Friday, October 6th, 2017
A root fracture is a very serious and traumatic injury to the root of a tooth. The direction the fracture occurs (horizontal or vertical), and how close the fracture is to the gum line, will determine the chances of recovery and avoiding tooth loss.
At Enhance Dental Centre, our Vancouver Dentists we have successfully treated many root fractures, and saved patients from losing their permanent teeth.
A root fracture is a tooth injury that occurs when the portion of the tooth below the gum line is fractured or cracked. As noted, this is a serious injury that can result in tooth loss if not treated promptly. As well, if left untreated, a root fracture can damage other areas of the tooth.
Here is a bit of information about what a tooth is composed of, so you will have a better idea of what a root fracture is, where it can occur, and what the collateral damage can be.
The outside of a tooth above the gum line is composed of enamel that protects the inside of the tooth (dentin and pulp). Tooth enamel is an incredibly strong substance, in fact it is the hardest substance in the body! That said, lifestyle choices, diet, and injuries can all contribute to a weakening or loss of enamel, which can increase the risk of suffering a root fracture.
Like enamel, cementum is a protective substance that covers the tooth roots. Cementum is not quite as strong as enamel, so any time an injury occurs at or below the gum line, the risk of fracture is somewhat higher.
Dentin is a bony substance beneath the enamel and cementum that makes up the bulk of the tooth.
Dental pulp is the material inside the dental canals and roots. It is composed of connective tissue, blood vessels and nerves. The blood supply to the pulp is what keeps the tooth alive.
The pulp or root canals are the spaces inside the tooth root that contain the dental pulp.
There are many things that can cause or contribute a root fracture:
If a patient’s teeth are not well cared for and have excessive decay, the tooth enamel and cementum can become weak, which raises the risk of a fracture.
If an old filling remains in the tooth without being replaced in a timely manner, the filling can break or expand, causing the surrounding tooth material to fracture.
One of the most common causes of root fracture is a previous root canal. While a tooth can survive post-root canal, it will never be as strong as it once was. And because there is no blood supply to the tooth, it will continue to weaken over time. This combined with the fact that most root canals require the use of large fillings can cause additional risk of fracture.
Any sudden injury to the teeth, gums or jaw can lead to a root fracture. As well, if you are a person who likes to eat very hard items such as ice or hard candy, your risk is increased. If you bite down on something that is very hard, it can fracture the tooth. Most people describe this as hearing a crunching noise followed by a sharp pain in the tooth.
As noted above, there are many things that can cause a root fracture. In some cases, the patient may not even be aware of the fracture, but in others, such as in the case of biting down on something hard, the patient will notice an audible crunching sound followed by sharp pain.
If you suspect that you have a root fracture, it is import to visit us at Enhance Dental Centre as soon as possible. Sometimes a simple visual exam can diagnose a root fracture if the fracture extends up into the tooth above the gum line. However, in most cases, because a root fracture occurs below the gum line, x-rays will be needed to see the fracture.
Treatment of a root fracture will depend on the severity of the injury. In cases where the fracture is what we refer to as ‘hair line’, ongoing observation may be all that is necessary for the time being. Hair line fractures usually don’t result in permanent injury or damage to the pulp of the tooth, so careful monitoring may be all that is needed until further damage occurs over time.
In more serious cases of root fracture, root canal or tooth extraction may be necessary. It depends on the type and direction of the fracture, and how much of the tooth structure and pulp below the gum line have been affected. Tooth extraction is usually the last option, as at Enhance Dental Centre, we will always try to preserve your natural teeth before we recommend extraction.
As noted, in some cases, the only treatment required for a root fracture is careful observation. Hair line fractures won’t ‘heal’ per se, but the dental pulp can recover, and the tooth may not require further treatment for several years. Other factors such as age, general dental health, and diet will dictate how long the tooth can be left alone before other treatment is required.
If a more serious root fracture is left untreated, a whole host of other problems could occur that include the following:
With regular dental checkups, appropriate dental hygiene, and a careful diet, you can reduce your risk of developing a tooth fracture. If you suspect a fracture has occurred, it’s best to have a Vancouver dentist at Enhance Dental Centre examine your teeth before the issue becomes more serious.