Definition and Overview
A pediatric broken tooth is a dental problem caused by the breaking, fracturing, or chipping off of a child’s tooth. This may be caused by trauma following an accident, such as a fall or a stumble. The damage can be mild or severe, and the extent of the damage is the primary consideration when deciding on the method of treatment that must be used.
Children grow two sets of teeth at different ages: the baby and permanent teeth. Baby teeth usually show signs of wear, such as small chips, especially along the edges. While this is not a cause for concern, larger chips and fractures affecting baby teeth may still cause some discomfort for the child, thus requiring some form of treatment. On the other hand, any form of damage to a permanent tooth should be addressed as soon as possible.
Causes of Condition
Broken teeth among children can be caused by several factors, but are most commonly linked to trauma due to accidental falls or stumbles. Sometimes, small chips caused by normal wear, which is very common with baby teeth, may weaken the tooth and make it more likely to break off even with mild force.
There is also the additional challenge of receiving proper dental care. Since children are still learning how to brush and take care of their teeth, there are cases wherein the tooth weakness becomes an inevitable consequence of a lack of proper dental care, making broken teeth more likely.
If a child breaks or chips a tooth, parents are advised to make the child rinse his mouth using warm water. If trauma is involved, using a cold compress may help reduce any inflammation that may occur. It may help to save the fragment of the tooth that broke off and bring it to the dentist during the checkup.
While teeth are generally able to withstand a considerable degree of force, trauma that is concentrated in a single spot is still quite likely to break a tooth.
Broken teeth are classified into four different classes based on their extent or severity. There are:
Class 1 – This is the mildest form of a broken tooth and occurs when the damage affects only the tooth’s outer enamel layer; this means the damage is usually in the form of small chips or very shallow fractures. Some class 1 broken teeth may still look bad, but they will usually not cause the child much pain or sensitivity, especially if the chip or fracture is very small. However, there is a risk that the small damage will become bigger and may lead to more complex dental issues, so it is still better to seek treatment for it.
Class 2 – This category is characterized by larger fractures that typically damage the dentin layer and may cause some sensitivity to cold and hot temperatures. However, the discomfort may also pass or subside over time.
Class 3 – This is a more serious form of the problem wherein the fracture reaches all the way into the pulp of the tooth. The main danger in this case is the pulp’s vulnerability to bacteria, but if the pulp gets a good supply of blood, the tooth often recovers well without the need for a root canal treatment. Also, the younger the tooth is and the earlier the damage is treated, the greater the chance for a smooth recovery. However, if a huge part of the crown breaks off, a root canal therapy may be necessary so that an artificial dental crown can be placed. Additionally, treatment will be affected by how much of the pulp is exposed.
- Class 4 – This is a less common but the most severe class of pediatric broken tooth and mainly involves vertical fractures or those that go deep down into the tooth's root. Due to its nature, such cases can be difficult to cut. In fact, in many such cases, the only feasible treatment is the removal of the broken teeth.
Who to See and Types of Treatments Available
Pediatric broken tooth can be treated by a dentist with training or special interest in treating pediatric cases. Parents can choose whether to go to their pediatrician for a referral or go directly to a pediatric dentist’s office.
There are several techniques that can be used to treat a chipped or broken tooth, but pediatric specialists always choose the safest technique for young patients. Also, the specific treatment method will be selected based on what kind of tooth was damaged. If it is a baby tooth, the only major concern is its unpleasant appearance, as the tooth will fall off eventually and be replaced by a permanent tooth. Thus, more conservative treatment options should be used. If the child is very young, e.g. 2 years of age, it is advisable to seek some form of treatment, especially to relieve any symptoms such as sensitivity and discomfort. But if a child is nearing the age of growing permanent teeth, some dentists may recommend completely removing the damaged tooth then helping the parent protect the permanent tooth that will grow in its place.
However, if the broken tooth is a permanent one, then more aggressive treatment methods can be used just to save the tooth. These may include:
- Composite filling or dental bonding – Highly effective for larger chips, this involves attaching a filling material to a broken tooth.
- Composite restoration – This is done to cover the dentin and relieve sensitivity, as well as to improve the appearance of a broken tooth.
- Orthodontic extrusion – This is one of the treatment options for class 4 types of broken tooth.
- Root canal treatment– This only becomes necessary when the pulp is exposed.
- Dental crown – This is used for larger tooth fractures.
- Veneers – This refers to a thin layer of composite porcelain material that can be placed over a tooth.
Caring for a broken tooth does not end with treatment. The initial trauma that caused the problem may still have some repercussions, making it likely for the tooth to develop an abscess or some other problem. Thus, it is still necessary for children, as well as for adults, to receive regular oral screenings in which the previously broken tooth may be monitored.
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Chou R, Cantor A, Zakher B, et al. Preventing dental caries in children <5 years: systematic review updating USPSTF recommendation. Pediatrics. 2013:132(2); 332-50.