Fractured Teeth and Transillumination

Shining the Light on Tooth Fractures

Teeth are strong, and by practicing good home care with regular professional cleanings and check-ups you are working to keep them strong! But, however diligent you may be at using these procedures, thus protecting your teeth cavities and erosion, we still cannot guarantee that accidents won’t happen, and unfortunately accidents can lead to fractured teeth.

Fractured teeth are the second leading cause of tooth loss in adults, with the first being periodontal or gum disease. There are several things that can cause teeth to chip, fracture or break, you may inadvertently bite down on something hard, sports injuries and accidents such as falling, being hit in the mouth or being involved in traumas such as a car accident. These factors can all break and crack teeth. Also large cavities can sometimes lead to ‘more cavity than tooth’ and the resulting thin shell of tooth is vulnerable to cracking and breaking.

For teens and young adults there is a new source of tooth fracture on the horizon – tongue and lip piercing. As this fad spreads, we are seeing more fractures in the front teeth among its followers. One study was conducted in Israel, where as many as 20% of teens have tongue or other oral piercings. Of the pierced teens in the study, researchers found that about 15-20% of them had either fractures or budding gum disease in their front teeth! Since prevention is obviously the best cure, the study’s authors encouraged the parents of teens who are looking at getting pierced to persuade them to change their mind. This may be easier said than done, but consider the hazards of tooth loss, as one author stated, “your kids will thank you for it later in life”.

How Will I Know If I Get A Tooth Fracture?

You’ll know if your tooth breaks severely enough to expose the sensitive inner material and nerve, it will hurt! The pain however, may come and go, it can be extremely sensitive to hot and cold drinks, or just being exposed to the air. The pain increases when you chew and put pressure on the tooth. You can also feel the sharp edge of the broken tooth with your tongue. If you experience any of these unfortunate events, please make an emergency appointment with your dentist to begin the correction and repair process.

Many tooth fractures, however, do not hurt and this is where the trouble comes in. Tiny hairline fractures that don’t enter the sensitive part of the teeth often go undetected. Over time, these fractures can form areas for bacteria to collect and begin the all-too-familiar process of producing acids that lead to tooth decay. Since any fracture is capable of going deeper, the existence of undetected fractures sets you up for a broken tooth waiting to happen. If the situation progresses to ‘more cavity than tooth’, the entire outer structure could fail. So often, these things happen at the worst possible time too. Like the start of a long holiday weekend, or the first night of your honeymoon, well, we surely hope not!

The key then, is to find and correct these little cracks before they become big ones. This is easier said than done. X-rays cannot be used to detect unseen fractures like those in bones, so often they are missed. Fortunately there is a new non-invasive approach called transillumination. This long word literally means ‘shining the light through’, and it is something that should be done with every examination these days.

Light Helps Us Find It, So We Can Fix It

As a kid, did you ever play with a flashlight on an overnight camping trip? Remember how the light could shine through parts of your hands, or produce weird looking shadows and effects (and a nice atmosphere for ghost stories) when angles on your face? In a sense, what you were doing was transilluminating.

The same principle holds in the dentist’s office (but without the ghost stories). A small, high intensity light is used to illuminate the teeth, gums and other mouth parts. Any small undetected fractures, such as the ones we have discussed above can easily be seen with this technique. Once found at this early stage, very often the crack or chip can be repaired with no risk of losing the tooth. This is so much easier than waiting for your tooth to start hurting or fall apart when the risk of losing the tooth becomes very real.

Many other potential problems can be found and corrected by using this transillumination method. These include small cavities, plaque or tartar located beneath the gumline, any hemorrhaging that might occur in injured teeth and any flaws or bubbles in cosmetic applications such as dental veneers. I believe that “a stitch in time saves nine” and examination procedures using on the power of light to find little problems, ensure they can be fixed before they get too big!