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My niece just broke her two front newly-descended adult teeth.
January 24, 2013 10:15 AM   Subscribe

Today my eight-year-old niece broke her two front teeth, both diagonally so that she has a triangle-shaped hole between her teeth. They are adult teeth. They are on their way to the dentist, but I just wanted to get some information from experiences you all may have had.

What are her options? What is the process like? It kills me that these are her adult teeth - is she going to have life-long issues? Is it worth getting a second opinion considering the impact this will have? Or, are the options fairly straight-forward?

Thanks for the help.
posted by anthropoid to Health & Fitness (37 answers total)
 
Don't worry about it. They'll make prosthetics that match her tooth colour exactly and cement them in place permanently. No one will notice.
posted by seanmpuckett at 10:21 AM on January 24, 2013 [10 favorites]


Anecdata to reassure you: I had a good friend who broke her two front teeth at about the same age. I knew her for years before I found out -- I always just thought she had really perfect teeth. They didn't give her any problems.

ETA: Also, poor thing! That's everyone's nightmare. I hope she has a lot of ice cream coming her way :/
posted by fiercecupcake at 10:22 AM on January 24, 2013 [1 favorite]


Coincidentally, I had this exact same injury years ago due my apparent belief that I could fly. I had two caps fitted onto my teeth (which are colored to match my teeth) and you can't tell that there's anything wrong. But I have to be careful about what I eat; I try to avoid biting into things that are really hard or sticky. I cut everything up into bite-sized pieces.

Still, every five years or so, one of the caps will fall off, and I have to go back to the dentist to get a new one put back on. I can actually tell that one is about to go now, I can feel the crack when I run my tongue along the back of my teeth. So, an annoyance, but not a huge, lifechanging event.
posted by backwards compatible at 10:24 AM on January 24, 2013 [3 favorites]


I broke both my front teeth playing hockey in college. The options are usually as follows:

1. Root canal. Crown it.
2. Yank it and put an implant in. Crown it.

Both options will need a porcelain crown, and these procedures are usually a tad more painful than back teeth because the dentist needs to poke the needle into the cavity above the front teeth to numb the patient. Normally, they take care of the root canal, then put in a temporary till the crown is made.

If they yank it, from what I remember, you'd have to wait for the hole to heal over so that base is created to set the implant in. Dentists usually push this as the best option because a root canal may eventually become infected 10-20 years down the line, and then you'd need to have it yanked anyways. I couldn't tell if that was simply to squeeze more money out of me or not, but dental insurance normally doesn't cover implants extensively.

I've had both crowns for over 5 years with no problems. *Knock on wood*
posted by MMALR at 10:27 AM on January 24, 2013 [2 favorites]


I had a very substantial break/chip in one front tooth from the age of eight until last Monday - it was not catastrophic enough to require emergency repair and we could not afford repair for any other reason, and then I just got used to it. It was a very big chip - about halfway across the tooth horizontally and 1/3 of the way up vertically.

The dentist used the fancy new resin they have now to sculpt a new tooth section. He did not need to do any drilling/anchoring and just used the surface of the tooth as it existed. He did caution me that this kind of repair is more fragile than repairs to other teeth and advised against biting into really hard food with that tooth. So far, this has been a bit of a nuisance, but I expect that I will get used to it. If your niece's situation is like mine, she may have to learn to be very careful about apples, carrots, etc.

The new tooth part perfectly matches my other teeth.
posted by Frowner at 10:27 AM on January 24, 2013


I chipped a tooth quite badly when I was a young teen -- and I got a cap at the time. It lasted until I was about 30 -- I am 43 now. At 30, I got a full porcelain crown and it looks really great. No one can tell.
posted by Lescha at 10:31 AM on January 24, 2013 [2 favorites]


I got shoved while drinking from a fountain in grade school in the 80s and got a diagonal chip across one of my two front teeth. What everyone is saying is basically true, the dentist can make it look like nothing happened.
posted by entropicamericana at 10:33 AM on January 24, 2013 [1 favorite]


I broke my first adult tooth on a shopping cart when I was the same age. Unlike your niece, it was one of the lower front tooth, and my dentist complained about the positioning every single time I went in to get it looked at. For some reason they didn't want to fix it immediately. My parents later told me it was because they wanted to match it to a second adult tooth for size but I call lies. Those were the worst months. I got a little cap put over instead and it seriously fell off just about every week and it SMELLED.

I finally got a root canal, which somehow had no needles, and I got a perfectly fit little tooth crown. You can't tell except for a slight color difference, nearly fifteen years will do that, and whenever I go somewhere with black lights it is the only tooth that doesn't glow.
posted by Marinara at 10:34 AM on January 24, 2013


I did this to myself back when I was about 10! I happened to hit a curb while riding my bike and flew over the handlebars, landing on my mouth. As a result, I had a nice big upside-down V shaped chip on my two front adult teeth.

My dentist just filled the gap with bonding material. If there's enough tooth left to fill in the gap, your niece might be able to have the same done. There's a barely noticeable line as a result of the color difference between real/fake tooth, but you really have to be looking for it. I had to have it re-filled in after re-chipping my tooth by chewing on a pen. I don't do that anymore.

I wound up learning not to bite anything hard directly with my front teeth. For corn on the cob, I just use the teeth more towards my canines.
posted by dobi at 10:35 AM on January 24, 2013


Ooo - oooh. I did exactly this at exactly the same age. Except that i was living an airline flight away from the nearest dentist.
(My mother STILL gives me grief about that.)

Yes, she is going to have life-long issues.
But they're not going to be much of a burden.

Adult caps are made of porcelain and last 15-20 years. You don't give them to kids, because kids are rough on their teeth (as your niece just demonstrated) and their jaws are still growing and the face is still shifting - adult caps are generally not put in until the child is in her mid-to-late twenties. I received mine at age 27.
Lesser sorts of caps are less solid - I went through two sets before my adult permanents - a new set when i was 14, which were done very badly and eventually fell out when i was 16, and the replacements for those - which were fantastic and lasted (albeit with small nicks and chips) until I had my permanents put in.
My brand new adult teeth are wonderful - a good cap is invisible, perfectly mimicing a real tooth. Only nicer. I have the very very nicest teeth on the block. And they are SOLID as houses. No nicks, 5 years on.

Like with any major prosthetic dental work, get the best dentist you can. Ask around. My experience at age 14 was horrendous - a dentist who didn't care about pain, who shaved off far too much of the remaining tooth, and gave me teeth made and set so badly that they caught EVERYTHING that I ever ate, and had me laughing with my hand over my mouth for years, and launched a dental complex that has endured until today. (I'm a crier.)

Even with a good job, your niece will have to watch what she eats - no sugarcane (don't know of that's an issue where you are!) or toffee apples - basically no hard or sticky things that will catch or snarl on the caps (think of having a big filling on the vulnerable OUTSIDE of the front tooth!) and she will probably develop an addiction to dental floss.
It's not a huge handicap. When the set I'd been given at 14 years old fell out, it was while biting into a piece of soft white bread, so you never can tell....

Find yourselves a good dentist, do some googling on the procedures, and resign yourself to a few repeat performances over the next few decades!
posted by tabubilgirl at 10:35 AM on January 24, 2013


My sister had something similar happen to her at a young age (I still deny any involvement) and ended up with a prosthetic/cap/veneer. Current prosthetics may have advanced since then, but over the years it did "age" differently than the rest of her teeth. So she will need to be diligent about brushing than my sister was or make sure to save some cash for a whitening procedure before prom.
posted by robocop is bleeding at 10:36 AM on January 24, 2013


My husband, at an age a bit younger than your niece, also broke his two front adult teeth, in a triangle shape across the two of them.

He got the filled in, with enamel resin. They look totally normal. It wasn't severe enough to need implants or caps/crowns. He did break a tiny corner of the "patch" a few years ago, biting into a hard candy. It was "re-patched". We have a vague idea that at some point, caps might need to be an option. We cary dental insurance and shrug our shoulders. Not much more you can do.

If circumstances allow, I would say the most conservative option is to "patch". Implants and caps both involve removing part/the whole tooth, which obviously can't be undone.

Aside from being a pretty-anxiety inducing injury, there has been no impact on his life. Eating apples, ears of corn, getting braces, etc all totally normal. The only thing to consider, is that as he grew into the coffee loving adult he is today, they stained differently than the rest of his teeth.
posted by fontophilic at 10:37 AM on January 24, 2013 [1 favorite]


I broke mine at that age. They put in a filler and you can't tell it is there.. I never know it is there. In fact, I forgot until I read your post. It was almost 30 years ago!
posted by LeanGreen at 10:42 AM on January 24, 2013


If the nerve is exposed or close to the break, a root canal and crown is usually done. If its just chipped they will bond it with resin that is akin to the material cavities are filled with. I chipped my front tooth a million years ago and had it bonded. I had it redone 20 years later since my teeth had changed color and the bonding material hadn't.
posted by PJMoore at 10:44 AM on January 24, 2013 [1 favorite]


I broke a front tooth at around that age. The tooth eventually died so I had a (pain free since tooth was already dead) root canal a few years later. The tooth has been bonded and every few years (5-10) I get it re-bonded to fix wear, color, any chips. My dentist would like to replace it with a crown but it's not been a priority for me - and I broke it more than 40 years ago.
posted by leslies at 10:48 AM on January 24, 2013


I had the exact same thing happen when I was about 12 -- so, 15 or so years ago, now.

The whole thing was surprisingly painless. The shock of the whole thing (and the feeling of my tongue against the broken teeth) was the worst part.

Luckily I didn't need a root canal or an implant. I had "temporary" caps put on a few days after it happened. In the last 15 years, these caps have fallen out and needed to be replaced by a dentist maybe 4-5 times. The first couple of times they fell out it was really annoying but as I got older it became just a minor issue. They look good enough -- even romantic partners are often surprised to learn that they're fake.

It's been on my to-do list to get more permanent porcelain veneers on for a while now, but the current caps are good enough that I haven't really been motivated to spend the money.

The only change in my lifestyle has been that I eat some things like carrots and hard cookies at the side of my mouth instead of biting in with my front teeth.

All in all it hasn't been such a bad thing for me. It's a good story and has had minimal impact on my life. Your niece will be fine!
posted by no regrets, coyote at 10:51 AM on January 24, 2013


Probably 18 years ago my sister fell face first on to the edge of a wooden chair's seat. One of her front teeth broke diagonally, practically from gum line to the opposite corner. You wouldn't know it to look at her now. I think the dentist just filled it in.

Your neice should be fine.
posted by PuppetMcSockerson at 10:52 AM on January 24, 2013


My husband did something similar when he was that age. He’s 63 now, and his prosthetics still look and work well.
posted by roomthreeseventeen at 10:52 AM on January 24, 2013


This happened recently to a 7 yr old friend, the cap on her tooth looks like her other unbroken front tooth and it was no big deal.

Two of my kids did the same thing as children, they're now in their late thirties. I remember that they had to get permanent caps (or whatever they were called) when they were full-grown, but that may not be the case any more.
posted by mareli at 10:55 AM on January 24, 2013


Like with any major prosthetic dental work, get the best dentist you can.

This cannot be stressed enough. My mother had a similar issue (a fall on the playground when she was 7 or so) and broke one tooth. My grandparents just took her to the dentist they'd always gone to, but his work wasn't very good, and the work he did caused issues with the surrounding teeth. Now, as an adult, my mom has several fake teeth, all traced to this original accident. She and my dad have joked that they didn't just have two kids to send to college: they had me, my sister, and my mom's dental work.

On the upside, you'd never know that her teeth were fake. I'm not sure whether they're capped, crowned, etc. but now they look lovely.
posted by ocherdraco at 11:29 AM on January 24, 2013


The same thing happened to me at the same age. The break didn't go extremely deep, so I didn't need a root canal or a full crown. I've had the same porcelain inlay for 15 years, and I've never needed to be very particular about what I eat to avoid harming it. If my diet has consisted of blueberry pie and red wine for a week, sometimes someone will notice it's slightly off from the color of the rest of the tooth, but it's never been an issue cosmetically or otherwise.
posted by lemonadeheretic at 11:30 AM on January 24, 2013


I broke one of my front teeth at that age. They watched and waited for a bit and then decided I needed a root canal, for which I saw a specialist. It was all about as painful as you would expect a root canal would be, so not an awesome experience but not life-scarring either. I had a patch on the tooth for awhile, and the whole thing was a minor issue when I got orthodontia. I got a permanent cap in college, maybe 15 years ago; my dentist thinks I should replace it soon. So, that's an expense, and like other posters, I avoid chomping down on apples or corn on the cob, etc., but overall it has hardly been a big deal. I'm a little self-conscious that it's just one cap because it doesn't quiiiite match the adjacent tooth, though people assure me that it's all in my head - so, there's a silver lining for your niece, that she broke both so they will always match! You're very sweet to worry. It should be fine.
posted by katie at 11:39 AM on January 24, 2013


I broke both of my front two adult teeth about a year or two after acquiring them. I was in a playful shoving match with a more fleet-footed friend coming in from recess. He jumped out of the way and I swan-dived to the pavement.

It really sucked when it happened, and I had to have a root canal on one about a year later. Day-to-day though, as an adult, I don't really even know they are fake. I've had them swapped out a couple of times since the accident happened, which was more than 30 years ago.

Sorry for your niece, but reassure her that there are huge numbers of us fake front teethers out there, walking amongst you all unnoticed.
posted by mcstayinskool at 11:41 AM on January 24, 2013


My mother had a similar issue (a fall on the playground when she was 7 or so) and broke one tooth. My grandparents just took her to the dentist they'd always gone to, but his work wasn't very good, and the work he did caused issues with the surrounding teeth. Now, as an adult, my mom has several fake teeth, all traced to this original accident.

On a related note, make sure they ask the dentist if it would be advisable to get a root canal now (or, go back in ~1-2 months to reassess), and if the dentist says yes, do it! When I went through a similar experience at a similar age, the dentist said a root canal would be "a good idea," but I was too much of a wuss to sit through it - and as a result I had to have relatively major dental surgery a few years later because it really had been infected that whole time.
posted by Joey Buttafoucault at 11:47 AM on January 24, 2013


I broke both of my front teeth around age 10, one side in a diagonal like your niece did, one straight across (apparently turning in sandy gravel on a bike going too fast = flying over the handle bars and into pavement). The diagonal one has been fine, they capped it and like said above, every so often it will break off and I'll have to get a new one (though I think that's only happened once so far (20+ years with them). The straight across one has caused me more of a problem because I lost the cap right before an orthodontist appointment and they actually mistakenly thought they needed to use the braces to pull that tooth down to make it level, and of course it has drifted back up after I got the braces off. But that was really an odd combination of events.
posted by katers890 at 11:50 AM on January 24, 2013


This sounds familiar.... I broke my two front (upper) teeth on our garage floor while in fifth grade. Two root canals and ceramic crowns later, I looked normal. Ceramic crowns were used while my mouth was still changing and growing.

During my senior year in high school the crowns were replaced with permanent porcelain ones. 29 years later, they are still in my mouth. I don't even think about them... no special care, no special foods, nothing. As far as I am concerned, they are my teeth.
posted by Leenie at 12:07 PM on January 24, 2013


My best (adult) friend had a tipsy bike accident one night and broke her teeth on one diagonal. Dentist capped them, no one could tell.

Two years later, she was walking down a street with her hands in pockets, tripped, and guess what, broke them on the other diagonal. Again, dentist capped them (shook his head at her incredulously) and no one can tell.

We expect she'll be having more dental work this year, but that's due to her klutziness more than anything.
posted by pixiecrinkle at 12:29 PM on January 24, 2013


I did the exact same thing at age 8! I was playing "blind person" with a friend and we were holding hands and running and she accidentally guided me into a soccer pole. I lost like half of one of my teeth, enough that the nerve was exposed. They glued on a little half-tooth at the time (which did have to be replaced a couple of times). I don't remember this being painful and it didn't show unless you looked really, really closely. When I was around 17, they did permanent crowns on both front teeth (so they'd match). The actual crown-getting procedure was not very fun, but they look and feel totally natural. I'm almost 30 and I actually forget they're there. I've had people tell me I have great teeth (that was in England though, not to perpetuate a stereotype). Assuming they have a good dental plan, she'll be fine.
posted by SoftRain at 12:30 PM on January 24, 2013


Thanks so much, everyone. Your stories really helped ease my mind about this and I've sent the link to my sister so hopefully she can get a better sense of the long-term as well. The break is very close to the nerve, so the dentist put a "barrier" on the broken edges and he's going to let the teeth heal for four weeks. We'll see what needs to happen after that! Thanks again.
posted by anthropoid at 12:37 PM on January 24, 2013


Chiming in to say I did the same thing when I was 11. The first few caps did not last more than a few months, but the cap I got put in when I was 14 is still there (I'm 37 now, overdue for a replacement I guess!). You honestly cannot tell it is there.
posted by arha at 1:02 PM on January 24, 2013


Oh man, I accidentally knocked out my best friends front tooth when we were 14. We were ice skating and were trying to do some Olympic Feat when started to fall, grabbed the closest thing to me (her) and down we went. We never found the tooth. It probably landed in the snow.

She forgave me before we got back to her house. She got a fake tooth that looked just fine. I still kick myself about it.

Oh, and if your niece has a sense of humor about it: give her the graphic novel Smile. It's about a girl who loses her front two teeth in an accident and the social trauma that follows. The main character is a thoughful, funny tween girl, but be warned: the descriptions of the procedures that she has to have after the tooth problem (mean dentist, funny looking fake teeth, etc) might freak her out right now. Wait until her pearly whites are back to normal and then consider it. It is a really great book.
posted by Elly Vortex at 1:09 PM on January 24, 2013 [1 favorite]


I also broke my front tooth in half at age 11. My dentist made me wait a few weeks after my injury before he filled in the gap, and that was probably the worst part of the whole experience. I remember not smiling or talking much in class for at least a few days. After that, it was no big deal. The colour matched well, and I haven't had anything done to it since (16 years later).

She might have difficulty with tooth whitening methods in the future, but that's probably not a concern at age 8!
posted by ashputtel at 1:16 PM on January 24, 2013


The break is very close to the nerve, so the dentist put a "barrier" on the broken edges and he's going to let the teeth heal for four weeks. We'll see what needs to happen after that! Thanks again.

I had this exact situation at a similar age. A little medication and barrier, then enamel resin of some sort to reconstruct the tooth. It looked fine, wasn't painful. The dentist told me it would discolor slightly differently than the other teeth, but it didn't.

~20 years later, I chipped the reconstructed part, and got crowns. Which hurt a little, but not bad overall. They also look fine.

She may have an adjustment period where saying "s" and "th" sounds feels weird - I did. It just took a few weeks to get used to the slightly different geometry. Nobody else noticed though.
posted by mrgoat at 1:57 PM on January 24, 2013


Yep. Me, too. Recess. Third grade. Playing tag. Home base was a basketball pole...surrounded by loose gravel. You can picture what happened.

I had my little false bits replaced when I was about 32 as they had discolored a bit due to youthful smoking (ugh) and coffee. They gave me new false bits, colored to match. She'll be fine. You could, maybe, at some point, tell her not to smoke or she'll mess up her false tooth bits. Heh. Maybe it'll work.
posted by amanda at 2:39 PM on January 24, 2013


My husband broke one of his front teeth in a bicycle-and-curb related mishap when he was 11. They bonded it at the time. All was well until he was about 22, when the nerve in the tooth finally died. He had an excruciatingly painful couple of days, then a root canal that made it feel better. The tooth had to be rebonded after that, but in the 15+ years later, there have been no further side effects.

She's not the first and won't be the last, dentists know how to cope!
posted by Andrhia at 4:37 PM on January 24, 2013


I also was 7 or 8 years old when I broke a triangular gap in my upper front teeth. My parents were told that I would need caps but to wait until I was older and my teeth had stopped growing. At least that's what I remember.

That gap lasted until I was maybe 19 or 20 when the teeth were patched not with caps but with the same resin bond that others have mentioned. I remember it being the least painful most trivial dental procedure that I had ever had - a standard annual tooth cleaning would hurt more.
posted by metadave at 4:46 PM on January 24, 2013


As you've probably guessed, it won't be as bad as it initially seemed.

I had something similar happen when I was 10, one tooth chipped diagonally, the other straight across. I found the half tooth and the dentist glued it back on. For the other tooth, the dentist created some sort of filler material to fill the gap. Neither repair was very noticeable. The goal was to let my mouth grow and shape, and then I'd get crowns later in adolescence. The glued together pieces broke a few times and were reglued, but the filler piece never had any issues. (I wasn't allowed to bite into apples or carrots etc. with my front teeth.) No problems when it came time for braces. When I was 16, I got crowns. Unfortunately, it wasn't much later that they realized I needed root canals. Not that it was bad, but if I could offer advice, do the root canals first! Just seems to make more sense (might even be able to do them in the same sitting).

No issues since then, and the two dentists I've been to since my childhood dentist have both said how great my crowns are. Also, "All I Want For Christmas Is My Two Front Teeth" will take on a new, cute meaning.
posted by Terriniski at 5:19 PM on January 24, 2013


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