Helpful Infographic on Cracked Teeth

A cracked tooth can be anything from a minor inconvenience to a major annoyance. Many times, small cracks begin showing painful symptoms only after weeks or months of continuous pressure  and abuse. Our friends at the Spear Institute put together this helpful guide on what to do and what to expect when you have a cracked tooth. As with most things in dentistry, the key is early detection and intervention. The sooner we can work on repairing a dental problem, the more likely the tooth can be saved. Take a look!

Replacing A Lost Crown

Imagine you are enjoying a nice meal when you suddenly notice a strange space open up in the front of your mouth. To your horror, a crown on one of your front teeth has fallen off! Every dental office sees two to three cases like this yearly- as with this patient today. Fortunately, we were able to replace the missing space with a cosmetic Emax lithium disilicate crown. The end result was fabulous- we saved the tooth and improved on the esthetics of the previous crown!

Dental crowns can come loose for a number of reasons. Most commonly, cavities start at the margin between the tooth and the crown and undermine the seal. Once this seal is broken, the crown quickly loses the adhesive and retentive properties that bond it on the tooth. Other common causes of crown loss include trauma, chewing sticky foods and post/core failure. 

If you ever lose a crown, do NOT try to re-cement it (even using temporary crown cement from the drug store). You run the risk of creating a bond so strong that the dentist cannot remove it without damaging the tooth or a bond so weak that it causes the crown to become a choking hazard. Rather, call our office as soon as possible and let us know what happened. Depending on how the crown fell off, what was underneath the crown and if there was any damage to the tooth we may be able to recement it with little modification.

Unfortunately, there is no way for us to determine if the crown or tooth is savable over the phone. Your best bet is to schedule an emergency appointment at your earliest convenience. The longer your tooth stays exposed without a crown, the more likely it is to become damaged through daily use. If you would like to know more about lost crowns and how to protect your teeth, please give our office a call!

Broken Teeth

Here you can see a maxillary first premolar fractured between its two cusps. Fractures commonly occur here due to natural stress points in the enamel and dentin. This tooth was fractured down into the root space and needed to be extracted. 

Like any hard object, enamel tends to crack or fracture when subjected to a large amount of force. Hence, broken teeth are a very common source of dental pain. Symptoms can range from mild discomfort to pain when chewing or a constant radiating soreness. They are sometimes preceded by an audible "crack" or "pop" while chewing a hard object. No matter your current state, a cracked tooth needs to be addressed by a dentist before the symptoms will subside.

One of the trickiest parts of treating cracked teeth is that they are difficult to see. Traditional X-Rays frequently miss cracks, as they are trying to represent your three dimensional tooth in a 2-D image. Visual inspection will reveal some cracks, particularly vertical fractures through the crowns. However, smaller crack and cracks in the root area are impossible to spot with the naked eye. The most reliable way to see if a tooth has broken is by imaging with a Cone Beam CT scanner. Here, a specialist (often times an endodontist or oral surgeon) will take a 3D image of your tooth, revealing any cracks or defects throughout its structure. 

Once a tooth is confirmed as cracked, it will typically need to be extracted. Large splits in enamel running into root structure are impossible to repair or remineralize. Still, some shallower cracks in ideal locations can be treated with a crown and/or root canal. Here, the actual cracked portion of the tooth is removed, preventing the possibility of the defect propagating and getting bigger. However, it is important to note that these conditions are rarely met and extraction is the most typical course of treatment for a broken tooth. 

The most important thing to remember is don't wait and suffer in pain! Especially if you have pain while chewing or feel your teeth "flex" or "shift" when you bite down, there is a good chance you cracked your tooth. This discomfort will not resolve on its own; in fact there is a good chance it will worsen with time. If you have any type of dental discomfort, call our office as soon as possible. We can help you alleviate pain, reach a proper diagnosis and plan for the best course of action for getting your mouth back to normal. 

Dental Questions: What can I do to make a toothache feel better?

Generally, toothaches are caused by inflammation of the nerve inside the tooth. The best way to temporarily relieve the pain is by taking a nonsteroidal anti-inflammatory over-the-counter medication such as naproxen sodium (Aleve) or ibuprofen (Motrin).  If the tooth is sensitive to temperature and biting pressure, then it likely needs a root canal to completely resolve the pain.  If there is swelling around the tooth or in the face, then the nerve inflammation has progressed to an infection and antibiotics and a root canal are required to fix the situation. 

You may be tempted to use over-the-counter toothache remedies such as topical anesthetic (Orajel). However, these medications are best used to treat sore gum tissue caused by ulcers or canker sores and will do little to remedy actual tooth pain. Remember, a toothache is caused by an inflammatory process that is occurring within the tooth (and not in the surrounding gums). Additionally, do not try crushing aspirin or other medications and placing them against the tooth area. These medications are only meant to be taken orally, and can cause serious chemical burns on the gum tissue and mucosa. 

Dental Questions: What Does It Mean If My Face Is Swollen?

Dental abscesses start small but can have very serious effects.

A swollen face in relation to tooth discomfort means that the tooth has an abscess that has not found a way to drain on it’s own.  An abscess forms when the body has detected a bacterial infection and “walled off” the affected area, but cannot naturally eliminate it. The associated swelling signifies a serious infection that has caused inflammation of the facial tissues. This is a health emergency and requires antibiotics and drainage of the abscess. 

Video Blog on Dental Emergencies

What constitutes a dental emergency?  If your face is swollen and you are in pain, that is the number one reason to call a dentist today.  Swelling of the face is the sign of a serious infection called an abscess.  It is necessary to seek treatment immediately to prevent the spread of the infection.  If it is after hours, then it is recommended you seek treatment at an urgent care or emergency room.  

The second biggest emergency is when an adult  tooth is knocked out of its socket.  This can happen from running and falling, falling off a bike, getting hit by a car, playing sports and getting hit in the face. It might be possible to replant the "avulsed" tooth, but it needs to be done in the first 30 minutes to one hour after it falls out, in order for the replantation to have a chance at being successful. To transport the lost tooth, it is best to either place it in a cup of milk or store it in your mouth until you are able to see a dentist.

The first two emergencies I mentioned are relatively rare occurrences.  The most common emergency I see is when a patient is having tooth pain.  And the second most common is when someone chips a front tooth or breaks a back molar.  

If you are having a dental emergency, please call my office and we will do our best to see you as soon as possible.

After Hours Phone Service

At Thousand Oaks Family Dentistry, we pledge to be committed and available to our patients. We understand that your dental emergencies and concerns may not coincide with our business hours. In fact, they typically seem to arise at the least convenient times possible. This is why we are proud to offer our after hours phone service.

Our promise to our patients is anytime you call our office number, one of our staff member’s phones will ring- any time, day or night. You will never be forwarded to a call service and any message you leave will typically be followed up in about two hours (a little longer for late night calls).

After hours callers will typically encounter our office manager, Michael. He brings years of experience in dental emergencies, insurance billing and scheduling to the convenience of your phone. Whether you have a filling fall out at 10am on a Saturday or an insurance question on an idle Thursday evening, he will be there to answer.

Our office manager, Michael. hard at work taking phone calls. 

Why do we provide this service? Simply put, our practice is a patient-centric environment. We know you have many options, and are honored that you choose to visit us at Thousand Oaks Family Dentistry. Dental care can be an intimidating endeavor, and thus we are here to make the process as easy, simple and convenient as possible.