A trip, a fall or a blow to the mouth can happen at any time, and can lead to the front teeth or tooth being damaged. This can be very distressing, as other than pain and loss of function, you are damaged cosmetically. This can lead to self-awareness and shyness, and affect you psychologically too.
Most breaks to the front teeth can often be repaired readily and easily, although this can be dependent upon the amount of damage.
Below is a short brief about a patient who attended recently (she has allowed us to use her pictures for the purpose of this blog). She attended the emergency dentist clinic following a fall the night before where she had broken her front right hand side central and lateral incisor. Due to the exposed dentine, the teeth were sensitive to cold, and other than the obvious cosmetic issues the injury were affecting her ability to eat and drink. X-rays were taken to confirm no physical movement or damage to the roots of the teeth.
Fortunately, the breaks (although close to the nerve) hadn’t physically exposed the pulp. We were able to place a lining material to help protect the nerve. Injuries that are close to the nerve (pulp) of the tooth, have a higher incidence of becoming infected or necrotic in the future, so regular monitoring of the health of the teeth is necessary to identify any issues at an early a stage as possible.
Time is of the essence as leaving breaks open can allow bacteria to enter the pulp through microscopic exposures.
We had a discussion with the patient and advised her that she will likely require crowns or veneers in the future, however, a medium term immediate solution would be to repair the teeth was composite filling repairs (composite bonding). This would successfully repair the breaks for now, address the cosmetic and functional issues caused by the injury and also “buy” some time to see what impact (if any) the injury has on the pulp of the teeth.
We were able to repair the teeth with composite bonding. Multiple shades were used to help achieve a more harmonious appearance. The breaks allowed us to help correct the position of the previously maligned right lateral incisor (it was previously pointing down and backwards).
Although we were able to achieve an immediate repair of the situation, better aesthetics can be achieved with porcelain restorations, and they tend to be stronger in the long run.