Dealing with a Cracked Front Tooth: Pain Management and Treatment Options - Dentistry

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The incisor is horizontally fractured down to the gum line (the incisor is reduced to half its thickness)?


Hello, doctor.
I had a car accident and my front tooth crown was broken in half, with the remaining part cracked on the inside (which means the tooth has become thinner).
The emergency physician temporarily filled it, and during my follow-up visit, they said it should be possible to avoid extraction.
I have an appointment scheduled for a follow-up in a month and a half, but it has been three weeks, and the tooth still feels painful (if I accidentally bite down on food while eating, it causes severe pain).
Is this a temporary phenomenon? What is the usual course of treatment moving forward? (Restoring aesthetics? Root canal treatment?)

xuesheng, 20~29 year old female. Ask Date: 2018/01/28

Dr. Zeng Guanghui reply Dentistry


If a dental crown has fractured due to trauma and is temporarily repaired but continues to cause pain, it is recommended to undergo root canal treatment, followed by consideration for a crown.

Reply Date: 2018/01/28

More Info


Dealing with a cracked front tooth can be a distressing experience, especially when pain is involved. Based on your description, it seems that the trauma from the car accident has resulted in significant damage to your tooth, which may require careful evaluation and treatment. Here’s a comprehensive approach to managing your situation.


Understanding the Damage
When a tooth is cracked, especially in the case of a front tooth, it can lead to various complications. The pain you are experiencing, particularly when biting down, suggests that the crack may have affected the nerve or pulp of the tooth. This is a common issue with dental trauma, where the internal structures of the tooth can become inflamed or infected, leading to pain and sensitivity.


Immediate Pain Management
In the short term, managing the pain is crucial. Over-the-counter pain relievers such as ibuprofen or acetaminophen can help alleviate discomfort. However, it’s important to follow the recommended dosages and consult with a healthcare provider if you have any underlying health conditions or are taking other medications.


Follow-Up with Your Dentist
Since you mentioned that you have a follow-up appointment scheduled in a month and a half, it’s essential to keep that appointment. However, if the pain worsens or becomes unbearable, you should seek immediate dental care. Your dentist may perform a clinical examination and take X-rays to assess the extent of the damage.

Treatment Options
1. Root Canal Treatment: If the crack has extended into the pulp of the tooth, a root canal may be necessary. This procedure involves removing the damaged pulp, cleaning the root canals, and sealing them to prevent further infection. After a root canal, a crown is typically placed over the tooth to restore its strength and appearance.

2. Dental Crown: If the tooth structure is significantly compromised but the pulp is healthy, your dentist may recommend placing a crown. This will protect the remaining tooth structure and restore its function and aesthetics.

3. Bonding or Veneers: For minor cracks or chips, dental bonding or veneers may be an option. These procedures can improve the appearance of the tooth without the need for more invasive treatments.

4. Extraction: In severe cases where the tooth is beyond repair, extraction may be necessary. If this happens, your dentist will discuss options for replacement, such as dental implants or bridges.


Long-Term Considerations
After treatment, maintaining good oral hygiene is crucial to prevent further issues. Regular dental check-ups will help monitor the health of your teeth and gums. Additionally, if you experience anxiety or stress related to dental visits, consider discussing this with your dentist, as they can provide support and options to make your visits more comfortable.


Conclusion
In summary, while the pain you are experiencing may be a temporary reaction to the trauma, it’s essential to have a thorough evaluation by your dentist to determine the best course of action. Whether it involves root canal treatment, crowns, or other restorative options, addressing the issue promptly will help ensure the best outcome for your dental health. Don’t hesitate to reach out to your dentist sooner if your symptoms worsen, as timely intervention can make a significant difference in your recovery and comfort.

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