Published by Bupa's Health Information Team, May 2011.
This factsheet is for people who have dental injuries, or who would like information about them.
A dental injury is usually caused by a blow to the face or mouth that results in one or more teeth being damaged or knocked out. This factsheet explains how to treat and prevent the most common dental injuries.
There are a number of ways you can get a dental injury, including chipping or breaking (fracturing) your tooth. Having a dental injury can also cause your tooth to come out of its socket (dental avulsion).
Any number of things can cause a dental injury. For example, you may have a fall, get hit in the face or be in a road traffic accident. Sometimes even eating something very hard can break your tooth, particularly if it’s been weakened by tooth decay.
While most dental injuries are accidental, there are some factors that make these accidents more likely to happen. Some of the most common are listed below.
If you have a dental injury, or someone you know has one, it's important to get the right help.
For example, if the accident causes you or someone you know to be knocked out (lose consciousness), or if there is a lot of bleeding, it's important to call for emergency help. Otherwise, you should contact a dentist straight away. If it's outside usual opening hours, go straight to the accident and emergency department at the nearest hospital.
Try to do the following if your tooth has been knocked out.
Even if you don't think your tooth is broken, it's still important to see your dentist as soon as possible. There may be an injury below the gum line that you can't see.
When you see a dentist, he or she will look inside your mouth to see if your tooth has been re-implanted properly. If not, your dentist will try to re-implant it as soon as possible. However, this may not always be appropriate - ask your dentist for information.
You will need to have your tooth splinted (joined to your neighbouring teeth) to hold it in place as it heals. There are different types of splint; the most common is made of clear plastic. Another type is a thin piece of wire, which attaches your loose tooth to those on either side of it. If you handled your tooth carefully and re-implanted it quickly, you will need to keep this on for one to two weeks. If your injury was more severe and caused root damage, you may need to wear the splint for several weeks.
Your dentist may take some X-rays to see how serious your injury is and if there are any pieces of broken tooth stuck in your lip, gum or tongue. If you think you have inhaled a piece of tooth, your dentist may refer you to hospital for a chest X-ray.
Treatment for a chipped tooth will depend on where your tooth has broken. Teeth have a core of blood vessels and nerves at their centre called the pulp. If your tooth is injured, the pulp can be damaged and the blood vessels may die.
If a piece of your tooth has chipped off but the pulp isn't damaged, your dentist will smooth the uneven edge and replace the corner with a tooth-coloured filling. If the pulp is damaged, you may need to have root canal treatment to remove the damaged blood vessels and nerves from your tooth.
Your dentist may also check your mouth to see if the chipped tooth has caused any further damage to your mouth. You may need to have an X-ray to check that a piece of your tooth isn’t embedded in your lip, for example.
Your teeth have roots that are set in your jawbones. If a root fractures, it's possible that your tooth won't look any different because the fracture is hidden by bone and gum. However, your dentist may be able to see a fractured root on X-ray images.
If your tooth is quite firm, your dentist may just ask you to come back for regular X-rays and tests to make sure that the pulp stays healthy. However, if your tooth is wobbly, it will need to be splinted for a few weeks to help the fracture heal.
If your dentist finds that the pulp has been damaged and isn't going to recover in the weeks and months after the root fracture, he or she may recommend that you have root canal treatment to save the tooth.
Some fractures are unlikely to heal, particularly if they are near the gum or the tooth has broken lengthways. Your dentist may recommend that you have your tooth taken out.
If at any stage you feel pain or notice any change in colour to your damaged tooth, it's important to visit your dentist as the pulp can die a long time after a dental injury. If you have had your tooth re-implanted, continue to get it checked as you may need treatment in the future.
Young children who injure their milk teeth may need different treatment to that given to adults or teenagers. For example, if a milk tooth gets knocked out, the dentist is unlikely to try to re-implant it. This is because it could damage the permanent tooth when it develops. Occasionally, an injury to a milk tooth can cause damage to the developing adult tooth. This will be monitored at check-ups.
If you regularly play a sport that puts you at any risk (eg rugby, boxing, cricket, hockey) you may wish to consider getting a mouthguard. This will offer some protection and can reduce the likelihood of you getting an injury. Mouthguards are usually made of rubber and form a cover that goes over your teeth and gums.
You can buy mouthguards in some sports shops but it's better to ask your dentist to make one that is specially fitted for you. If your mouthguard has been made properly, you should not have any problems talking or breathing normally while you are wearing it. Your dentist will take a mould of your teeth using a putty-like material. This is then sent to a laboratory where your mouthguard is made. Children will need to have their mouthguards replaced as new teeth develop and their mouths grow.
For answers to frequently asked questions on this topic, see Common questions.
For sources and links to further information, see Resources.
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This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the About our Health Information page.
Publication date: May 2011
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