Figure 6-6.Types of tooth fractures.
Upon examination of a type I fracture, you may
A slight chip or fracture of the tooth enamel layer
only, or with possible minimal dentin involve-
No exposure of the dentin or pulp
Perform the emergency treatment guidelines. The
following is a typical treatment plan that a dental
officer might authorize you to perform to treat a type I
Smooth sharp edges of the chipped area with
sandpaper strips or disk to eliminate irritation of
the tongue and lips.
Carefully dry the chipped area with a cotton roll
Apply small coats of cavity varnish over the
chipped area with cotton forceps and cotton
Instruct and caution the patient not to consume
hot or cold liquids and food. Extreme heat or
cold may damage the tooth pulp.
Symptoms (Type IIEnamel/Dentin Fracture)
A patient with a type II tooth fracture may
complain of the following:
Very rough or sharp edges
Severe pain from heat, cold, or air
Upon examination of a type II fracture, you may
observe the following:
Extensive fracture involving the enamel and
No pulp exposure
Perform emergency treatment guidelines. Except
in rare cases, the dental officer will provide emergency
treatment. If for some reason he does not treat the
patient, the dental officer could authorize the assistant
to cover the exposed dentin with a temporary type
paste or place a temporary crown.
The procedures for covering a type II with zinc
oxide and eugenol paste or other temporary paste are as
Isolate area with cotton rolls.
Carefully dry the fractured tooth off with cotton
rolls or 2 x 2 gauze. (Do not use direct air with
the 3-way syringe.)
Coat all exposed dentin with a zinc oxide and
eugenol paste or other temporary material,
including light cured glass ionomer cement.
Advise the patient that this is a temporary
procedure to relieve pain and sensitivity. The
coat of zinc oxide and eugenol may come off the
Instruct patient to eat a bland diet and avoid
extremely hot and cold foods, liquids, or sticky
foods, and not to chew on the fractured tooth.