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Dentistry/broken tooth


I was biting a rubbery piece of bread and hit my top front teeth with the bottom one really hard. I heard a crack noise and felt like someone was pulling out my bottom tooth. I was conveinced that I broke something but there is n visible crack or chip. However my tooth now feels unconfortable not really painful but sensitive and slightly wobbly and I wouldnot feel confrtable chewing on anything. I can't reach a dentist until Monday. Is there a chance the root is broken and how could I know. If so what are the risks and what should I do until I can get to a dentist.

Good Day Frank,
Sorry to hear about your misfortune.
You should keep from chewing on the area, gently brush and use mouth wash to keep the area clean. Do not play or wiggle it with your fingers or tongue.
Without a thorough  clinical and radiographic examination its impossible to ascertain a proper diagnosis and treatment plan. However, having seen this situation many times previously, your history would lead me to think about several causes.
Some of the situations that could have severely weakened your tooth are:  
a)underlying micro cracks in the enamel and /or root from previous trauma.(For example, have you ever been hit on that tooth playing sports,suffered a blow to the area from a bike or car injury, grinding on your teeth)
b)Repetitive blows can cause underlying damage and weakened the tooth so that when you chewed on it a more severe crack resulted.
c) A tooth may be weakened by fillings, restorations, recurrent decay and or periodontal (gum disease). If there is less bone support due to any of the above factors a blow even chewing a piece of bread can result in damage since many of these factors can be accumulative.

When a tooth is wobbly, it means there is potential crack in the crown and /or root of the tooth which may not be visible to the naked eye. Its sensitivity is due to the irritation and damage of the inside of the tooth and root(the pulp,nerves and blood vessels). When this occurs it is necessary to treat this condition with root canal therapy, before restoring the crown of the tooth. The sheath around the root of the tooth is a collagen sling of fibrous tissue called the periodontal ligament. This acts like a cushion and connects the root to the bone. When the root is damaged, as in the case of trauma, the tooth may feel loose and wobbly. So it may be that part of the crown and or your root is involved. The treatment is root canal therapy and restoration of the crown of the tooth. This is provided that the periodontal tissues and bone are healthy and or can be repaired.
The only real way to fully know the extent of your injury and thus the proper treatment protocol is to have radiographic and clinical examination. Currently, digital periapical radiographs are the standard of care. However, according to new American Association of Endodontics guidelines, Cone Beam Scans are appropriate for cases of trauma.This is important in your situation if a simple periapical xray in unable to ascertain the correct diagnosis.

My suggestion is you seek the care of a Endodontist, a specialist in root canal treatment. Further, you could seek care at a dental school that has a endodontic department with trained faculty.I hope you are able to resolve your unfortunate situation promptly.  


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robert block


I would prefer to answer questions related in my specialty of Endodontics( ROOT CANAL THERAPY) I am a Board Certified Endodontist with a special interest in advanced surgical endodontic procedures. I know root canals create a lot of apprehension in patients, and they usually have many questions about the procedure. I can address patient concerns either before or after their root canal treatment. I also have re-treated numerous patients who have had previous endodontic treatment. As a result of these clinical failures,and the increase in the use of dental implants, its important patients understand the alternatives of therapy. There are often many components to treatment that interrelate the disciplines of endodontics, periodontics and restorative dentistry.Patients frequently question the importance of considering all facets in a clinical regimen. Hopefully, I would be able to educate and contribute some information from the endodontic perspective.


Diplomate American Board of Endodontics, 35 years plus private practice experience. Formerly Professor and Chairman, Department of Endodontics at US dental school. Editorial journal reviewer for the endodontic section of The Journal of American Dental Association. Serve as a reviewer on several editorial boards.

American Association of Endodontists, College of Diplomates, American Board of Endodontics

Over 150 publications, abstracts, case reports, chapters in textbooks. J. Dental Research, J. of Endodontics, J. of Oral Surgery Oral Medicine Oral Pathology,The NEXTDDS J.For example: The Single File Approach for Predictable Endodontic Canal Instrumentation:The Wave One, THE NEXTDDS J. 4-2:13-17 Fall 2014 Non Surgical Management of an Endodontic Failure Utilizing Contemporary Technology, www.THENEXTDDS 5-1:60-63 Spring 2015 Are You Still Using Formocresol? An Update, Tn. Dent. J. 89-4:14-19 Fall 2009 Management of Endodontic Failures, Oral Surg.vol.66:711-Dec.1988

BA. DePauw University, DDS. University of Michigan, MS. Medical College of Virginia, Virginia Commonwealth University, Gen. Practice Resident, University of Connecticut, Endodontic Resident Medical College of Virginia, Virginia Commonwealth University

Awards and Honors
Numerous Awards and Honors, Edward P. Hatton Award( Int. Assoc. of Dental Research), Endodontic Memorial Research Award ( American Association of Endodontics) Outstanding Endodontic Department Teaching Award (given by dental students)Fellow American Academy of Dental Science

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