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February 8, 2012
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Broken or Knocked-out Teeth

Medical Author:
Victor M Almeida, DO
Coauthor:
Joseph J Sachter, MD, FACEP
Medical Editor:
Scott H Plantz, MD, FAAEM
Medical Editor:
Francisco Talavera, PharmD, PhD
Medical Editor:
Jerry R. Balentine, DO, FACEP
Jerry R. Balentine, DO, FACEP
Jerry R. Balentine, DO, FACEP

Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.

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Broken or Knocked-Out Teeth Overview

Each individual tooth is composed of calcium and several other organic components. It is divided into 3 layers: enamel, dentin, and pulp—each layer having a specific role.

  • Enamel is a hard outer protective coating. It is the hardest substance in the body. A similar substance called cementum provides a protective coating over the root. It differs from dentin by virtue of its porous nature.

  • The vast majority of the tooth is composed of dentin, which is found directly beneath the enamel.

  • The pulp, the innermost layer, contains the blood supply that nourishes the tooth as well as nerve fibers that provide pain and temperature sensation. It also produces the dentin.

Anatomically, the tooth is made up of the crown and root. The crown is the visible portion you see inside the mouth. The root extends beneath the gum line. The tooth is positioned in a bony socket called the alveolus. It is anchored by a ligament and protected by the gums.

The 20 primary or baby teeth are replaced, beginning at about 6 years, with 32 adult or permanent teeth. Injury to teeth, especially permanent teeth, can be painful and serious.

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Broken or Knocked-out Teeth

Toothache »

Toothache Overview

Toothache or tooth pain is caused when the nerve root of a tooth is irritated. Dental (tooth) infection, decay, injury, or loss of a tooth are the most common causes of dental pain. Pain may also occur after an extraction (tooth is pulled out). Pain sometimes originates from other areas and radiates to the jaw, thus appearing to be tooth pain. The most common areas include the jaw joint (temporomandibular joint or TMJ), ear pain, and even occasional heart problems.

  • Bacteria growing inside your mouth can contribute to gum disease, plaque, and dental decay. These problems can become painful. The cause and prevention of dental disease has been well investigated.
  • You can prevent the majority of dental problems through flossing, brushing with fluoride toothpaste, and having your teeth professionally cleaned twice a year. The dentist may apply sealants and fluoride, which are especially important in children.
    • /...

Read the Toothache article »


Read What Your Physician is Reading on Medscape

Fractured Teeth »

The ability to care for dental fractures in the emergency department or clinic setting is a skill required during the career of every clinic-based or emergency physician.

Read More on Medscape Reference »

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