Repairing a Broken
Front Tooth
It’s traumatic for your child to break a front tooth,
but today abroken tooth can be restored to nearly new
condition, function and
appearance, thanks to new bonding techniques and materials.
Bonding is the artistic placement of a tooth-colored plastic
material
to restore a misshapen, discolored or broken tooth. Bonding
is aflexible and adaptable means for repairing teeth,
as it can restore the appearance and function of one tooth,
or a number of teeth. And theeffects are not merely cosmetic.
Bonding protects your child’s teeth from additional
wear and damage.
The procedure
Bonding is usually a single-appointment procedure. The
first step is the careful selection of the color and type
of tooth-colored bonding
material, called composite resin, to match the color of
your child’s teeth. Next, we lightly reduce the tooth
with the dental handpiece, and a conditioning solution
is applied to roughen the tooth surface and ensure that
the resin will bond to it. Then, we apply the bonding
material, sculpt and contour it to the proper shape, and
then harden it with a harmless, high-intensity light.
Lastly, we smooth and polish the new restoration to a
high luster.
What are the alternatives?
Broken front teeth are a common problem among children.
They can be unsightly, and may have a negative impact
on your child’s selfesteem. The problems don’t
end there; a broken tooth may be more susceptible to fractures
and decay. Alternative treatments include crowns and veneers,
but bonding conserves a maximum amount of tooth structure
while providing a terrific-looking result!
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| A common problem |
Resin is placed |
The beautiful result |
What Is a Rubber Dam?
A rubber dam is a small, stretchable sheet of rubber
that we use to isolate the teeth we are working on and
keep them dry. The rubber dam also keeps debris from falling
to the back of your throat.
How is it placed?
To use a rubber dam, we first put holes in it that
match the teeth we are working on. We put one or more
small meta clamps over those teeth, and then attach the
rubber dam to the clamps. We stretch the rubber dam over
a small frame that holds it tight and keeps it out of
the way.
Why do we use a rubber dam when we
work on your teeth?
Normally, your teeth are bathed in saliva, and this is
usually very beneficial to them. However, when we are
working on your teeth, it’s better for you and for
us if the area is kept dry. This enables us to prepare
and restore your tooth with precision. Additionally, the
state-of-the-art adhesiveswe use when we restore your
teeth require a dry environment to bond properly, so a
rubber dam helps us to produce the best possible result.
The rubber dam also works to hold your mouth open and
keep your tongue out of the way. And finally, the rubber
dam prevents any debris from the procedure from falling
to the back of your throat. When the procedure is complete,
the rubber dam comes right off.
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| We punch holes to fit
the dam |
A rubber dam protects
you |
The tooth is kept dry |
What Is a Pulpotomy?
A pulpotomy is the surgical removal of irritated, inflamed
nerve tissue (also called pulp) from within the crown
portion of a primary (baby) tooth. The healthy root canals
are left intact. When decay in your child’s tooth
penetrates the enamel, and then the next layer –
the dentin – it quickly approaches the innermost
part of the tooth, the pulp. At this point, when the decay
is close to or has barely penetrated the pulp, the nerve
is still alive, but it is compromised. If left untreated,
the decay will penetrate and spread throughout the nerve
tissue in the pulp, which will lead to discomfort.
A pulpotomy halts this deterioration.
It typically involves these steps:
• First, because we want the treatment procedure
to be comfortable for your child, we thoroughly numb the
affected area.
• Next, we place a rubber dam to isolate the tooth
from the rest of the mouth and keep it dry. A rubber dam
also protects like a safety net, preventing debris from
falling to the back of your child’s throat.
• To get at the irritated tissue, we make an opening
through the top of the tooth down into the pulp chamber,
and thoroughly clean out the nerve tissue.
• We then place a medicated dressing inside the tooth
to promote healing.
• Finally, we place a stainless steel crown on the
tooth, to seal and protect it. Discomfort after the procedure
is unlikely. However, if your child does experience some
pain, a children’s pain reliever should be given,
following label directions.
A pulpotomy is a relatively quick and painless procedure
that’s extremely effective in eliminating infection
in the nerve and saving your child’s tooth.
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| Decay enters the pulp |
Medication is placed |
Stainless steel crown |
Space Maintainers
Why are baby teeth important?
Normally, as a permanent tooth comes in under a baby tooth,
the roots of the baby tooth dissolve away and the permanent
tooth
replaces the baby tooth. In addition to being important
for chewing, the baby tooth holds the adjacent teeth in
place. When a baby tooth is lost early, due to decay or
injury, the adjacent teeth may drift together causing
loss of space in the dental arch.
Placing a space maintainer
When a baby tooth is lost early, this shifting and loss
of arch space can be prevented by placing a space maintainer.
It generally takes
two appointments to complete a space maintainer. During
the first appointment, an orthodontic band is carefully
placed and an
impression is taken. A model of the child’s mouth
is made from this impression so that the dental laboratory
can form the space
maintainer to the exact contours of the mouth. During
the next appointment, the space maintainer is tried in,
adjusted if necessary,
and then cemented in place.
Caring for the space maintainer
Space maintainers are used until the permanent teeth begin
to break through the gums. While wearing a space maintainer,
it
is important to avoid chewing gum, sticky candies, and
hard foods like Cornnuts or ice. Following up with periodic
checks of the space maintainer here in our office will
make sure it’s still functioning properly and keeping
all the teeth in their proper position.
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| Teeth can shift |
A space maintainer |
Stainless
Steel Crowns
Stainless steel crowns
Small cavities in primary teeth can be repaired with fillings,
because after we remove the decayed part of the tooth,
there’s still plenty of remaining natural tooth structure.
However, when a primary tooth has a large cavity, there
may not be enough tooth structure left to place a filling.
For this reason, we use crowns to repair large cavities
in primary teeth. A crown covers a damaged tooth to strengthen
and protect it. Crowns for adult teeth are fabricated
in a dental lab and are made of porcelain, metal and porcelain,
or gold. Crowns for children’s primary teeth are
most often pre-made of stainless steel, and can be adapted
to your child's tooth and cemented in place in only one
appointment. They are relatively easy for children to
take care of, and are much less expensive than adult crowns.
The procedure
We want the entire procedure to be comfortable for your
child, so the first thing we do is thoroughly numb the
tooth and surrounding area. Then we use the handpiece
to remove any decay and shape the tooth. We select a crown,
shape it, and adjust it until it fits the tooth precisely.
We then cement the crown in place. To complete the procedure,
we doublecheck both your child’s bite and the fit
of the new stainless steel crown.
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| The crown is
adjusted |
Cemented in
place |
