Not all fracture lines or fractures need to be actively treated by a dentist. There are a number of important factors to consider which will determine whether a fracture in a tooth needs to be actually treated by a dentist.
1) The age of a patient is important to consider. It is uncommon to find significant fracture lines in a young patient in their teens but for an old age pensioner, there will be many fracture lines and fractures in the dentition. Therefore you can say that the appearance and presence of fracture lines is part of the normal ageing process by which teeth undergo wear and tear.
2) The presence of symptoms for a patient will often cause them to see a dentist for treatment. Depth of fracture lines involving dentine and or the pulp will cause symptoms. Disturbance to the dentine causes fluid movement within the dentinal tubules which are then registered as pain or sensitivity. If a fracture involves the dental pulp in this will also cause bacteria to invade and attack the pulp producing symptoms.
3) As well as symptoms as discussed directly above, the other presenting issue data patient can be in asking the dentist concerning that of appearance or aesthetics.Fracture lines can become stained hence they become apparent to a patient and of course an actual loss of tooth substance due to a fracture will be paramount in the aesthetic zone. This will most of the time involved the incisal edges of Upper central incisors, upper lateral incisors and canines. In addition, it can sometimes be also an aesthetic concern when loss of tooth enamel occurs due to fractures of lower incisors. At the same time also, the patient will be aware that something is rough or catching their tongue and therefore they will want to have this also be eased off.
4) The presence of many fracture lines or fractures in teeth can also be an important indicator of para functional activity. This parafunctional activity is often known as bruxism which comprises of daytime clenching achieved or and excessive grinding of teeth.
It is important for a dentist to address abnormal occlusal functions as this can cause extensive damage to the integrity and structure of teeth. There can also be a subsequent symptoms such as jaw ache, headache, neck pain and general tightness around the facial muscles.
So in answer to the question of how a dentist treats fractures in a tooth, a dentist will make an overall assessment once the dentist has carried out a full examination and history of the patient. Importantly there will also be prevention advice given. In terms of treatment this can range from minimally invasive to extremely complex and invasive treatment. Needless to say, a dentist should always consider the least invasive treatment possible that will address the problem for the patient. An example of a minimally invasive treatment is simply to smooth a portion of a tooth that has chipped slightly. This is a good example of treatment as it is minimally-invasive, it has minimal cost implications for the patient and it also is less time consuming. Importantly, It is also a reversible type of treatment so the patient does not have to compromise any biological tooth structure. On the other end of the scale, a patient may need extensive invasive treatment involving full mouth rehabilitation including altering the occlusal equivalence relation and full mouth crowns. This will have major implications for a patient and one of these is that crowns have limited life spans and 30% of all crowns will develop non vitality affecting the dental pulp.
Finally, an important part of how a dentist treats fractures in a tooth is that of monitoring both short-term and long-term with a flexible treatment plan.
Dr Muzzafar Zaman 