At Beverly Hills Advanced Specialties of Dentistry, patients in the Beverly Hills, California area can have a variety of procedures performed by our dentists, Drs. Frank Vidjak and Fanny Yacaman. In addition to endodontic services, our team also ensures patients have access to general, cosmetic, and restorative dentistry. Patients who find themselves with a chipped or cracked tooth may be interested in finding out more about the treatments offered to protect the tooth from further damage and cosmetically repair the tooth’s structure.
What treatment is available for a cracked or chipped front tooth?
Teeth that are damaged may require restoration to ensure that the tooth is not impacted permanently. Chipped and cracked teeth can leave sharp edges that can cut soft tissues in the mouth, and it can leave a tooth susceptible to infection and inflammation. When a patient arrives at Beverly Hills Advanced Specialties of Dentistry with a chipped or cracked tooth, treatment options may be recommended. They include:
- Dental crowns. Larger teeth, such as the molars, can be covered with a dental crown to protect the tooth from further damage and infection. A dental crown is a porcelain restoration known as a “cap” that covers the exposed tooth and protects it.
- Porcelain veneers. A porcelain veneer is an extremely thin shell of ceramic that is bonded onto the front of a tooth to cover imperfections including chipped, cracked, stained, or gapped teeth.
- Composite resin bonding. With composite resin bonding, referred to by some as dental bonding, a resin material can be placed onto a tooth, shaping it, curing it, and polishing it to look like natural tooth enamel. It is an alternative to porcelain veneers and can be done in a single appointment.
Do you have a cracked or chipped front tooth?
Whether you have a large chip in one of your teeth or a hairline crack in a tooth, it is important that you work with a dental professional to seal the tooth and ensure infection does not occur. Contact Drs. Frank Vidjak and Fanny Yacaman of Beverly Hills, California to discuss your needs. The office is located at 465 North Roxbury Drive, Suite #703 and is available by phone at (310) 861-3955.
Witness Dr. Yacaman execute a thorough endodontic diagnosis on a patient with significant trauma on her front teeth at Beverly Hills Advanced Specialties of Dentistry!
Ok again I tell you the story about my patient. She is my mom, she fell on August 11th and when the patient falls so hard like she fell, all this was purple. She fractured this tooth that you wanted to see. It is the canine and now she has pain in all these areas, all these areas. When I saw the first time she had the fracture here, which is an oblique fracture, I will show you in an x-ray later. How do you know as a patient what to do? You have to wait 14 days after you fall and then you have to see your dentist, Endodontist and they have to do a testing again. So everything will be different and now I find out all these teeth are normal to cold and this is how we do the testing. Now we place the cold in the middle of the tooth and we wait for the patient to say if she feels it (doctor speaks in Spanish)
Ok she felt it? No. Then if your assistant is busy writing the data, then I ask the patient to do the suction by themselves because it is my mom! I am just kidding, usually my assistant does. Now – we go to the next tooth, she is normal and (doctor speaks Spanish) on Number 9 she is complaining of pain when I touch her. She is not giving me any response so I have to perceive that this tooth is not cracked. This is a C02 test which is 70 degrees below 0, we use it in the universities, not all the endodontic offices have it. Personally very stubborn, I want to have exactly by the book. At this point if she doesn’t feel anything with the cold (Doctor speaks in Spanish) the tooth could be necrotic which is interesting because this is the one she has more pain so we are doing a test in this area to see which one of the teeth are there and amazingly enough, the one with the fracture is still alive. She has pain even when I touch here, and she has pain (doctor speaks Spanish) in this one a little bit but I don’t know why the response to cold is negative.
That doesn’t mean you are going to do root canals or they have to do root canals on you, in the whole mouth. It just means that we have to wait again to do another testing. I don’t like to do root canals until I am sure that you are really going to need it, but that is the cold test and we will be back with the 2nd test which is bite test Percussion for the patient and etc. you will see it.
Watch Dr. Yacaman use the bite test to ascertain accident damage on her mom’s upper jaw.
Where is your… so Maria was asking why the patient is having pain in this tooth when I touch it, when the accident was mainly in these teeth and I was talking to Maria that the referred pain can work from here to this tooth, but one thing that is interesting that I didn’t finish telling you Maria, is that I didn’t realize this tooth is on the other side, so referred pain from this cannot go to this side. Referred pain is only one side on the mouth. If you have pain on the back, that can go to the right and to the left but the mouth only refers to this side and the problem with this, having the pain and answering very little to cold means this tooth was hit also, and still it is alive, we are going to wait a couple of weeks and do an exam again.
Now we are going to put the second part which is the bite test. So we are going to ask the patient to bite, open and bite.
Ok, see so I didn’t even have to –close. Marie follow me. Marie is going to follow me and write the tooth number, tooth number 9, negative bite. Negative number 8. See how it’s amazing this. The endodontic test is fascinating so your Endodontist has to do step by step.
Mhmm open, open, bite, open, bite, open, bite, open, bite, open, open, bite, bite. Okay so we are going to go again. Ok she doesn’t have pain on almost 11 she has pain here. Then bite, so this is the worst. From 1 to 10 – so she has a positive 9 pains. We have to put three arrows up with the number 9. So your Endodontist has to see, if all of these teeth are important to compare because this is the only one who is giving her the pain. I thought this one was going to be the worst and no, I thought the fractured tooth was going to be the worst but now what is giving us the worst part is number 7, which on the x-ray is also showing a sign after all these weeks, about having a problem and a tooth coloration is darker. We are going to do the same test on the lower, but now we are going to go to the second, to the next test.
Using the Percussion test – the next step in diagnosis by Dr. Yacaman when performing correct Endodontic Diagnosis.
Now we are going to go to the 3rd test which is Percussion. Be sure your Endodontist, in my case I am a little exaggerated especially it is my mom. I go by quadrant but in this case where the accident was here and all this area was extremely purple, I have a picture, I will display it also for you guys, so I am testing the open and the lower but I am finishing with this step which is Percussion so we go again from the tooth and we are (doctor speaks in Spanish). Ok she has positive 8, Marie follow me, tooth number 9 – positive 8 tooth number 9. Level of pain is 8.
8 Marie – come and see the teeth that I am working please. This is tooth number 1, ok so this will be the level of pain Marie will be number 10 and number 8, number 8. Tooth number 10 is the level of pain. Ok so I am comparing because she can be exaggerating a little bit because patients get scared, and it is my mom. Hard to treat family you know. Trying to distract her attention so she can’t concentrate. See, so it only makes sense because she has the widening of the, it means it shows inflammation on the crown of the roots and around the root, patients don’t know why they need a PDL but it means a semi inflammation and then in the accident she fractured this tooth, Dr. Bridget tried to place a Prosthodontist that is we are working together and he tried to accommodate the patient at the beginning , just until we wait for which is going to be the final treatment plan but as you see, ok she has positive A. Now she is asking me to rest, and if I don’t listen imagine it is my mom. So I have to listen. (doctor speaks in Spanish) See she is complaining about the same level on all the teeth so in this case, I mean all this area is still inflamed. The only one that I am very sure of a problem is this, but the rest I cannot take into consideration, the results of today with Percussion. We have to wait until it is more healing and do it again to have a more accurate diagnosis and that is what your dentist is going to do for you.
Witness Dr. Yacaman conduct the Palpation technique.
Now Senorita, (Doctor speaks in Spanish) we are doing to do the last test which is palpation, kind of the last one, we have to use a clinical judgment you have to look at the x-ray that Maria my business manager is taking the video today and she is going to place pictures today at the end, but we are talking about palpation so you very delicately, grab very gently – the doctor has to do that. Very gentle so you can differentiate where the pain. You can do this test yourself, and then you can compare with your dentist what he is doing and look at this area, if there is any pain so when the impact was there – So here is another problem. My mom is a heavy grinder and clencher and if she is not using her snore guard that she has already – or her night guard, what she is doing is aggravating everything which makes the diagnosis more difficult.
So now we go slow, okay mama? No. (Doctor speaks in Spanish) See how it is interesting she doesn’t have pain here but then we go here, look at this, this is fascinating for me you are going to see alter the oblique fracture in this tooth in the canine, but if we go a little bit here, then she has pain. She is asking me if I have my nails long, I will show you my nails – nobody at the office is allowed to have long nails except if you have any enamel placed on top, any colors because if you do this, my staff doesn’t do it, I do the patient, but still you need to be without nails to check these very delicate.
No pain, ok? Ok so number 6, number 7, no? Ok, number 8 and 9 she does have, but the thing she was saying is that she was having pain here so watch that maybe she forgot about this pain. See? So with the patient you start, you have to be very careful of her responses. She is like oh my God I have pain here it is a level from 1 to 10 – 8, and then she comes now and I am pressing really hard, harder than before and now she doesn’t feel anything? Now (Doctor speaks in Spanish) that is why I like to repeat the test. Mama? See now she doesn’t have pain in number 9, number 8, number 7, number 6. Okay mama, she feels like I am pinching her. See now she doesn’t complain about this area. Ok so we have 6 and 7, positive on palpation number 8 and the last one quickly we do a probing test for the patient and I am checking if she doesn’t have any and of course she is killing me because she thinks I am poking her. This is only to make sure, if there is any fracture in a different way, so I do that on the lingual and I am making an assessment and later on probably in a week or two I will bring the patient and I do the same testing here and I mean in this case, it is my mom but then with a regular patient that is what I do I wait 2, 3 weeks after the accident I go over to the testing, we analyze x-rays, all the symptoms and then we make a decision. Which tooth is going to need a root canal treatment and what is the level of root resorbtion after the trauma. Is the resorbtion coming up soon? When shown on the x-ray? Normally we see in the future a topic, very interesting that is called Root Reception and we are going to go over it, but root reception is caused by these type of traumas. This is my mom, I am very grateful that she is here and the next test I am going to do the same all over on the lower. Thank you for your attention if you have any questions doesn’t forget to contact us at (310) 248-2336 or you can send a messenger through our Facebook, I guess in YouTube I don’t have experience or you can – on the website also you can send messages. Thank you!
Understanding cracked tooth symptoms and treatment.
American Association of Endodontists – specialists in saving teeth.
Our smiles are built to last in fact, tooth enamel the outer surface of our teeth is the hardest substance in the human body – stronger, even than our bones. That tooth enamel can withstand a lot of wear and tear, but as we live longer and expose our teeth to stresses like clenching, grinding or chewing on hard objects we can put our smiles at risk!
Cracked teeth – signs that you may have a cracked tooth are, pain when you are biting or chewing, or sensitivity to hot or cold foods, but sometimes there are no symptoms at all. That is why regular dental checkups are so important. To understand why a cracked tooth hurts – let’s take a look at a healthy tooth. Inside the tooth under the white enamel is a hard tissue called dentin inside the dentin is a soft tissue called pulp. The pulp contains the tooth’s nerves and blood vessels – it extends from the crown of the tooth into the roots of your teeth. When the enamel of the tooth is cracked – chewing can cause the pulp to become irritated. This irritation can grow and eventually the pulp can become injured. Besides pain and sensitivity – the injury may lead to infection of the pulp tissue. That is why it is important to diagnose and treat a cracked or chipped tooth quickly so the problem does not get worse.
There are many types of cracked teeth, treatment will depend on the type location and severity of the crack – common cracks include fractured cusps, split teeth and vertical root fractures. If you have signs of a cracked tooth, you should see an Endodontist – a specialist in diagnosing tooth pain. Endodontists are experts in saving your natural teeth – using state of the art technologies like microscopes and digital imaging, defined cracks in your teeth and treat you quickly and comfortably. Your endodontist will discuss your symptoms and examine your tooth to determine your treatment options – treating a cracked tooth, usually with a root canal procedure – will relieve your pain and reduce the likelihood that cracks will worsen. During root canal treatment, your Endodontist removes the irritated or damaged pulp and cleans, shapes, fills – and seals the root canals to keep bacteria from entering the tooth. After your Endodontist is finished you must return to your dentist to have your tooth properly restored with a crown – that protects the tooth and is important to ensure the success of your root canal treatment. For a detailed explanation of root canal treatment and how it can save your tooth, please watch our root canal treatment video. Nothing looks, feels or functions like your natural teeth so talk to your Endodontist about treatment options to save your cracked tooth. Protect your teeth from life stresses and make sure your smile lasts a lifetime by having regular dental checkups.
For more information go to www.aae.org
The skilled doctors at our practice are Frank M. A. Vidjak, DDS, MSEd and Fanny Yacaman, DDS, MSEd, MS.
Dr. Vidjak is a member of the American Dental Association, California Dental Association, Los Angeles Dental Society, American College of Prosthodontists, Beverly Hills Academy of Dentistry, San Gabriel Dental Implant Study Club, Advanced Treatment Planning Study Group, and West Los Angeles ITI Study Club, and a Fellow of the International College of Dentists and Pierre Fauchard Society.