Tooth Trauma (Part IV of IV)

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.

Teeth Grinding

Worn Teeth From Night Grinding

Damage Due To Night Grinding

Damage Restored With Beautiful Porcelain Crowns

Damage Restored With Beautiful Porcelain Crowns






Teeth grinding is a very common problem. It’s not unusual for someone to not be aware that they are even doing it. It is more common at night since during the day, most people can catch themselves in the act. Stress is the most common reason for grinding. While sleeping (called nocturnal bruxism), it becomes an outlet for the normal stresses involved in everyday life. Another cause can be an uneven bite and the body’s reaction to try to even it out by subconsciously gnashing the teeth together in an attempt to even everything out.

Untreated teeth grinding can cause pain in the jaw joint (temperomandibular joint) and the surrounding muscles. It can also lead to premature extreme tooth wear necessitating major dental reconstruction.
To counter the problem, if the grinding is present during the daytime, I tell my patients to try to catch themselves doing it. If they find that they are clenching, then they should have “lips together, teeth apart”. This has been very successful for many of my patients. However, most of the grinding problems occur at night. In that case, it is best to build a nightguard, a plastic mouthpiece, to help prevent any further damage from occurring.