By: Dr. Elizabeth Eggert
How did this start?
Caleb was on spring break in Florida, vacationing with his family at the beach and playing in the sand with his sister. He accidently fell on a metal shovel on the beach and chipped his front tooth. His mom called from Florida to let Eggert Family Dentistry know what had occurred and asked how she should proceed. It was recommended that she send a picture of the tooth and keep the fragment in water so that we would have a better idea of the extent of the fracture. Caleb was still out of town for a few days, but was seen at the office when he returned. Unfortunately, Caleb was ill with a severe cough right after coming home, so it was over 2 weeks before he was able to see Dr. Jeff Eggert to attempt to reattach the fragment.
What was recommended?
Tooth trauma, also known as dental trauma, refers to injuries to the teeth, gums, and surrounding soft tissues of the mouth. These injuries can range from minor chips or cracks to more severe issues like tooth displacement or jaw fractures. Common causes include accidents, sports injuries, falls, and even biting down on hard objects. Symptoms can include pain, bleeding, swelling, and a change in how teeth fit together. Treatment depends on the type and severity of the injury, and may involve repositioning the tooth, root canal treatment, or other procedures.
Upon examination, Dr. Jeff reviewed some signs and symptoms with Caleb and his parents and did some tests to verify the status of the tooth’s nerve. Luckily, the tooth was still responding as vital, which means that the nerve was trying to heal after the injury. Teeth undergoing trauma like Caleb’s are at high risk for nerve necrosis (dying) and abscess (infection). It was decided to repair the tooth with composite filling material to build back what had broken since Caleb’s tooth fragment had now been out of his mouth a few weeks and the fragment available couldn’t replace all of what was missing.
Caleb was only 11 years old at the time of the trauma to his front tooth. When considering repairing a fractured front tooth, the appropriate treatment options and considerations can vary depending on a person’s age. Preserving the natural tooth structure, including the tooth’s pulp for as long as possible is very important for the longevity of the tooth and surrounding tissues. Even though Caleb’s tooth nerve was testing vital, things can change overtime.
After a trauma like this, it is important to follow the tooth over time. Depending on the injury it is typical to reevaluate the tooth over a period of weeks, then months, then years to make sure that complications aren’t developing.
What else was involved?
Caleb’s tooth did very well for about 10 months and then his parents called reporting that he was having intense pain, sensitivity and swelling with the tooth. We saw him for another exam and unfortunately, the tooth was showing signs of a tooth abscess. Caleb saw the root canal specialist for a root canal as they were able to get him in for an appointment faster for that procedure, in fact, they were able to see him the very same day!
Caleb’s tooth has been stable and he now is in braces to help correct his bite. This will help keep his tooth better protected from forces for the long-haul.
What does he think?
It has been over 2 years since Caleb’s accident and his tooth is still doing well. The bonded composite filling has stayed in place and looks very natural. Because of how large the fracture was it is likely that the tooth will eventually benefit from a crown, but while the repair is holding up, Caleb will keep the filling.
Caleb and his parents were very appreciative of how quickly he was taken care of and monitored throughout the process. Caleb said “I thought it was kind of cool, how they just fill my mouth with filler stuff and then make it tooth sized.” He says he feels the same as before his tooth fractured and thinks “you can’t even notice it!” We look forward to seeing Caleb’s magnificent smile and his family as well for many years to come!
At Eggert Family Dentistry we have had many patients over the years that we have been able to help with dental trauma. Here are some additional examples of what trauma can look like:
