Dr. Hall,
I was recently assaulted by my ex-boyfriend, the father of my child. He punched me directly in the mouth. Now both of my front teeth are loose; one is more loose than the other. I went to the e.r. and they took a cat scan. They said that there were NO fractures. I am 26 yrs. old and I am scared to death that I will loose my two front teeth. Is there a good chance that my dentist will be able to save them? Also if they can be saved, what long term effects can this have on me? He also completely ripped the piece of skin that holds my upper lip to my mouth. At the e.r. they said there was “no point in stitching it, some people have that piece of skin and some don’t, if it’s not there it’s not a big deal.” Do you agree with that statement?
– Carrie
Dear Carrie,
I’m sorry to hear what happened to you. I feel for you.
If the roots of the teeth aren’t fractured, they need to be stabilized in the correct position in the next day or two. Your dentist needs to bond these two teeth into a fixed position, making sure that the position he fixes them into is the correct position, and then the bone will heal and they should be fine.
The ER is right that this piece of skin that was ripped is no big deal. It may grow back anyway. Sometimes, because it pulled at the gum tissue, we would try to clip this piece of skin and it would grow back anyway.
Long term, again as long as the roots aren’t fractured, you should be able to keep these teeth and everything will be fine. And then I would go back to the dentist after two or three weeks and have him check to see if the nerve of either tooth is damaged. If it is, you’ll need a root canal treatment. If that is the case, tell your dentist not to leave any gutta percha or root canal cement in the crown of the tooth. He or she will understand what that means. Leaving this in the crown of the tooth causes the tooth to go very dark in time. If the gutta percha and cement is removed, it will go dark very very slowly–over a period of years, and you can deal with that much later down the road.
Some dentists think that every tooth that has a root canal needs a crown, to strengthen it, but if there are no large fillings in any of these teeth and one or both needs a root canal, I would advise you not to get the crown, because a crown on a very front tooth that is otherwise intact and only has a root canal–a crown in that situation will actually weaken the tooth.
And if you need help with any treatment, the American Academy of Cosmetic Dentistry has a program to help victims of domestic violence. If you want help like this, look up the “Give Back a Smile” program of the AACD. You may not need anything until later, if either tooth turns dark. But I’d check out the program and see what you have to do to document that the problem was caused by your ex-boyfriend assaulting you, and be sure that’s in place so you can later take advantage of the program if that comes up.
Dr. Hall
Read related information at www.mynewsmile.com:
The difference in having a root canal on a front tooth as opposed to a molar
A dead tooth turns dark and can crack.
Read about a case where a front tooth broke off because a dentist did crowns on front teeth that had root canal treatments.
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About David A. Hall
Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.
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