What to do when your child chipped or broke front teeth?

You probably would panic to see your child's front tooth broken because no one wants to see a smile with a broken front tooth. When children fall, usually they hit one of the upper two central front teeth or both teeth because they are primarily in the front. There are two possibilities: the broken tooth or teeth are baby teeth or adult teeth. If it is a baby tooth, you most likely do not have to worry too much.

You only have to worry about when/if the baby tooth shifts, especially if it moves into the gum because above the baby tooth, adult teeth are forming. If the baby tooth pushes into the gum, that could damage the adult teeth. Other than that, if the tooth breaks or ultimately comes out, adult teeth will replace the area. Adult front teeth will erupt around age 6. When the tooth chips or breaks, you can do bonding to fix it.

When the tooth chips or breaks, you can do bonding to fix it. If the pulp or the nerve is exposed, the tooth needs root canal treatment and bonding as necessary. Depending on the age, you could take the tooth out. Sometimes, the tooth might look OK and have no findings on the x-ray, but a couple of months later, the tooth might change to brown in color. That is a sign that the nerve (pulp) in the tooth is dead or dying. Then it would be best if you had root canal treatment.

Don't throw away broken teeth.

veneers applied to child's teethIf it is an adult tooth, things could get more complicated. If the tooth ultimately comes out or moves into the gum, you might need to visit an oral surgeon. Your general dentist can refer you to one.

Do not dry the tooth. If possible, you can place the tooth in the milk or the child's mouth. Make sure they do not swallow. If the tooth shifts or the position moves, you probably need to visit an oral surgeon to reposition the tooth. Most likely, you need root canal treatment.

When you break the adult tooth, and no nerve (pulp) is exposed, and the position has not moved, general dentists usually can help, but it would be ideal to seek cosmetic dentists.

Save a broken piece of tooth

child breaks a permanent tooth before treatmentIf you have the piece of the chipped tooth, bring it to the dentist, and sometimes we can bond the piece back. If you do not have the broken portion of the tooth, we can always rebuild the tooth.

Usually, we use a direct bonding or direct veneer technique for children. Lab processed porcelain veneers are possibilities and better, but they cost more, and your child's gum line will keep moving up naturally over time. So, most of these cases will end up needing to replace the porcelain veneers sooner.

Direct veneers before and after

Here is a case for direct bonding or direct veneers to a 7-year-old girl. When she fell, she hit and broke 2 of her upper front teeth. As you can see, all her teeth are not in a final position, and she has more baby teeth in the back. She might need braces in the future. So, lab-processed porcelain veneers are not an option. She was fortunate to have no nerve (pulp) exposure or tooth shift or movement. I only rebuilt the chipped area by bonding direct veneers (Composite). Unlike porcelain veneers, dentists have to do the whole procedure, so it is very technique sensitive, and not all dentists can get excellent natural-looking results.

My American Academy of Cosmetic Dentistry (AACD) 's Accreditation exam passed case shows the use of layered bonding over the teeth.

child breaks a permanent tooth after treatment Natural look and strength: Just like your original teeth

As you can see, the two central teeth have different lengths when finished and not straight, but after they fully erupt or after braces, they should match.

And because they are bonding or direct veneers, at a later time, if they do not straighten, we can always modify them, which is impossible with lab-made porcelain veneers. We can do this in one visit without anesthesia, and usually, we make another appointment for a bite check because if you have a slightly high bite, it could chip the bonding. We need to do a simple follow-up at the dental cleaning appointments to see if the color changes to brown. If so, the nerve is dead or dying and will need root canal treatment. However, with newly erupted adult teeth, it is less likely. Suppose this should happen to the adult's permanent teeth. In that case, the possibility of root canal treatment is higher, and lab-processed porcelain veneers or crowns usually have a better result and are recommended.It gets more complicated if the tooth breaks and the nerve (pulp) exposure is noted.

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Dr. Shimizu is an accredited member of the American Academy of Cosmetic Dentistry. There are 419 dental professionals worldwide (Only four in Houston) as of 2022 who have achieved this prestigious honor.