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Dental trauma is a very big topic and it covers quite a lot of things. The trauma that you can sustain to your teeth can be very simple or it can be very complicated. For example, you could have a small chip on your front tooth, that’s considered a traumatic injury to your tooth. It can be just a small little chip and might not even cause pain, but it can still be considered to be trauma. On the other spectrum, you could have trauma to your teeth as a result of a very serious accident, for example, road traffic accident.
If you detect the crack early, a simple reinforcement could be to do a plastic filling over the crack. If the crack is bigger and more extensive, it could involve a dental crown, a porcelain crown or cap, or you could even have a porcelain inlay or onlay which is slightly smaller and not as aggressive as compared to a dental crown.
First of all, when I see patients who have been involved with car accidents, immediately after the car accident, you’re not really thinking so much about your tooth. You’re thinking about your spine, your neck, your brain. After a serious car accident, the ambulance will rush the victim to the hospital to stabilise the patient, to make sure that there are no major injuries to the body, brain, or spine. So by the time all these other body injuries are settled, then the tooth is kind of secondary importance.
Most cases that I see, Dr Gerald has seen as well because in our clinic we do a multi-disciplinary approach. Dr Gerald is very strong in surgery but some patients like the little girl who’s just 10 years old -- we’re not going to put dental implants in her. But for some patients with trauma, a lot of them tend to end up with root canal complications. For adult patients, usually, the nerve is not going to heal itself, so we have to do the conventional root canal treatment.
Yes. When sleeping you could also be suffering from a condition called bruxism, which is the professional term for night grinding or teeth grinding at night. Some patients grind their teeth so heavily at night that over many years of constant grinding, you can see vertical cracks on their teeth and severe wear and tear on their teeth. And a lot of patients who grind their teeth don’t even realise that their teeth are so damaged because there is simply no pain just yet.
If you have a root canal-treated tooth that has failed, you can extract it. I mean if it is a hopeless case, there’s no way of saving it, you have to extract it. But the problem with extracting root canal-treated teeth is that they are very weak and brittle. So when the dentist tries to extract the tooth, there’s always a chance that the tooth may shatter and it may break or fracture. Extracting wisdom teeth could be simple if the dentist is skilled and is able to remove the tooth in one piece but if the tooth breaks or fractures, it becomes a very difficult extraction.
Yes, you could have dental trauma without even knowing it. A very common minor traumatic injury to the tooth that I often see happens when you are eating. For example, if you’re eating and you are biting down on something really hard. For example, using your teeth to bite on chilli crab shells, or if you use your teeth to open beer bottles. People use their teeth to do a lot of silly things. So when you do that, sometimes you injure the tooth by using too much force on it and then you can have a chipped tooth or you can have a small crack on the tooth.
Yes. Let me give an analogy, think of your teeth as a glass window. You have a glass window, a piece of glass, and then you can have a very minor hairline crack on it. But if you keep on hitting that piece of glass, that minor hairline crack will get bigger and bigger and it’ll split in whichever way. It could split to the left, it could split to the right, it could crack all over the place if you hit that piece of glass hard enough. So it’s like that for teeth as well.
Yes. If the tooth splits right down. If the tooth is cracked right down the middle, and if it splits and shatters into small bits and pieces, then there’s no hope in saving the tooth. Then it’s down to extraction and replacing the tooth with a denture, dental implant or a dental bridge.