Diagnosis
The diagnosis of an incisor that has broken off usually involves several steps. At the beginning a detailed doctor-patient consultation (anamnesis) is usually carried out. During this conversation, the dentist tries to get a first clue about the severity of the anterior tooth trauma based on the existing symptoms and the description of the accident event.
In addition, the patient concerned should be questioned with regard to possible underlying diseases (e.g. high blood pressure) and the intake of medication. In particular, taking the drug Aspirin can lead to severe bleeding in the area of the impaired incisor. Following the doctor-patient consultation, the patient will be evaluated.
In the case of an incisor that has broken off, attention should be paid to local swelling and bruising outside the oral cavity. In addition, the upper and lower jaws, as well as the zygomatic bone and the boundaries of the eye socket should be palpated. Conspicuous edges or steps along these bony structures can provide an initial indication of a bone fracture.
The oral cavity, especially the affected half of the jaw, must then be examined. In this way, the extent of anterior tooth trauma can be estimated. In this context, different types of tilting of the incisors must be distinguished.
The so-called peripheral tipping includes all degrees of loosening (including complete tooth loss) of the incisor. The term “central tilt”, on the other hand, refers to a tilt of the incisor in the direction of the jawbone. In addition, the actual tooth breakage is also divided into different types.
In the case of an incisor that has broken off, a distinction is made between cracks, enamel, crown and root fractures based on the size of the tooth fragment. Furthermore, the direction of the fracture edge must be described for an incisor that has broken off. In this context, a distinction is made between transverse, oblique and longitudinal fractures. Since an anterior trauma is not necessarily clinically recognizable as such, it is essential to initiate a radiographic examination after an appropriate application of force to the jaw. The extent of the anterior trauma can usually be reliably identified on the X-ray image.
