Treatment for Broken Front Tooth

My son is 11. His trumpet was hit while he was playing it, and it broke the lower portion of his front permanent tooth. What would be the treatment - bonding?

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You should have the fractured tooth evaluated by a dentist. This evaluation should include a clinical exam, a radiograph, and possible pulp (nerve and blood vessel) vitality testing. If the fracture has not exposed the pulp tissue, and the tooth appears to be vital (living), a simple composite resin (tooth-colored filling material) may be sufficient for short-term relief. If it is a fairly large fracture, you might consider a porcelain veneer in the future because veneers are generally more esthetic and last longer. Pulp testing and radiographs may be necessary at follow up intervals of three months, six months, and one year to determine the vitality of the pulp tissue. Teeth which have undergone trauma may require root canal treatment in the future.

If the pulp tissue has been exposed, additional factors must be considered. First, consider the length of time since the exposure. If it has been several hours, the prognosis for more conservative treatments is better. If it has been several days, small abscesses may already be occurring in the pulp tissue, leading to the need for root canal therapy. Small exposures which are quickly capped and covered by a filling may not lead to the need for a future root canal; however, follow-up dental visits at three months, six months, and one year should be done to determine pulp vitality.

In addition, sensitivity to heat, prolonged sensitivity to hot or cold, and spontaneous pain are signs that the pulp tissue was unable to repair or heal itself. Signs of infection, such as swelling and redness in the area of the root of the tooth, may also appear. If any of these signs or symptoms occur, it is advisable to seek consultation and treatment with a dentist as soon as possible. Occasionally, the pulp tissue will "die" without any signs or symptoms. In this case, the condition may only be discovered on a radiograph. Teeth with nonvital pulps may also darken over time.

It is important to have the tooth assessed and treated as soon as possible. Even if the pulp tissue is not exposed, but the dentin (second layer of tooth structure underneath the enamel) is, the pulp tissue can become irritated. This might increase the likelihood of future root canal therapy.

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