Perhaps you got a chipped tooth while eating a hard food item or playing a sports game. A little tender and somewhat mobile chipped tooth surely affects your smile. But can it be repaired and can its function be restored?
What causes teeth to start chipping?
A chipped tooth is a result of a tooth fracture. Tooth fractures should be treated immediately so the tooth can restore its function. Most tooth fractures are in the upper jaw and front teeth, i.e., central incisors, lateral incisors, and canine teeth.
Tooth fractures are commonly caused due to oral trauma in sports injuries, accidents, and sometimes physical violence. As such, tooth fractures are more common in children than adults. However, permanent teeth are chipped more commonly than milk teeth. Males are more commonly affected as compared to females.
In road traffic accidents, dental injuries from airbag explosions were quite common. Another common type of traffic accident was bicycle accidents among school children. Among sports activities, American football, hockey, ice hockey, lacrosse, martial sports, rugby, and skating are high-risk activities, while basketball, team handball, diving, squash, gymnastics, parachuting, and water polo are considered medium-risk sports.
Tongue or lip piercings lead to traumatic dental injuries, and about 19% of people with tongue piercings have experienced chipped teeth. Another reason for dental injuries that is not widely discussed is domestic abuse or child abuse. Sometimes it is the dentist who suspects child abuse, but in a survey study, only approximately 9% of dentists reported child abuse.
Occasionally, a tooth may get chipped during certain emergency medical procedures. For instance, intubation is a medical process in which a healthcare professional puts a tube through a patient’s mouth or nose to maintain the airway for breathing. In previous literature, few cases of chipped teeth after intubation have been reported. In such cases, a chipped tooth can be treated later after the patient stabilizes.
Types of dental trauma
The World Health Organization has provided a classification of traumatic dental injury. These injuries are usually associated with a chipped tooth.
- Injuries to the hard dental tissues and the pulp
- Injuries to the periodontal tissues
- Injuries to supporting bone
- Injuries to gingiva or oral mucosa
These categories have several subtypes: enamel fracture, complicated crown fracture, and intrusive luxation.
Treatment of chipped tooth
Treatment of dental trauma can be complicated, and the prognosis may be uncertain. For a dentist, treating trauma may not be a routine procedure. It requires training for precise diagnosis, emergency management facilities, and a patient’s willingness to follow up for a successful outcome.
Although an x-ray may be done for diagnostic purposes, some cracks may not be visible in the image. Dentists must do a thorough visual and oral exam using a microscope that magnifies up to 8 times and shadow-free light.
Multiple dentistry specialists may be needed to treat chipped teeth associated with conditions such as luxation. Hence the number of visits for treating chipped teeth may range from one to nine.
The treatment of chipped teeth can be expensive. This often causes avoidance or delay in the treatment. But chipped teeth can have a negative psychosocial impact on the patient. It affects the facial appearance of the patient. Hence, starting the treatment as early as possible is usually recommended.
Furthermore, complications such as a crown, fistula, or periodontitis discoloration can occur. In crown fractures, harmful oral bacteria may enter the wound and cause infection. As a result, inner structures such as dental pulp may become inflamed and later may cause necrosis of tissue around the tooth.
Treatment of dental fractures usually starts with the management of associated symptoms. For example, getting control over bleeding if there is bleeding. A cold compress may be necessary to manage swelling and pain. Analgesic drugs may also be prescribed for managing pain.
Several treatment options are possible depending on the diagnosis of a chipped tooth. For instance, no further treatment may be necessary for the enamel craze line fracture. Dentists may suggest monitoring the fracture and periodic routine check-ups. A dentist may polish the tooth or place a direct restoration in case of a cuspal fracture.
If the extent of tooth fracture is more involved, then a crown may be placed on the tooth structure, or endodontic treatments may be necessary. In some cases, when multiple teeth are involved, a denture may become necessary. Whereas in certain extreme cases, tooth extraction may be necessary.
Any other associated conditions such as inflammation or jaw fracture may be treated as necessary. In the case of primary teeth, a chipped tooth is treated promptly so that the eruption of permanent teeth can be a smooth process. If patients have oral piercings, then they are educated to maintain oral hygiene and reduce dental fractures.
A chipped tooth is a result of a tooth fracture. Tooth fractures should be treated immediately so the tooth can restore its function.
A chipped tooth is not desirable from a cosmetic point of view and a psychosocial point of view. But more importantly, it can negatively impact overall oral health.
Consult your dentist soon if you have a chipped tooth. With timely and complete treatment, the prognosis for the chipped tooth can be improved.
- J. S. Mamoun, and D. Napoletano, 'Cracked Tooth Diagnosis and Treatment: An Alternative Paradigm', Eur J Dent, 9 (2015), 293-303.
- A. K. Patnana, and T. Kanchan, 'Tooth Fracture', in Statpearls (Treasure Island (FL): 2022).
- V. Zaleckiene, V. Peciuliene, V. Brukiene, and S. Drukteinis, 'Traumatic Dental Injuries: Etiology, Prevalence and Possible Outcomes', Stomatologija, 16 (2014), 7-14.