Is A Tooth Breaking An Emergency?

Video Transcript:
“Is a chipped tooth an emergency?” I get this call a lot. On the weekends. I don’t mind it, because I care about my patients. I want to understand what concerns them. And, one call I get is, “I just chipped my tooth. Oh my God. Do I need to come in?” Well, let’s talk about that, because there are a number of scenarios there. And, now a days with an iPhone or whatever smart phone you have, yeah, just take a photo of it, text it to me and we’ll look at it. And, what I’m looking for is… how much tooth structure has been damaged? So, let’s just say it’s a front tooth and you’re eating something and you’re just really excited about the mean and you bit down into your fork – that happens – and you feel like… ugh! I have a piece of tooth in my hand – that’s scary, and it’s very alarming and I will get a call like 10 seconds later. So, first of all, it’s not like, in that scenario, that you most likely have done damage to the tooth where, first of all, where it’s going to cause a lot of pain. It may jar it at first, and it may be a little of alarming, and it could hurt the overall tooth for the next 30 seconds, but as that subsides from that initial impact, the important thing to know is that it is not a nerve exposed, because most likely you chipped it into the enamel. So, how do you know that even without sending it to me and looking at that and diagnosing that? Well, if you chipped it and you look at the remaining tooth structure and it’s white – that’s enamel – that’s okay. It may be a little inconvenient. If you chipped a pretty large piece, then in that case it would be appropriate to address that on Monday and to replace that with some bonding, or if you have an important thing coming up the next day, certainly I would see you and address that in that situation. But, if you chipped it and it’s more substantial, let’s say like on a back tooth that takes a lot more impact, and now you chipped it and the piece has, not only white, but a little bit of a yellow interior, you’ve chipped it a little more substantially and now this could still not be into the nerve of the tooth to where the pain you feel would be like, “Hey doctor, I’ve chipped my tooth. It hurts when I drink something cold” – Is that an emergency? It’s not. So, in that situation it is still appropriate, still, to come in the following Monday and address that with either a filling or a crown to replace or repair the dentin and enamel that has been damaged. The next scenario would be, you bit into something and you hear a crack. Well, that happens and it is an emergency, because now if you’ve bitten into something and you heard a crack and now you bite down and it is a very sharp, extreme pain… in that situation, you’re probably not going to make it through the weekend without having to come see me. So, that happens not very frequently, but the way you know it is, when you go to chew something over on that side again, you cannot chew on that tooth. So, in that case, most of the time, that tooth has to be removed, because now, what you’ve done is, you’ve not only cracked through the enamel and through the dentin of the tooth, but you’ve cracked all the way into the nerve. So, that is a very true emergency and something that requires, most likely, immediate attention.