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The upper front teeth are prone to injury and fracture. A person who has brief, sharp pain while chewing or while eating something cold may have an incomplete fracture of a tooth. As long as the fracture is incomplete and part of the tooth has not split off, the dentist can often correct the problem with a simple filling. More extensive fractures may require a crown, with or without root canal treatment.

If after an injury a tooth is not sensitive to air, most likely only the hard outer surface (enamel) has been damaged. Even if the enamel has been slightly chipped, immediate treatment is not required. Fractures of the intermediate layer of the tooth (dentin) are usually painful when exposed to air and food, so people with such fractures seek dental care quickly. If the fracture affects the innermost part of the tooth (pulp), a red spot and often some blood will appear in the fracture. Root canal treatment may be needed to remove the remaining injured pulp before it causes severe pain.

If an injury loosens a tooth in the socket or if the surrounding gum tissue bleeds a great deal, a person should see a dentist immediately. Seriously loosened baby (deciduous) teeth in the front of the mouth are often removed to prevent harm to existing permanent teeth without losing space for the permanent teeth that are yet to erupt.

Did You Know... A container of milk can be used to transport a knocked-out tooth to the dentist.

Knocked-out (avulsed) baby teeth should not be reimplanted because reimplanting these teeth may damage permanent tooth buds. However, a knocked-out permanent tooth requires immediate treatment. The tooth should be rinsed off and placed back in its socket. If that is not possible, the tooth should be wrapped in a moistened paper towel or placed in a glass of milk (the milk provides a good medium for sustaining the tooth). In either case, the injured person and the tooth should be taken immediately to the nearest dentist.

If a tooth is reimplanted within 30 minutes, the likelihood that it will stay healthy is good. After 30 minutes, the longer the tooth is out of the socket, the worse the chance for long-term success. The dentist usually splints the tooth to the surrounding teeth for 7 to 10 days. If the bone around the tooth also has been fractured, the tooth may have to be splinted for 6 to 10 weeks. Reimplanted teeth eventually need root canal treatment.

Last full review/revision October 2008 by David F. Murchison, DDS, MMS