Figure 6-6. - Types of tooth fractures.
Upon examination of a type I fracture, you may observe:
A slight chip or fracture of the tooth enamel layer only, or with possible minimal dentin involvement
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 fracture:
1. Smooth sharp edges of the chipped area with sandpaper strips or disk to eliminate irritation of the tongue and lips.
2. Carefully dry the chipped area with a cotton roll or pellets.
3. Apply small coats of cavity varnish over the chipped area with cotton forceps and cotton pellets.
4. 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 II - Enamel/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 dentin layers
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 follows:
1. Isolate area with cotton rolls.
2. Carefully dry the fractured tooth off with cotton rolls or 2 x 2 gauze. (Do not use direct air with the 3-way syringe.)
3. Coat all exposed dentin with a zinc oxide and eugenol paste or other temporary material, including light cured glass ionomer cement.
4. 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 fracture.
5. 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.Continue Reading