Hi there,
My tooth chipped about 6 months ago now. I have been meaning to go to the dentist but I have not had time due to other health issues.
There is only about half of my tooth left now, some bits are going black and it bleeds every so often.
Would you recommend going to the dentist? What do they normally do for a chipped tooth? I think it's one of my baby teeth (I am only twelve years old)
Many thanks
Alison

Hi Ali!
Well, it sounds like the tooth is pretty broken down, but please try not to worry. It is important that you go to the dentist as soon as possible because the black that you see is a cavity and it can be very deep. Cavities are a type of infection in a tooth and like any other infection in the body, it can spread to other areas of that tooth or even another tooth. The bleeding is a sign that bacteria has built up and this too is a sign of infection.

If it is a baby tooth, the infection can actually spread to the permanent tooth that is underneath, so it's not a good idea to ignore it. If the tooth has to come out, you will get a new one in it's place anyway.

If it is a permanent tooth, then you may only have two choices. One is to have a root canal and the other is to have it removed. Having a root canal is a temporary fix and you will find yourself at some point dealing with an infected tooth. Removing the tooth gets rid of the infection completely. Depending on where it is in your mouth, the dentist may put a temporary space maintainer in after the extraction to keep the other teeth from shifting unnaturally into that space. Then when you are a little older, you could have a dental implant put in there.

I know it all sounds a bit scary, but generally teeth come out very easily in children your age and you will heal very quickly.

Please keep in touch and let us know how you are doing!

Bryanna ~'.'~

((((((Alison)))))) <<-- those are hugs

My son fell on his face and broke one of his two big front teeth when he was about 8. It broke in a really weird way -- sort of kitty-cornered.

He had to go to a Children's Hospital dentist in Boston (hospital because he had a heart murmur at the time).

What they put on his tooth was something called an an 'acid-etch'. It's sort of like a sleeve that fits over the end of the tooth, then they etch it with a type of acid to turn it white like a tooth.

He had this done when he was 8. When he was about 11, he bit into a candied apple at the Fair, which he knew he should not had done. Apparently, the wearer of an acid-etch tooth can tell by the feeling of pressure whether they should or should not eat something very hard. Anyway, they had to replace the acid-etch. He's now 39 and wearing the same acid-etch.

So, that's my real-life experience with a broken tooth.

Now, myself, I'm older and had periods of not being able to take care of my teeth due to finances and lack of work. So, about a year or so ago I had to go through some major-league renovations. Some of them were "crowns". They file down your tooth and cement an artificial tooth on top of it. I've got two on the side on the big teeth (molars) and one in the front.

Another thing that they can do is called a "temporary bridge". I had this a long time ago. They remove the tooth and make an artificial tooth this is hooked onto the teeth using special wires to the left and to the right. These are removable for cleaning. You cannot tell that you're wearing them.

Then they have what's called a "permanent bridge". This is usually put in to fill a place where there is a missing tooth. Again, they make an artificial tooth to fit into the empty space (it looks like a pearl, it's pretty!!). Then they file down the teeth on the left and on the right and put "crowns". The crowns have the artificial tooth suspended between them. The whole thing is cemented into your mouth. I have two of these. You brush them just like your regular teeth, except that you have to use a special kind of floss to clean underneath the artificial tooth.

Now, the thing about ignoring damage to teeth is that the tooth can die. Then you have to get a root canal. A root canal basically means that they have to remove the root and fill up that remaining hole with a special material that keeps the inside of your tooth cavity clean and germ-free. I have one of these. I always freaked out when I heard the term "route canal" because I always thought it would be major-ly painful. It wasn't. I'm a big chicken at the dentist and this procedure didn't really hurt. That's why you have to have a really good dentist that you trust.

I go to the dental school and get either 3rd year or 4th year students. They're well supervised and they're close to graduating and setting up their own dental practices. I've had really good luck with them and the cost is much less then what a private practice dentist would charge.

As you can see, there are a lot of different options. The dentist will discuss with you which one is the best for you.

Alison, the big thing is you have do something NOW. The black on the tooth could either indicate cavities or it could indicate that the tooth may be starting to die. You have to take care of it now before you get into either bigger or more expensive problems. If teeth get infected, they can cause health problems throughout your entire body.

Good luck. Hugs. I'm proud of you for realizing that you need to take care of your own health and your body and you've started doing that by asking the 'right' questions.

Barb

Hi Barb,
Sounds like you have been in the dental chair alot and have had some exstensive dental treatment!

I always encourage my patients to ask questions so they become better informed on what is happening to their teeth. I also feel that it is equally important that they know and understand what their treatment options are and why or why not those options may be limited. Children have different treatment options compared to adults because they are still in the growing stage and may or may not have all of their adult teeth yet. Generally, we've lost all of our baby (primary) teeth and gotten our adult teeth by the age of 12-13. Some people can lose their teeth earlier and some later. The wisdom teeth generally do not come in until around 17-21 years of age unless they are impacted in the jawbone.

Your son was fortunate when he broke his front tooth that he didn't injure the nerve causing the tooth to die. The restoration that they placed on it is called a Composite Bonding. It is the same tooth colored material that is used to fill other teeth after a cavity is removed. The acid etch that you speak of is a Phosphoric Acid that is applied to the prepped tooth to help bond the filling material. The tooth colored composite material is then placed over the etched surface in layers and a curing light is used to secure each layer. The life span of this type of filling material is about 7-10 years. After that time, the edges of the filling begin to break down and leak allowing bacteria to get underneath the material. The actual filling may look ok in the mirror, but clinically under the dental light, we can see the breakdown along the edges. In our office, we take pictures of the patients teeth with an intra-oral camera so we can show the patient a close up shot of what we see. These close up photos look alot different than what we see in our bathroom mirror!

The temporary bridge that you describe is called a Removable Partial Denture. It replaces missing teeth with false teeth that are attached to a wire frame that sometimes hooks around other teeth. These can be made to accomodate missing teeth on just one side of the mouth or both sides of the mouth at the same time on either the upper or lower arch. Actually, they come in a variety of sizes and shapes to accomodate various dental situations.

Alot of people have misconceptions about root canal and what it actually is. During a root canal, the inside of the roots (canals) are cleaned out with special instruments in an attempt to remove the infected nerve material that once use to supply the nutrients to the tooth. These canals are then somewhat disinfected and a filling material is placed in each canal to replace where the nerves were. The root of the tooth is not removed, it remains intact. The down side to this procedure is that it is not possible to remove all of the infected nerve material from inside the root for several reasons but one main reason is because there are nerves also located in tiny microscopic areas called dentin tubules or accessory canals. Because there is no way to access these tiny areas, the nerve material inside of them which is no longer being supplied any nutrients, becomes necrotic and basically causes the tooth to be chronically infected. Although the only alternative to a root canal is extraction, science and logic tells us, it is never healthy for the immune system to continuously fight an infection especially in people who already have compromised immune systems.

I found it very interesting how you understood the concept "that If teeth get infected, they can cause health problems throughout your entire body". You are absolutely correct!!

I hope Ali gets the dental care that she needs soon and I'm sure she will be just fine.

Bryanna

Thanks, Bryanna.

I'm glad I was paying attention when my student dentists were getting their instruction sounds like I passed

I figure if a younger person can hear some of the first-hand 'crap' that us adults have had to put up with and have survived, it'll give them the incentive to take care of themselves.

My Mom was terrified of dentists. Had a really bad incident when she was a child -- of course, that was close to a hundred years ago.

She would not go a dentist. My brother and I used to take turns taking her to the dentists. She'd actually run out the front-door. (Now I know where I get my chicken-ness from.) She finally went in-hospital and got it all done at once -- a real good alternative for someone with the major problems that she had. That's taught me that you DO NOT WAIT.

Thanks, I appreciate your going over my thoughts and making sure they were correct. Sounds like you're a professional. I wouldn't want to pass on incorrect information.

Hugs.

Barb