured. When a tooth fractures, then, the force of the blow is dissipated. Unfortunately, the intact teeth will transmit all of the energy of the insult directly onto the end of the root. The problem with this is that the end of the root is where the nerves and blood vessels enter the tooth. If the force is great enough, then the nerve and blood vessels can be severed. This will cause the nerve to die and will necessitate root canal treatment to save the tooth. It’s hard for a dentist to tell right away whether a traumatically injured tooth may need root canal treatment. Many times, it takes up to six months before a dead nerve can be detected, and there are times that the damage will show up decades after the initial injury.

Repairing Chipped Teeth

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Bonding To Repair a Broken Tooth

Before

A chipped front tooth can be a very unsettling thing for a person of any age.  Before the bonding era, the tooth would have to be whittled and a crown (cap) placed.  Now, front teeth can be restored to the point where the repair is virtually imperceptible.  The tooth is first cleaned up and any rough edges are smoothed.  A long bevel is prepared on the enamel surface to increase the amount of enamel that is available for bonding.  Then, an acid solution is applied to the surfaces.  After rinsing, thousands of microscopic crevasses are present.  Although they are very tiny, these areas allow for a liquid plastic to be flowed into these crevasses then hardened with an intense light source.  This alone is adequate to retain the repair in place for a number of years.

Bonding To Repair a Broken Tooth After

Dr. Gangwisch Repaired This Tooth With Bonding

 A composite (tooth-colored filling material) is then color matched with the remaining tooth.  It is built up in multi-colored increments in order to mimic nature.  Each layer is light hardened, then it’s time to contour and polish the restoration.  The resulting filling looks great when it is finished.  With proper care, this repair can last five to ten-plus years.  Since it is not as durable as porcelain, one must be careful not to bite on hard things with it.  The tooth may eventually require a crown, but repairing a chipped front tooth with a bonded filling can be a conservative, less-expensive alternative.