Cavity potential in chipped tooth?

My little 16 month old daughter fell yesterday and has taken a small chip out of the bottom & side of one of her front teeth. Apart from it being sharp, I am concerned about susceptibility to cavity and/or nerve exposure and damage. Could you please advise what I should do?


Dear Julie,

My advice is to call your dentist to determine if he or she will see your daughter (Some general dentists do not feel comfortable seeing children so young.) If your dentist will not see her, ask for a referral to a pedodontist or other general dentist who will. An examination and possible radiograph of the area should be done. Factors which will affect the type of treatment to be performed include the condition of the tooth and surrounding structures and the reaction of your daughter to the situation.

If only a small piece of tooth is missing, leaving the enamel (outer layer of tooth structure) intact, this is generally of no great concern. Treatment may only consist of smoothing the sharp edge, and watching the tooth for any changes such as darkening of the tooth or signs of infection which may indicate the nerve "died" due to the trauma. If the dentin (second layer of tooth structure) is exposed, some type of filling may be in order. Dentin is more susceptible to decay and can be more sensitive.

If a rather large piece of tooth is missing, the nerve may be exposed or close to exposure. If the nerve is exposed, the tooth will either need to be extracted or have a "baby root canal", followed by a filling or crown. If the nerve is close to exposure, a filling or crown may suffice, but future treatment, such as the root canal or extraction, may be necessary. Signs that some type of future treatment may be needed include darkening of the tooth, signs of infection, or complaints of pain. If the tooth only darkens with no other problems, a "wait and see" approach may be taken.

Again, please have your daughter's tooth evaluated by a dentist. Then you will know what the proper treatment will be for this tooth.

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