Fractured Tooth Treatment & Management

Updated: Oct 21, 2015
  • Author: Lynnus F Peng, MD; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Treatment

Emergency Department Care

Provide adequate pain management and tetanus vaccination, and ensure proper follow-up care.

  • Ellis I fracture: Smooth rough corners with a dental drill or an emery board.

    • Treatment of fractures contained solely within the enamel alone requires no urgent care. The tooth can be repaired cosmetically at the convenience of the patient

  • Ellis II fracture: Cover exposed dentin with a layer of zinc oxide or calcium hydroxide paste (Dycal).

    • Dycal requires the tooth to be absolutely dry for adherence. Cover the tooth with a small piece of dental or aluminum foil. Exposure to humidity increases the rate at which the Dycal will set.

    • In patients younger than 12 years, coverage is especially important to prevent infection.

  • Ellis III fracture: Cover exposed dentin with a layer of zinc oxide or calcium hydroxide. Bleeding and moisture with this type of fracture usually makes it more difficult for these materials to adhere to the tooth. Cover with dental foil and expediently refer the patient to a dentist.

  • Root and dentoalveolar fractures require splinting by a dentist for several weeks.

  • Bone wax (Ethicon), which is a combination of beeswax and isopropyl palmitate, is not recommended for open dental fractures because it can cause inflammatory reactions of the surrounding soft tissues (eg, pulp).

Next:

Consultations

See the list below:

  • Consult a dental or oral maxillofacial surgeon.

  • Depending on the extent of the fracture, the dentist may do perform a root canal with calcium hydroxide followed by a gutta-percha filling or a partial pulpotomy.

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