Thursday, September 2, 2010

Fractured Teeth, Causes and Implications



During routine examinations I will often detect fractures in teeth. The most common areas are your back teeth (molars and bicuspids). These teeth are used to pulverize food, bite into hard candy, hit the occasion pit in pit less cherries, and chew ice. I do not recommend chewing ice-EVER! However, I can’t argue with the rest. Things just happen over time. Teeth fracture because of:
1. Burrowing decay
2. Root canal treatment for dying nerves
3. Unusual clenching or grinding
4. Overbites
5. Trauma and accidents
6. STPD (stupid things people do)
7. Ageing

As far as STPD I can think of things like opening bottles with teeth, opening chip bags with teeth, wearing some piece of jewelry in your tongue, chewing ice and hard candy.

Examinations will detect fractures when they get big enough to see with a magnifying lens or exhibit unusual light reflections. I use a bite stick or a wet cotton roll to see if there is any tenderness to biting. Hopefully, the tooth will not hurt and I will recommend a restoration to protect the underlying tooth structure. It is established by the root canal specialists that if a tooth is crowned (capped or covered) soon enough, only twenty percent will need future root canals. The percentages just go up the longer an untreated fracture exists.

Fractures never heal or go away. That is why your dentist checks your teeth very closely. Fractures often do not hurt until the break occurs. When the break occurs it can be a simple chip or a fatal shear fracture through the middle of the tooth. Fractures can injure the nerve in the root canal. That is why the root canal is treated, filled and sealed. It is a must for the tooth to be returned to normal function with a build-up and a crown. I have seen hundreds of rotting teeth with old root canals that were never restored with a crown.

Get your kids started early with dental visits. Today we fill cavities very conservatively with bonded resin (white) filling materials. This will keep the tooth stronger throughout one’s lifetime and may prevent fracturing from developing. As a kid I had average size silver/mercury fillings placed (everyone did at that time). They weren’t big, but as time wore on my teeth weakened and I eventually needed four crowns to repair the damaged teeth. This is very typical of people my age.

Finally, let’s talk about longevity. I am sure that prehistoric people did not worry about fractured teeth and aging. By the time they were 30 they were old and started dying. Teeth usually do not start fracturing until you about age 40. Today my practice enjoys treating hundreds of people in their seventies, eighties, and nineties. Their teeth become “work hardened” and brittle. Fracturing occurs more often. Fortunately, dentists can routinely repair these problems so we can continue to enjoy eating and socializing for years to come.

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