Trauma and Chipped Teeth
Sometimes teeth will chip after sustaining little bumps such as on drinking from a bottle, or when someone accidentally bites down on their fork or a hard piece of food. Teeth can also chip from repetetive habits like biting one's nails, tearing open plastic bags with their teeth or chewing on pens with their teeth. These events may cause small chips in the enamel, and sometimes deeper crack lines can radiate out from these initial small chips. It is wise to have these chips checked and either polished out, or the tooth repaired, as this is less likely to lead to the chip progressing into a bigger crack and eventually causing a fractured tooth.
Unfortunately, teeth can also break more significantly as a result of trauma. Whether it is through a bump during sports, an accident around the swimming pool, trampoline or on a bike, or sadly, through an assault, teeth that have sustained a major knock and have fractured, will usually require more significant restoration. It is also important that traumatised teeth are checked and then monitored to ensure that their pulps (nerves) do not subsequently die.
This young boy had an accident in the swimming pool and he hit both of his incisors on the coping tiles. Both teeth fractured but fortunately, neither of the fractures reached the pulps (nerves) of the teeth. The two central incisors were then restored with carefully placed, multi-layered composite resins.
This young boy fell off his skateboard and struck his chin on landing. This caused his teeth to hit hard together and the lower incisor fractured. He was very fortunate that the fracture did not quite reach the pulp (nerve) of the tooth and so we were able to bond a composite resin to replace the fractured part of his tooth. He was then reviewed over the next 12 months to ensure the pulp stayed alive and did not perish subsequent to the trauma.
Case 1 - Fractured Upper Incisors
This photo shows the boy as he presented with half of his left central incisor fractured off, and the corner of his right incisor also missing.
The extent of the injury
This close-up photo shows the fractured teeth and the fine cracks radiating out into the remaining tooth structure. It is important that these cracks are covered and sealed in order to try to prevent their spread in the future.
A model to guide the process
When a larger amount of tooth has fractured, we may take an impression of the teeth and make a plaster model. The missing parts of the teeth are then replaced on the model in wax. A silicone matrix is made from the model and this silicone matrix is then used to help fabricate the final composite restorations in the mouth.
After Treatment and Polish
The composite restorations were made with multiple layers and shades to simulate the adjacent natural tooth structure. After shaping and polishing, the final restorations blended seamlessly into the teeth, recreating the original appearance and function of the teeth.
Case 2 - Lower Incisor
A damaged smile
People sometimes ignore chipped edges on lower incisors, but as this photo demonstrates, they still show upon smiling.
The lost tooth structure also meant that the deeper dentine layer was exposed. This little boy was experiencing a lot of cold sensitivity each time he tried to eat or drink anything.
Restored incisal edge
A carefully bonded composite restoration was used to replace the missing enamel and restore the incisal edge.
The renewed smile
The boy and his parents were all much happier once the tooth was restored and his smile was returned to normal.