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Damaging the crown of a tooth (the part of the tooth that is visible above the gums) is the most common type of dental injury. The tooth may be broken or chipped. It is good to be prepared by knowing how such cases should be treated.

What is the first thing to do if my tooth is chipped or broken?
If fragments broke off the tooth, try to find and save them. They can probably be reattached to the tooth by bonding.

Does a chipped or broken tooth hurt?
The tooth may be sensitive to touch, hot and cold. Depending on the type of injury and how much of the tooth's inner surface is exposed, there may also be pain.

How long can I wait before getting treatment?
Get treatment right away, within 12 hours if possible. Teeth with crown fractures can be treated within 12 hours without affecting long-term outcomes.

What types of treatment may be used?
The treatment recommended depends on the tooth and the type and severity of the injury. Exposure of a tooth's inner pulp can be treated by a pulpotomy (partial pulp removal) technique. Front teeth can be temporarily restored with special cements, or the original tooth fragments may be reattached by bonding. Composite resin bonding may be used to restore the tooth's original appearance and function. Composites can be made in a wide range of tooth colors and can match the original tooth almost exactly.

Is treatment different if the damaged tooth is a primary (baby) tooth?
Chipped or broken primary teeth are generally treated similarly to permanent teeth. The treatment depends on the extent of the injury and damage to the tooth. Treatment of fractured primary teeth also depends on the proximity of the injured tooth to the permanent tooth beneath it, which will ultimately replace it. If a fractured primary tooth cannot be saved, it may be removed.

What if my tooth is loosened but not broken?
If the tooth is loosened but not cracked, broken or chipped, no dental treatment may be required. However, we will collect baseline clinical and x-ray information and keep an eye on the tooth or teeth in the future. We will need to check the tooth during recall visits to see whether the dental pulp is still living or whether it has died as a result of its injury. The latter condition can lead to a variety of problems and will require treatment.

Contact us today at 518-237-0019 to schedule an appointment to discuss your questions about repairing a chipped tooth. You can also learn more by reading the Dear Doctor magazine article “The Field-Side Guide to Dental Injuries.”

Most dental treatment has a cosmetic aspect to it since in the act of “restoring” teeth they are made to look better. The word “cosmetic” comes from roots meaning, “to adorn, dress and embellish.” Here are some terms and cosmetic dental techniques that could change your smile.

• The best and easiest way to remove stains on your teeth? Make an appointment to see a dental hygienist to remove unwanted stains from coffee, tea, red wine, that can discolor the outer surfaces of your teeth. Your teeth will look better and be healthier as a result.
• Dental office or home whitening? Dull, dingy and discolored teeth can be whitened with over-the-counter products at home, or professionally in our office. If you use the home method, be sure to follow the manufacturers' instructions carefully to make sure you don't overdo it. In our office we can use stronger bleaching solutions with special precautions to protect your gums and other tissues and achieve whiter teeth more quickly.
• Cosmetic change for back teeth? Tooth-colored composite resin filling materials are a relatively inexpensive way to replace tooth structure that has been damaged (by decay or otherwise) with non-metallic materials that bond to your natural teeth, match their color and make them stronger. (Sometimes metal restorations, like gold are advised for people who grind their teeth.)
• Cosmetic change for front teeth? Tooth-colored composite resin restorative filling materials — can be bonded directly to natural tooth structure becoming “one” with it. Used to replace tooth structure damaged by decay or injury such as chipped teeth, they are especially useful for front teeth in the smile zone. And they actually strengthen the teeth as well as providing highly cosmetic tooth restorations. In artistic hands nobody will know your teeth have been changed, except you and your dentist.
• Porcelain Veneers are thin layers of glass-like ceramic material that replaces the original tooth enamel. Veneering a tooth often involves some enamel reshaping or removal to accommodate the veneer. Veneers are bonded to the underlying tooth, but can be made brighter and whiter than your own enamel to cosmetically enhance your smile.
• Porcelain Crowns are similar to veneers in their cosmetic appearance but they cover the entire surface of a tooth, replacing tooth structure that has been damaged, lost or has become very discolored.
• Clear Aligners are a newer technique used in orthodontics (tooth movement) to move teeth into better position to enhance cosmetic change and improve biting function. A series of clear plastic trays is used to gradually move teeth to more attractive and functional positions.
• Dental Implants replace the roots of missing teeth. They are placed into the jawbone and become fused with it. Once implants have integrated with the bone, crowns are attached that look, function and feel just like stand alone natural teeth.

Contact us today at 518-237-0019 to make an appointment or to discuss your questions about cosmetic dentistry. You can also learn more by reading the Dear Doctor magazine article “Cosmetic Dentistry: A time for change.”

Nearly every parent and caregiver has experienced that almost instantaneous sick feeling when they see that their child has been injured, especially when it is an injury to the mouth and teeth. For some, it is just a bloody lip; however, if the accident chipped a tooth, then you may have a completely different situation on your hands. If the nerve of the tooth has not been damaged, you needn't worry too much — a composite (plastic) tooth-colored restoration that is actually bonded to the tooth is an ideal material for repairing most broken or chipped teeth. Call Dr. Marra as soon as possible at 518-237-0019 to assess the extent of injury, so that proper and appropriate action can be taken.

An additional reason why bonding with composite resin may be the ideal choice for repairing a child's chipped tooth is that it can be custom created in virtually any shade so that it perfectly matches the damaged tooth and the surrounding teeth. It is also far less expensive than a crown, an important factor to consider when repairing a primary (baby) tooth that will eventually fall out to make room for a permanent tooth. If the injury is to a permanent tooth, a composite resin still may be ideal to use as a restoration until your child or teenager has stopped growing or playing contact sports. This is because your teenager may be too young for a more permanent restoration such as a crown or porcelain veneer.

An important, proactive step you can take to be prepared for the next time your child has a dental injury is to download Dear Doctor's Field-side Pocket Guide for Dental Injuries. This handy, quick reference guide is a must have for athletes, parents, caregivers, teachers, coaches or anyone who is often in an environment where a mouth injury is likely to occur. Knowing what to do and how quickly you must respond can make the critical difference between saving and losing a tooth.