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Canine broken off

definition

Both Canines it concerns the teeth next to the small incisors. They are usually pointed and are also called fangs in animals. Caries and forces that do not occur under normal conditions (e.g. as a result of Trauma) are the most common causes of a canine tooth breaking off. In technical terms, this process is called "fracture“.

Often only a piece is lost, but sometimes the entire crown is lost. The fracture may even reach under the gums. In most cases, the broken piece of tooth can be restored.

Read more about this topic: What to do with a broken tooth

causes

Teeth break off (fracture) when their own stability is insufficient to withstand an external force. The tooth itself can be due to various reasons unstable have become. For one, it causes tooth decay Loss of tooth substance due to bacteria, which makes the tooth porous and can break faster, on the other hand a tooth also becomes after a Root canal treatment unstable.

In the case of weakened teeth, a small amount of force, for example by chewing hard bread, is enough for the tooth to give way and a crack to break. It is similar with heavily filled teeth.

Of course, a completely healthy tooth can also break off. However, the force acting on this must be correspondingly high. This happens to one Fall or by a slap on the face. Such Accidents mostly arise at Sports. Often there is also damage to the surrounding teeth.

diagnosis

The dentist can usually diagnose a broken canine at first glance. Still one will complete medical history to learn more about the condition of the tooth and the process that led to the fracture. After the consultation with the patient, the doctor first examines the tooth with his instruments (mirror and probe).

Then he leads one Cold test and a knock test. The vitality of the tooth is checked with the cold test. A cold cotton pellet is held against the tooth and it is waited to see how the tooth reacts.
At the Knock test one taps the tooth with an instrument. By doing this, the doctor wants to find out whether the canine is hurting more than the other teeth, which may indicate a periapical inflammation. Then one follows X-rayto rule out a fracture of the tooth in the invisible area below the gum line. Finally, information can be given about how to proceed and treatment can be initiated.

Symptoms

A broken tooth is usually associated with many symptoms. Typically, it is extremely sensitive to pain (hypersensitive). Above all, release thermal stimuli such as hot and cold strong pain out.

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These only end when the dentist has carried out a treatment. A simple filling is often sufficient for this. There is also pain when eating, which is triggered by the pressure that is created when chewing. If it feels like there is knocking in the broken tooth, then it speaks for one Root canal inflammation with pus formation. In this case, however, these symptoms typically existed before the fracture. In most cases, they were previously less pronounced.

treatment

Once a canine has broken off, one should Dentist appointment to be agreed. It doesn't matter whether the tooth is in pain or not. With a broken tooth there is always an increased risk of tooth decay and inflammation. Reason for this are rough breaking edges or an opened tooth cavity.

The dentist will start treatment after the diagnosis. In the simplest case, one is enough Composite filling out.
If the broken part has been properly saved, the fragment can sometimes even be reattached. However, if most of the tooth crown is affected by the break, then it is usually one Root canal treatment with following Crown inevitable.
Sometimes the damage to the canine is too severe, then it has to be pulled. The tooth is then replaced with a bridge or a prosthesis or implant. The right supply is made individually for each patient. In this case, self-treatment is not possible.

Those who are visually annoyed can go to the dentist on the same day, who may have a temporary solution ready.

What to do if only one piece has broken off?

If only a piece of the canine breaks off, there are several treatment options. These depend on the degree of breakage and the size of the broken piece. A simple fracture runs only in the enamel / dentin, but does not affect the tooth cavity (pulp). So it arises no damage to the tooth nerve. In this case, the tooth is provided with a plastic filling (composite).

However, if the fracture also affects the tooth cavity, the Tooth nerve damaged. Then one must Root canal treatment carried out, as bacteria may have already reached the tip of the root. Then the Crown of the tooth. This is necessary because the root-treated tooth is no longer adequately supplied with nutrients and then becomes brittle over time. A crown ensures sufficient stability here.
If this treatment is not carried out, the tooth will become inflamed within a short time and there may be great pain and possibly even tooth loss.

filling

If it is no longer possible to reposition the broken tooth fragment or to reattach it to the tooth, the defect must be treated with a Filling material to be rebuilt. There are many different variants of filling materials that are selected depending on the size of the defect and the location (e.g. visible or invisible area, occlusal surface or tooth neck, etc.). The possibilities are diverse and range from direct restorations Cement, amalgam or plastic (so-called composites), which are manufactured directly on the chair in one session, through to laboratory-made fillings Ceramic or gold.

Because of the wide range of options, the Wide-span costs for a filling and are depending on size and material between 40-500 €. The question of the material always depends on the situation and must be individually tailored to the patient and discussed with the respective dentist. This should explain the advantages and disadvantages, costs and longevity of the respective material, so that you as the patient can weigh up which material seems the best to you.

The question arises as to whether it is necessary for the dentist to use the drill if a tooth has broken off. The answer here depends on how large the defect is, what material is used for filling and whether there is any tooth decay. If only a small piece of the tooth has broken off and accordingly little area is available for the filling to hold, the area may have to be enlarged with a drill. This is especially the case when the tooth is filled with conventional cements or amalgam. Composites, on the other hand, are attached to the tooth in such a way that they form a bond with the tooth and can therefore also hold on to small areas.

If the tooth is carious, the caries must be completely removed with the drillso that the caries can be prevented from progressing under the filling. Even if drilling is necessary, anesthesia is not always necessary. Often the defect is so far away from the nerves of the tooth that pain is hardly noticeable. Even if the tooth has already died it does not need to be anesthetized.

Provisional

In some cases, if very much broken off the tooth is, it is no longer possible to provide this with a filling and the respective tooth must have one Crown to get. A crown is made in the laboratory and cannot be inserted directly in the first session. The preparations on the tooth for the acceptance of a laboratory-made crown are also more extensive than for a filling, so more time has to be planned for the first appointment. If you come to the practice with a broken tooth as an emergency, you have to reckon with the fact that you will first have a Provisional receives. As the name suggests, a temporary solution is only a temporary (provisional) solution and accordingly only serves as a Temporary solution until the actual crown is completed.

Temporary restorations are made of tooth-colored plasticswho have temporarily made a beautiful aesthetics and also restore the chewing function. However, these are Materials not very stable and not particularly abrasion-resistant, so they cannot stay in the mouth for long without breaking or discoloring. In addition, temporaries are a foreign body that does not provide a sufficient fit, so that the gums are permanently irritated and inflamed. A temporary should not stay in the oral cavity for more than a few weeks to a few months. The cost of a temporary restoration of one or more teeth is included in the cost of a crown and there are usually no additional costs.

Is it necessary, however, that the tooth needs to be temporarily restored on a long-term basis, e.g. Long stays abroad, illness, pregnancy, financial reasons or the like, a Long-term provisional which is manufactured in the laboratory and a higher stability and mouth resistance having. This can result in additional costs. A long-term provisional can be worn for 6 to a maximum of 12 months.

Tooth turns black

If a piece of tooth breaks off and the remaining part becomes dark or it was already dark in color, it can be assumed that the Tooth already dead is. How does this happen? If the tooth is a violent shock gets or one deep caries or fracture has, it reacts with a Inflammatory response. The dentin (dentin) and the pulp (tooth cavity), which are filled with nerves and blood, react to such non-physiological (pathological) stimuli with inflammation and try to regenerate.

In the event of a shock, nerves and vessels can tear off and in the case of deep caries or a deep fracture, the pulp (tooth cavity) is exposed and microorganisms can penetrate deep into the tooth. In both cases there is an inflammatory reaction. If the body does not manage to control the pathological stimulus through this natural defense mechanism, the nerve dies and the tooth is no longer supplied. Because of this, the tooth is discolored and must be Root canal treatment be initiated.

After the root canal treatment, however, it is by no means the case that the tooth is supplied with blood again or that the nerve is regenerated. Accordingly, it can be assumed that the tooth will retain its dark color or possibly even get darker over time. For this reason you have to get around the original color of the tooth restore either one Filling or crown attach to the tooth. If the tooth has not suffered any major damage and a filling or crown is not necessary, it is also possible to close the tooth from the inside bleaching.

All three alternatives are very effective and can usually completely restore the previous situation and aesthetics. However, for all three treatment options, an own contribution must be expected which the health insurance does not pay. Once the root canal treatment has been completed, the discoloration of the tooth poses no further danger and can be left as it is if desired.

Complete demolition of the tooth crown

If the canine breaks off completely down to the gum level, then the tooth cavity is definitely affected. In this case, the root canal treatment is the first thing to do, followed by a crown with a post-and-stump structure. This means that a post is anchored in the root canal in order to then build up an artificial tooth stump. This is required for the crown to hold sufficiently. Then an artificial crown can be made for the tooth, which is cemented onto the abutment.

However, if the tooth breaks below the gum line, treatment is usually a little more difficult. To preserve the tooth, the dentist must ensure that there is enough space (2mm) between the bone and the restoration (biological width), otherwise the tooth would become inflamed. If this biological width cannot be maintained, a surgical crown lengthening is necessary. This treatment is billed privately to the patient.

Sometimes a broken canine can no longer be saved, then it has to be pulled. A bridge can be used to fill gaps, for example. To decide on the right treatment, a visit to the dentist is imperative. Remote diagnosis is not possible.

See also under: extract a tooth

forecast

No general statement can be made about the prognosis because to assess each patient situation individually is. In general, however, the following applies: the less your own tooth substance has broken off, the better the chances of the tooth being preserved. It is also an advantage if the tooth cavity (pulp) is not affected by the fracture. Then there is an almost 100% chance of recovery.

However, as soon as the pulp has been opened by the fracture and the tooth nerve has been irritated, a root canal treatment is necessary. Then the prognosis falls, as the root canal treatment is only an attempt at maintenance. Your probability of success is between 70 and 90%.

costs

The resulting costs depend on how the canine is treated.
If only a small piece has broken off, one is enough free plastic filling out. However, if a Crown possibly with Pen construction becomes necessary, the supply can be quite expensive.

A non-precious metal crown veneered in the visible area (NEM) starts at around € 200. Depending on the material, prices can rise sharply.
If the tooth can no longer be preserved and is pulled, the gap must be filled with a bridge, prosthesis or implant. Costs for a simple bridge start at € 300.
If a prosthesis is already available, it may be possible to expand it inexpensively. Sometimes there is also a new production, this increases the costs significantly.
At a Single tooth implant can be expected to cost around € 1000.

Every dentist charges different prices for a restoration, depending on their expertise and the material used, as well as the dental laboratory.
The legal Health insurance pays always the Standard supply, if the bonus booklet is kept properly, the co-payment is reduced by a further 10 or 15%