The outer crown of a tooth is separated from the internal root, which is a part of the alveolar bone. Enamel covers the tooth, shielding the dentin where the pulp and the tooth’s neurovascular supply are situated. The periodontal ligament, a connective tissue enveloping the root that creates the socket wall, holds them in alveolar bone sockets.
Broken facial or mandibular bones should be checked for injuries. Examine the jaw for malocclusion, bony sensitivity throughout the mandible and facial bones, and sensory disturbance or numbness. The mandibular teeth receive sensory innervation from the inferior alveolar nerve, a branch of the trigeminal nerve’s mandibular division, as well as the lower lip and chin via the mental branch. As a result of its frequent involvement in mandibular fractures, sensory disruption in these areas should trigger a thorough evaluation of the jaw. Never discount the chance of a serious head injury. Consider getting a chest x-ray to be sure the tooth hasn’t been inhaled in the event of an avulsion if the tooth cannot be seen and there are historical indicators, such as choking or coughing.
The impact on the underlying permanent tooth is the clinical significance of acute injury to deciduous teeth. The likelihood of harm is increased since the wounded deciduous tooth root’s tip is so close to the permanent tooth germ. Possible post-injury consequences include malformation, impaction, eruption disruption, and discoloration. As a result, as seen below, the treatment of damage to deciduous teeth differs from that of permanent teeth.
- Enamel, enamel-dentin, and enamel-dentin-pulp fractures are the three types of dental fractures. The socket of the alveolar bone as well as the root are both brittle.
- Sharp edges just need to be smoothed down and sanded down in enamel cracks.
If at all feasible, enamel-dentin fractures should be repaired, and patients should be checked again in 3–4 weeks.
- The most severe of the three are fractures of the enamel, dentin, and pulp. Apical periodontitis and lack of root development may occur if the pulp cavity is not sealed up with something like calcium hydroxide paste. The alternative is to just pull the tooth and be done with it, which is not an option for permanent teeth. There is no proof that patients with these tooth fractures need to be given preventive antibiotics.
- If you suspect a tooth has a broken root, look for bleeding from the gingival sulcus; this may be the sole sign. If the fragment is misplaced, realign it, bind it with a temporary splint as soon as you can in the emergency room, and refer you to the dentist as soon as you can for an evaluation for a formal splint.
- Alveolar fractures: These bone socket fractures are known as alveolar fractures. They might extend into the mandible; one or more teeth might be movable, and there might be issues with the occlusion of the jaw. Both will need immediate dental work done for splinting. Any piece that has moved should be repositioned right away. Discuss this with the on-call dental or maxillo-facial staff because a general anaesthesia will probably be needed.