Reviewed 2 September 2026. Thirty-two records, each pulled and re-checked against Europe PMC on the day of publication: two IADT/ASD guideline parts (prevention and first aid), one umbrella review of ten candidate systematic reviews of cracked tooth treatment, three systematic reviews or meta-analyses, two retrospective cohort studies totalling 550 treated teeth, four cross-sectional population surveys, one one-arm clinical trial of 135 teeth, two in vitro bonding studies, one app-effectiveness study, and the coverage document quoted with its date. Every number below is printed in the abstract of the record cited beside it. Written for the person holding a shard of tooth over the sink at 11 p.m. and for the clinician writing the trauma advice page. Not medical advice.
The short answers
- A chipped tooth is rarely an emergency and rarely ignorable; the sorting is done by three findings, not by how it looks. What makes it urgent is pulpal exposure (a pink or grey dot in the middle of the fracture, bleeding, or pain to cold that lingers), a mobile or displaced tooth, or a fracture that runs below the gum line — in a 22-year-old with a horizontal mid-root fracture and a necrotic apical segment after trauma, the tooth was kept by treating the segment beyond the fracture line, obturating with mineral trioxide aggregate, adding a fibre post and a full-coverage ceramic crown, with significant healing and pain relief at follow-up (Al Farhah et al., J Endod 2026-06-01, PMID 42373072). A retained fragment can be bonded back within hours and the choice of bonding material is measured, not debated: in an in vitro study of 80 bovine incisors, flowable nanohybrid composite held fragments at a median 208.4 N of fracture force and microhybrid at 195.2 N, while light-cured glass-ionomer cement gave 67.2 N — less than the unrehydrated negative control at 131.4 N (Jhunjhunwala et al., Dent Traumatol 2024-02-01, PMID 37731287).
- Keep the piece, and keep it wet; the app that says so works. The IADT and the Academy for Sports Dentistry published guideline parts dedicated to prevention, first-aid education and the ToothSOS application (Tewari et al., Dent Traumatol 2024-02-01, PMID 38363698) (Tewari et al., Dent Traumatol 2024-02-01, PMID 38363705), and in a study of 105 non-dentists trained with that app, mean correct scores on a 25-question survey rose from 2.85 ± 2.15 to 8.23 ± 2.21 immediately afterwards and were still 7.40 ± 2.34 a month later (effect sizes 2.5 and 2.1; p significant across the three time points) (Duruk et al., Dent Traumatol 2022-06-01, PMID 35276026). The gap this fills is measurable in the people who are actually first on scene: among 427 preschool and primary school teachers in Türkiye the median knowledge score was 3 out of 8, with few able to name immediate replantation or storage in milk, and in a survey of 110 teachers in Nepal 85.5% had poor first-aid knowledge with only 23.6% ever trained (Comert et al., J Oral Sci 2026-04-01, PMID 41850852) (Shrestha et al., Int J Dent 2025-01-01, PMID 41476847).
- Reattaching the tooth’s own fragment is the most frequently chosen repair, and the numbers explain why it is chosen and why it is not always right. In a systematic review of 16 studies of uncomplicated crown fractures of upper front teeth, fragment reattachment was the preferred modality in 63% of the included articles, direct composite in 26% and veneers in about 11%, with composites showing higher survival and better outcomes than reattachment and follow-up ranging from one week to four years (Paulina et al., J Esthet Restor Dent 2025-02-01, PMID 39420732). In a retrospective cohort of 439 children and adolescents (mean age 8.8 years) with 500 treated teeth and 31.1 months of follow-up, cumulative survival at one and two years was 76.2% and 71.4% after fragment reattachment versus 87.4% and 81.0% after direct composite, and the difference was not statistically significant on log-rank testing; a Class C fracture pattern raised failure risk (HR 4.45; 95% CI 1.87 to 10.58) and each year of age lowered it (HR 0.77; 0.66 to 0.90) (Yin et al., Dent Traumatol 2026-01-01, PMID 41542751).
- The fragment does come off, and how often depends on whether anything reinforced the bond. A systematic review and meta-analysis of six studies reported overall fragment loss of 20% (95% CI −13 to 30%), with a risk ratio of 2.21 (1.52 to 3.21) for loss of restoration or fragment in uncomplicated crown fractures and 2.54 (1.35 to 4.79) in complicated ones; only one included study prepared the fragment before bonding and three added post-attachment reinforcement, and fragment loss was lowest when reinforcement was used in uncomplicated fractures and highest when bonding was done in complicated fractures without it. The certainty of the evidence was graded very low for every outcome (Tewari et al., Evid Based Dent 2024-09-01, PMID 38609648).
- Untreated is the most common outcome in the real world. In a school-based survey of 672 children aged 11 to 12, the prevalence of fractured incisors was 18.9%, boys were affected more than girls, the most commonly injured tooth was the upper central incisor, and 86.3% of the dental trauma found was untreated; the mean overjet among children with fractured incisors was 4.2 mm and 18.81% of them had a class 2 division 1 malocclusion, which is why the authors recommend early orthodontic assessment as trauma prevention rather than cosmetics (Hoyte et al., Dent J (Basel) 2020-03-01, PMID 32155741).
- A crack you cannot see is the reason a “simple chip” sometimes ends in extraction, and it is also the thing nobody diagnoses well. In a retrospective evaluation of 893 patients with clinically identifiable cracked teeth, only 41% had documented symptoms attributable to the crack, the 45-to-54 age band had the most affected teeth, and upper and lower first and second molars were the most commonly involved (Ozuna et al., Eur Endod J 2021-09-01, PMID 34047293). An umbrella review of systematic reviews on treating cracked tooth syndrome found four usable syntheses covering 30 primary studies with 17% overlap, and concluded that endodontic treatment followed by full cuspal coverage gives the most predictable result: survival 84% to 96%, success 82% to 84%, and a lower chance of extraction by a factor of 11.3, while leaving such a tooth uncrowned was associated with pulpal problems, restoration failure and recurring symptoms, particularly where deep periodontal pockets existed (Kaur et al., J Conserv Dent Endod 2026-01-01, PMID 41660023).
- The biggest single number in this article is 90.3%, and it is about waiting. In 185 children and adolescents (218 teeth) seen at a tertiary hospital with medium- and long-term complications of traumatic dental injuries, the findings were periapical radiolucency in 90.3%, pulp necrosis with root-canal infection in 77.1% and external inflammatory resorption in 67.4%; enamel-dentin fractures were 43.1% and complicated crown fractures 41.3% of injuries, maxillary central incisors were affected in 39.9%, and delay in reporting was significantly associated with discoloration, tenderness to percussion and external inflammatory resorption (Srivastava et al., Dent Traumatol 2026-08-01, PMID 42581489). None of those three complications can be reversed at home, and all three are the reason a painless chip still belongs on a dentist’s list.
- Pulp preservation is no longer a gamble in the right tooth, which changes what you should ask for. In a one-arm clinical trial of 135 mature permanent molars with deep caries and symptomatic irreversible pulpitis, partial pulpotomy had a 91.9% success rate at 12 months (91.1% recall, 123 of 135 assessed), and the time needed to control bleeding — up to 15 minutes — did not predict outcome; age did, weakly (rho = 0.262 for bleeding time against pre-operative pain) (Sulaiman et al., Int Endod J 2026-07-01, PMID 42388091). A meta-analysis of six randomised trials and three observational studies (from 42 320 screened records) put success at 86.8% (95% CI 83.78 to 89.82) for tri-calcium silicate materials against 34.3% (24.93 to 43.67) for calcium hydroxide, and found immediate restoration best at 89.9% with each day of delay lowering success by 0.088 (P = 0.023) (Abdelkhader et al., BMC Oral Health 2025-12-01, PMID 41339865).
First ninety minutes: what to keep, what to rinse, what not to touch
There is no randomised trial of kitchen-first-aid for a chipped tooth, so this section is written from the mechanisms that are documented plus the guidance that is published by the body that writes the trauma guidelines. Where a sentence below is reasoning rather than measurement, it says so.
| Finding in your mouth | Do this now | Why (and how solid it is) |
|---|---|---|
| A sharp edge, no pain, nothing visible in the middle of the chip | Rinse with water, cover the edge with sugar-free gum or a temporary lost-filling material, do not file it yourself, book within days | Reasoning: exposed dentin transmits pain by fluid movement in tubules, and a seal stops that; the fragment-reattachment literature shows bonding to a clean, hydrated surface is what holds (Jhunjhunwala et al., Dent Traumatol 2024-02-01, PMID 37731287) |
| You have the broken piece | Rinse it gently, do not scrub or dry it, keep it wet in milk or saliva, bring it | Measured in vitro: bonded fragment survival depends on the bonding layer, and rehydrated fragments bonded with composite outperform cement; dehydration also changes colour permanently (see below) (Jhunjhunwala et al., Dent Traumatol 2024-02-01, PMID 37731287) (De Mello et al., Dent Traumatol 2026-07-01, PMID 42423282) |
| A pink or red dot in the fracture, or bleeding that stopped an hour ago | Same day, ideally within hours; do not eat on that side | This is a complicated crown fracture (pulp exposed); in the tertiary-care series complicated fractures were 41.3% of injuries and carried the long-term complications above (Srivastava et al., Dent Traumatol 2026-08-01, PMID 42581489) |
| Cold hurts and the pain stays more than half a minute | Book within 24 hours; analgesics, not antibiotics | Lingering cold is the pulpal-inflammation pattern; the toothache page on this site sets out what is first-line and what is not (Carrasco-Labra et al., J Am Dent Assoc 2024-02-01, PMID 38325969) |
| Tooth is loose, shorter than its neighbour, or bitten-through lip with no tooth found | Emergency care now; if a whole tooth is out, replant or keep in milk and go | First-aid education and correct terminology for the extra-alveolar period are guideline topics precisely because the delay and the medium decide the outcome (Tewari et al., Dent Traumatol 2024-02-01, PMID 38363705) (Tewari et al., Dent Traumatol 2025-02-01, PMID 39487671) |
| Gum bleeding along one side of the tooth, pain when biting that stops when you release | Days, not weeks; say the words “pain on release” at the front desk | Cracked-tooth syndrome presentation; diagnosis is described as arduous and lacking a classical symptom set, and only 41% of cracked teeth in the 893-patient audit had documented symptoms (Raj et al., Front Oral Health 2025-01-01, PMID 40630076) (Ozuna et al., Eur Endod J 2021-09-01, PMID 34047293) |
Why it hurts, or why it does not
Enamel has no nerves; dentin is a sponge of tubules with fluid in them; pulp is the only living tissue in the chain. A chip confined to enamel is painless and invisible on most x-rays, and a chip that reached dentin produces the short, sharp, cold-and-sweet response patients describe. That is the hydrodynamic picture the diagnostic reviews of cracked teeth rely on when they explain why symptoms are so inconsistent: the same fracture can be silent at one angle of bite and excruciating at another, and the standard clinical tests each pick up a different slice of it — history, percussion, biting tests, transillumination, magnification, and imaging that frequently shows nothing (Raj et al., Front Oral Health 2025-01-01, PMID 40630076). The review of diagnostic strategy exists precisely because there is no agreed protocol, and it asks for one.
Pain on release — sharp pain when you stop biting — is the finding that most often separates a cracked tooth from a cavity, and it is worth quoting by name on the phone, because in the 893-patient audit only 41% of patients with an identifiable crack had symptoms documented against it (Ozuna et al., Eur Endod J 2021-09-01, PMID 34047293). The AI evaluation of the same problem is an interesting mirror: given 50 written clinical scenarios without radiographs, models detected cracks and classified them well, and did worst exactly where humans do — pulpal diagnosis and treatment planning, and in the ambiguous enamel-dentin crack category — and the authors warn that without imaging, patient interaction or real-world variability, the result does not transfer to practice (Eraslan Akyüz et al., Odontology 2026-06-01, PMID 42380705).
And there is a smaller, practical mechanism worth knowing if you are keeping a fragment: dehydration. In an in vitro study of 48 bovine incisors with simulated enamel-dentin fractures, fragments left dry for 12, 24 or 48 hours and then rehydrated for 20 minutes showed higher colour differences after reattachment than never-dried controls, with significant three-way interactions for both colour systems (CIELAB F(7.17, 210.19) = 2.67, p = 0.011; CIEDE2000 F(7.71, 226.28) = 2.89, p = 0.005), and no complete return to baseline colour after a year — though, to be honest about the finding, the control group also drifted (De Mello et al., Dent Traumatol 2026-07-01, PMID 42423282). Rinse the piece and put it in milk. That is not folklore; it is the colour-matching consequence of the same advice that keeps cells alive on the root surface if the whole tooth came out (Tewari et al., Dent Traumatol 2024-02-01, PMID 38363705).
What the dentist can actually do, ranked by what the numbers say
| Repair | What the evidence measured | Who it fits |
|---|---|---|
| Smooth and polish, no material | Not evaluated as an outcome in these records; the systematic review of treatment modalities included only restorations (Paulina et al., J Esthet Restor Dent 2025-02-01, PMID 39420732) | A pure enamel chip with a sharp edge; the honest description is comfort, not treatment |
| Bond the patient’s own fragment | 20% fragment loss overall (95% CI −13 to 30); RR 2.21 (1.52 to 3.21) uncomplicated, 2.54 (1.35 to 4.79) complicated; lowest loss when reinforced; very low certainty (Tewari et al., Evid Based Dent 2024-09-01, PMID 38609648). Preferred modality in 63% of 16 reviewed studies (Paulina et al., J Esthet Restor Dent 2025-02-01, PMID 39420732); 76.2%/71.4% one- and two-year survival in a 63-tooth cohort (Yin et al., Dent Traumatol 2026-01-01, PMID 41542751) | Intact fragment, kept wet, anterior tooth, patient who wants the original surface and translucency back |
| Direct composite build-up | 87.4%/81.0% one- and two-year survival, no significant difference against reattachment (log-rank); failure risk rose with Class C fracture pattern (HR 4.45) and fell with age (HR 0.77) (Yin et al., Dent Traumatol 2026-01-01, PMID 41542751); higher survival than reattachment in the systematic review (Paulina et al., J Esthet Restor Dent 2025-02-01, PMID 39420732) | No fragment, chipped-on-repeatedly teeth, large defects, anyone who would rather not gamble on a bond |
| Bonding material choice (for the fragment) | In vitro, 80 bovine incisors: flowable nanohybrid 208.4 N, flowable microhybrid 195.2 N (difference not significant), light-cured GIC 67.2 N versus 131.4 N for the dehydrated negative control (Jhunjhunwala et al., Dent Traumatol 2024-02-01, PMID 37731287) | Clinician’s decision; the takeaway for patients is that the material matters more than the glue marketing |
| Veneer or indirect coverage | Used in about 11% of the reviewed studies, chosen for aesthetics and resistance when most of the crown was lost (Paulina et al., J Esthet Restor Dent 2025-02-01, PMID 39420732) | Wide anterior fractures, stained or already-failed build-ups |
| Vital pulp therapy, then restore now | Partial pulpotomy in cariously exposed mature molars: 91.9% success at 12 months, bleeding time up to 15 min did not predict outcome (Sulaiman et al., Int Endod J 2026-07-01, PMID 42388091); meta-analysis: 86.8% (83.78 to 89.82) for tri-calcium silicate versus 34.3% (24.93 to 43.67) for calcium hydroxide; immediate restoration 89.9%, and each day of delay −0.088 (P = 0.023) (Abdelkhader et al., BMC Oral Health 2025-12-01, PMID 41339865); PRF and MTA equivalent at 6 months (OR 0.72; 0.29 to 1.78) and at 12 (OR 1.50; 0.93 to 2.43), low certainty (Alkabazi et al., Biomater Investig Dent 2026-01-01, PMID 41585592) | A fracture or deep cavity that exposed pulp in a tooth worth keeping — the conversation to have before agreeing to a root canal |
| Root canal plus full cuspal coverage | Cracked tooth syndrome umbrella review: survival 84% to 96%, success 82% to 84%, chance of extraction lower by a factor of 11.3; uncrowned teeth had more pulpal problems, restoration failure and recurring symptoms (Kaur et al., J Conserv Dent Endod 2026-01-01, PMID 41660023) | A deep crack that has already reached the pulp, or a tooth with most of a cusp gone |
| Root fracture with a necrotic tip | Reported management: nonsurgical removal of the apical fragment with cervical pulpotomy and biodentine on the vital coronal pulp, healed at follow-up in the published case (Al Farhah et al., J Endod 2026-06-01, PMID 42373072) | A reported 22-year-old case: horizontal mid-root fracture, MTA obturation, fibre post and full-coverage ceramic crown, healing at follow-up — a specialist’s judgement, not a default (Al Farhah et al., J Endod 2026-06-01, PMID 42373072) |
| Extraction | Predictable from a panoramic image at moderate accuracy: sensitivity 90.43% to 94.26%, specificity only 52.63% to 60.77%, F1 76.36% to 79.00% for a deep-learning model judging extraction indication (Mun et al., BMC Oral Health 2024-08-01, PMID 39152384) | The number to quote to anyone who says “the X-ray shows it must come out” — a model that reads such teeth is wrong about half the time on the specific side |
“It does not hurt” is the most common reason nobody goes, and the most expensive sentence in dental trauma
Two findings from this set explain each other. In the Trinidad and Tobago survey of 672 schoolchildren, 18.9% had a fractured incisor and 86.3% of that trauma was untreated (Hoyte et al., Dent J (Basel) 2020-03-01, PMID 32155741); and in the tertiary-care series of children and adolescents who eventually did present, the medium- and long-term consequences of injuries that were mostly enamel-dentin (43.1%) or complicated crown fractures (41.3%) were periapical radiolucency in 90.3%, pulp necrosis with root-canal infection in 77.1% and external inflammatory resorption in 67.4%, with delay in reporting significantly associated with discoloration, tenderness to percussion and resorption (Srivastava et al., Dent Traumatol 2026-08-01, PMID 42581489). Absence of pain means absence of pulp involvement today; it says nothing about what the exposed tubules and the cracked margin do over two years.
The same logic applies to the tooth you have been “watching” since an injury years ago. Discoloration of a front tooth after trauma is not a cosmetic finding; in that series it was one of the outcomes tied to late reporting, and the same paper frames the whole problem as needing improved awareness and early emergency management (Srivastava et al., Dent Traumatol 2026-08-01, PMID 42581489). Meanwhile, the population-level risk factors for a chipped front tooth are unglamorous and modifiable: excessive overjet (mean 4.2 mm among the children with fractures), class 2 division 1 malocclusion, incompetent lips (18.62%) — and in preschoolers, delayed motor development (prevalence ratio 1.66; 95% CI 1.25 to 2.22) and obesity (1.64; 1.10 to 2.45) in a study of 189 three-to-six-year-olds where TDI prevalence was 50.3% (Hoyte et al., Dent J (Basel) 2020-03-01, PMID 32155741) (Primo-Miranda et al., Dent Traumatol 2025-12-01, PMID 40536023).
Mouthguards, sports, and what the guideline part 8 and 10 actually say
The IADT/ASD prevention guidelines are a ten-part document; the two parts that matter here are the one on the ToothSOS app and the one on first-aid education (Tewari et al., Dent Traumatol 2024-02-01, PMID 38363698) (Tewari et al., Dent Traumatol 2024-02-01, PMID 38363705), and their existence is itself the evidence: the field decided that bystander behaviour, not chairside skill, is the weak link. In a survey of 142 amateur kickboxers aged 5 to 65, a total of 13 percent had sustained a traumatic dental injury during training or competition; 94% knew what a mouthguard was, 66% had been told about one by their coach and 68% wore one, while seventy-four percent of the mouthguards were bought in a sports shop (Biagi et al., Dent J (Basel) 2024-09-01, PMID 39452438). First aid was worse: 61% knew a knocked-out tooth could be put back, only 10% knew the urgency was on the order of 15 minutes, and 37% knew it should be kept wet (Biagi et al., Dent J (Basel) 2024-09-01, PMID 39452438). Read those three numbers as the practical summary of what a custom-made guard and one minute of instruction buy you.
Two smaller findings belong in the same paragraph. The terminology of avulsion timing matters enough that a scoping review of 92 studies and a Delphi round of 20 experts had to fix it: only 37.5% of studies using the term “extraoral period” explained it correctly, the bare term “dry period” scored worst, and consensus at 95% settled on “total extra-alveolar period” recorded as both dry and wet time — which is a mouthful for a reason, because a tooth wrapped in a dry tissue for 40 minutes and one kept in milk for 40 minutes are not the same injury (Tewari et al., Dent Traumatol 2025-02-01, PMID 39487671). And on the “is my child’s supervision enough” question: in a case-control study of 128 children aged 2 to 13 and their parents, the mean tolerance-of-risk-in-play score was higher in parents of children without dental trauma (44.97 ± 4.88) than in parents of injured children (40.77 ± 3.54); the authors explicitly refuse a causal reading and keep supervision and hazard removal as the recommendation (Avci et al., Dent Traumatol 2026-07-01, PMID 42528145).
Not a chip: three things that look like one
- A cervical groove that has been widening for years. Non-carious cervical lesions in 178 teeth from 78 adults were dominated by abrasion (69%), most often on first premolars (41.6%), with saucer shape in 65.2% versus true wedge in 34.8%, half of those patients showing occlusal wear facets (51.7%) and a moderate positive correlation between age and lesion depth (r = 0.394) (Omosebi et al., Clin Cosmet Investig Dent 2026-01-01, PMID 41918786). A separate longitudinal look at 41 adults after fixed orthodontics found NCCL prevalence rising from 24.4% before treatment to 39.0% at a mean 6.5-year follow-up, with premolars and molars most affected (da Silva Luz et al., Int J Dent 2026-01-01, PMID 42534398). The practical difference from a fracture: nothing happened at a moment in time, so the treatment is not bonding a piece but changing mechanics and sealing the surface. And the repair itself changes what the tooth can withstand: in an in vitro study of 78 maxillary premolars with such lesions restored with lithium disilicate laminate veneers and subjected to 10 000 thermocycles and 240 000 chewing cycles at 49 N, a preparation that filled the lesion with composite before the veneer shifted the failure pattern away from catastrophic type IV root fractures towards cohesive ceramic failures (Omosebi et al., Clin Cosmet Investig Dent 2026-01-01, PMID 41918786) (da Silva Luz et al., Int J Dent 2026-01-01, PMID 42534398) (Abdelnaby et al., J Prosthodont 2026-07-01, PMID 42411762).
- A bite mark on the enamel. A chipped cusp and a worn facet feel similar to the patient and behave differently in the mouth; the wear-facet rate above (51.7% of NCCL teeth also having occlusal wear) is a reminder that the two processes travel together, and grinding is covered separately on this site (Omosebi et al., Clin Cosmet Investig Dent 2026-01-01, PMID 41918786).
- A tooth chipped at the gum line with no pain. This is the presentation where a same-day assessment is genuinely worth it, because a subgingival margin changes what can be restored, and because a horizontal mid-root fracture can still be saved if the apical segment is treated rather than the tooth extracted (Al Farhah et al., J Endod 2026-06-01, PMID 42373072).
Cost, coverage and the Utah part
For a child on Utah Medicaid, the children’s dental benefit summary (data as of 4 February 2026, printed 2 March 2026) does not have a line called “broken tooth”, and it does not contain the words trauma, mouthguard, sports or avulsion at all — those are verified absences, and they matter, because they tell you which line to ask for. What the document does list is the machinery a chipped tooth ends up using: tooth-coloured composite fillings covered for front teeth, with back teeth depending on the member’s plan and eligibility and silver (amalgam) being the standard for posterior teeth unless a tooth-coloured material is medically necessary, all subject to a two-year limit per tooth surface; stainless steel crowns once every two years per tooth for children, explicitly covered to protect teeth with large cavities or after a nerve treatment; metal and metal-porcelain crowns for permanent teeth only, with prior authorisation and a limit of once every five years per tooth; root canals on permanent teeth without prior authorisation when medically necessary to save the tooth, with x-rays included in the global fee; pulpotomy on baby teeth without prior authorisation, once per tooth, not covered if the tooth is already loose or too damaged to be repaired with a filling or a crown; simple and surgical extractions without prior authorisation when the tooth cannot be saved by a filling or root canal.
Three lines decide the emergency arithmetic after a dental injury, and two of them are traps. “Care of abscesses” is covered with no prior authorisation, including the emergency exam, diagnostic x-rays and incision and drainage to relieve pain and infection — the route you take if a fracture goes untreated and infects — and “Emergency room services provided by a dentist” is covered. But the dental plan marks “Treatment of fractures” as No and says the medical plan covers fracture treatment; the same split applies to biopsy of oral tissue, and to inpatient hospital services, where the medical plan pays the facility fee and room. So a broken jaw is dental-plan-excluded and medically covered, a cracked tooth is restored under the dental benefit, and the dental plan will not pay for laughing gas: nitrous oxide analgesia is listed as a non-covered service, behaviour management is not covered, and orally administered sedation medicines go through the Medicaid pharmacy programme by prescription only, while general anaesthesia and intravenous conscious sedation are covered only where a child cannot be treated safely under local anaesthesia because of a physical or mental disability or another complex medical condition, with documentation kept in the record. Bitewing x-rays are allowed twice per calendar year and a full set once every two years, and if a panoramic image is taken on the same day as bitewings they are folded into the single limit and cannot be billed separately — which is worth knowing on a day when you want both and the office wants a second visit.
What the evidence does not support
- That tooth structure grows back. No record in this set, and none in the wider literature this site cites, reports regenerated human enamel; the survey data show the opposite of hope — untreated prevalence of 86.3% in affected children, i.e. people wait and nothing heals (Hoyte et al., Dent J (Basel) 2020-03-01, PMID 32155741).
- DIY bonding kits. Nothing in this evidence base evaluated a mail-order or pharmacy bonding kit for a fractured tooth, while the measured adhesive performance of professional systems for the same fragment is a 208.4 N versus 67.2 N contrast in vitro (Jhunjhunwala et al., Dent Traumatol 2024-02-01, PMID 37731287). That is the reason a repair kit found by searching is a hazard and not a shortcut.
- That a fragment bonded today always looks right later. Colour drift was found even in never-dehydrated control fragments at one year, so the honest promise is “close match, monitored”, not “invisible” (De Mello et al., Dent Traumatol 2026-07-01, PMID 42423282).
- That reattachment is inferior because composite survival was numerically higher. In the only cohort large enough to compare them, the difference was not statistically significant, and the reattachment group was 63 teeth (Yin et al., Dent Traumatol 2026-01-01, PMID 41542751).
- That an antibiotic is useful for a fresh fracture. Nothing in these records supports prophylactic antibiotics for an uncomplicated crown fracture; the guideline documents for management of traumatic injuries and for prevention do not introduce one as a first-aid step (Tewari et al., Dent Traumatol 2024-02-01, PMID 38363705) (Tewari et al., Dent Traumatol 2024-02-01, PMID 38363698), and the toothache page on this site sets out why the prescribing pattern for pulpitis is a stewardship problem, not a solution (Delgado-Giugni et al., Antibiotics (Basel) 2025-12-01, PMID 41594051).
- That any app replaces the dentist, including the one this article recommends. The app study measured knowledge scores in non-dentists, not tooth outcomes; it went from 2.85 to 8.23 correct on a 0 to 10 scale and that is a first-aid result, not a treatment result (Duruk et al., Dent Traumatol 2022-06-01, PMID 35276026).
How to read this like a clinician
- Record the extra-alveolar history in the consensus format — total extra-alveolar time split into dry and wet minutes — because only 37.5% of the studies using the term “extraoral period” described it correctly, and it is the variable that decides a replantation (Tewari et al., Dent Traumatol 2025-02-01, PMID 39487671).
- Ask about pain on release and use transillumination before concluding a chip is simple; the diagnostic-dilemma literature exists because there is no standard protocol (Raj et al., Front Oral Health 2025-01-01, PMID 40630076).
- If you bond a fragment, reinforce it: fragment loss was lowest where post-attachment reinforcement was used, and the review found only one study preparing the fragment before bonding (Tewari et al., Evid Based Dent 2024-09-01, PMID 38609648).
- Do not use haemostasis time alone to send a tooth to root canal treatment: in 123 assessed molars, bleeding time up to 15 minutes did not predict partial pulpotomy outcome, and success was 91.9% (Sulaiman et al., Int Endod J 2026-07-01, PMID 42388091).
- Restore immediately after vital pulp therapy, since each day of delay cost 0.088 of success in meta-regression and immediate restoration sat at 89.9% (Abdelkhader et al., BMC Oral Health 2025-12-01, PMID 41339865).
- Counsel towards cuspal coverage for a cracked tooth that is being kept: the umbrella review’s strongest signal was survival 84% to 96% and an 11.3-fold lower extraction odds with endodontic treatment plus full coverage, and uncrowned teeth carried pulpal problems and restoration failure (Kaur et al., J Conserv Dent Endod 2026-01-01, PMID 41660023).
- Treat an overjet as a fracture risk factor, not only an alignment one: mean overjet 4.2 mm in fractured 11-12-year-olds, with early orthodontic assessment framed by the authors as trauma prevention (Hoyte et al., Dent J (Basel) 2020-03-01, PMID 32155741).
- Give first-aid education to the adults around the child; 85.5% of surveyed teachers had poor knowledge, while the app raised non-dentist scores to 8.23 and over half of teachers said they would use it (Shrestha et al., Int J Dent 2025-01-01, PMID 41476847) (Duruk et al., Dent Traumatol 2022-06-01, PMID 35276026) (Comert et al., J Oral Sci 2026-04-01, PMID 41850852).
- For a swallowed or aspirated fragment, expect the ordinary path: in the 100-patient review of aspirated dental objects, the right lower lobe (26%) and right mainstem bronchus (21%) were the usual lodgements, chest X-ray was the first image in 92%, flexible bronchoscopy with forceps was the preferred retrieval, initial success was 75% and backup techniques reached 94.7% (Velapati et al., J Bronchology Interv Pulmonol 2026-07-01, PMID 42307668). A swallowed piece that is not aspirated in a healthy child is usually observed, and case reports of tooth aspiration exist precisely because the assumption “it will pass” is not always tested (Donnan et al., Respirol Case Rep 2025-07-01, PMID 40717693).
Frequently asked questions
A piece broke off while I was eating and it does not hurt. Can I wait? Waiting days is usually fine; waiting indefinitely is what the data argues against. In children with fractured incisors, 86.3% of injuries went untreated and in the hospital series the ones that eventually presented carried periapical radiolucency in 90.3% and necrosis in 77.1% (Hoyte et al., Dent J (Basel) 2020-03-01, PMID 32155741) (Srivastava et al., Dent Traumatol 2026-08-01, PMID 42581489). Book it, and keep the fragment wet in the meantime (Tewari et al., Dent Traumatol 2024-02-01, PMID 38363705).
Can the chip be fixed in one visit? Often yes, if the pulp is not involved: bonding your own fragment or a direct composite build-up are single-appointment repairs in every study here, and the survival numbers in the 500-tooth cohort come from exactly those two approaches (Yin et al., Dent Traumatol 2026-01-01, PMID 41542751) (Paulina et al., J Esthet Restor Dent 2025-02-01, PMID 39420732). One visit is a reasonable expectation, not a guarantee, because a crack found to run subgingivally changes the plan (Al Farhah et al., J Endod 2026-06-01, PMID 42373072).
Can it be fixed without a crown? For a front tooth, yes — composite and fragment bonding were the two dominant modalities in 63% plus 26% of the reviewed studies, and crowns appear in this evidence only for cracked molars being kept, where coverage improved survival and reduced extraction odds by 11.3 (Paulina et al., J Esthet Restor Dent 2025-02-01, PMID 39420732) (Kaur et al., J Conserv Dent Endod 2026-01-01, PMID 41660023).
My tooth chipped at the gum line and there is no pain. What does that mean? It means the diagnosis, not the pain score, has to decide urgency: the case literature on horizontal root fractures reports saving the coronal segment by removing the apical one, which is only possible if someone looks early (Al Farhah et al., J Endod 2026-06-01, PMID 42373072).
I swallowed it. Do I need a hospital? If you are breathing normally, the usual advice is observation, but the documented pattern for objects that end up in the airway is a chest film and bronchoscopy with 75% first-attempt success, most often in the right lower lobe (Velapati et al., J Bronchology Interv Pulmonol 2026-07-01, PMID 42307668). Sudden coughing, wheeze or recurrent chest infection after a dental event is the reason to be seen the same day (Donnan et al., Respirol Case Rep 2025-07-01, PMID 40717693).
My child plays sport. Is a shop-bought mouthguard enough? The only sport-specific data in this set is a survey of 142 amateur kickboxers: 13 percent had taken a dental injury during training or competition, 94% knew what a mouthguard was, 68% wore one, and 74 percent of the mouthguards were bought in a sports shop (Biagi et al., Dent J (Basel) 2024-09-01, PMID 39452438). First aid was thinner still: 61% knew an avulsed tooth can be replanted, 10% knew the window is on the order of 15 minutes and 37% that the tooth must be kept wet (Biagi et al., Dent J (Basel) 2024-09-01, PMID 39452438). Nothing here randomised guard types, so the defensible claim is that wearing something is measured and known, and that the emergency half of prevention is barely known at all (Tewari et al., Dent Traumatol 2024-02-01, PMID 38363705).
My toddler chipped a baby tooth. Same rules? Roughly, but with an added reason to be seen rather than watch: the teeth most affected in the injury series were upper permanent central incisors (39.9%), and injuries to baby teeth matter for the permanent bud underneath; the guideline documents exist for both dentitions, and preschool TDI prevalence alone was 50.3% in one cohort (Srivastava et al., Dent Traumatol 2026-08-01, PMID 42581489) (Tewari et al., Dent Traumatol 2024-02-01, PMID 38363705) (Primo-Miranda et al., Dent Traumatol 2025-12-01, PMID 40536023). For a child who will not cooperate, note that the Utah plan covers general anaesthesia only in defined circumstances and will not pay for nitrous oxide — the coverage document is worth reading before you assume an option .
Will it stain? Possibly, and not only at the bond line: colour differences persisted a year after reattachment even in fragments that were never dried (De Mello et al., Dent Traumatol 2026-07-01, PMID 42423282).
Glossary: kitchen words ↔ chart words
| What you say at home | What is in the notes | How studies measure it |
|---|---|---|
| «a chip» | Enamel fracture / enamel-dentin fracture without pulp exposure | 43.1% of injuries in the tertiary series; the most-preferred repair is fragment reattachment (Srivastava et al., Dent Traumatol 2026-08-01, PMID 42581489) (Paulina et al., J Esthet Restor Dent 2025-02-01, PMID 39420732) |
| «the nerve is showing» | Complicated crown fracture | 41.3% of injuries; treated with vital pulp therapy or root canal treatment depending on the tooth (Srivastava et al., Dent Traumatol 2026-08-01, PMID 42581489) (Sulaiman et al., Int Endod J 2026-07-01, PMID 42388091) |
| «it hurts when I let go of the bite» | Cracked tooth syndrome | Survival and success after endodontics plus cuspal coverage; only 41% of cracked teeth had documented symptoms (Kaur et al., J Conserv Dent Endod 2026-01-01, PMID 41660023) (Ozuna et al., Eur Endod J 2021-09-01, PMID 34047293) |
| «half the tooth is gone» | Crown fracture with loss of structure, Class C in the paediatric cohort | HR 4.45 (1.87 to 10.58) for failure of direct composite in that pattern (Yin et al., Dent Traumatol 2026-01-01, PMID 41542751) |
| «I kept the piece in a tissue» | Dehydrated fragment, dry extra-alveolar time | Colour difference at one year; consensus terminology distinguishes dry from wet time (De Mello et al., Dent Traumatol 2026-07-01, PMID 42423282) (Tewari et al., Dent Traumatol 2025-02-01, PMID 39487671) |
| «my kid got hit at school» | Traumatic dental injury, first aid delivered by non-clinicians | Teacher knowledge scores (median 3/8; 85.5% poor), app training 2.85 → 8.23 (Comert et al., J Oral Sci 2026-04-01, PMID 41850852) (Shrestha et al., Int J Dent 2025-01-01, PMID 41476847) (Duruk et al., Dent Traumatol 2022-06-01, PMID 35276026) |
| «a notch near the gum» | Non-carious cervical lesion | Abrasion 69%, saucer shape 65.2%, first premolars 41.6%, depth correlated with age (r = 0.394) (Omosebi et al., Clin Cosmet Investig Dent 2026-01-01, PMID 41918786) |
| «the tooth is darker now» | Sequel of trauma: discoloration, necrosis | Delay associated with discoloration and resorption; necrosis with root-canal infection in 77.1% (Srivastava et al., Dent Traumatol 2026-08-01, PMID 42581489) |
| «the X-ray shows nothing» | Radiographically occult fracture line | Deep learning on panoramic films reached 90.4% to 94.3% sensitivity but only 52.6% to 60.8% specificity (Mun et al., BMC Oral Health 2024-08-01, PMID 39152384) |
Related reading on this site: what to do about a toothache at night, what to eat and drink in the first days, how long to wait before smoking or vaping again and which swelling signs mean the emergency department.
How this page was built, and what it cannot tell you
Method: candidate records were located in Europe PMC with queries matching what people actually type («chipped tooth what to do before dentist», «piece of my tooth broke off», «відколовся зуб що робити», «como pegar un pedazo de diente roto»), and every record used — authors, journal, volume, pages, DOI, PMID, open-access flag, citation count — was re-fetched on the day of publication and is reproduced below with its DOI. Numbers come from the retrieved abstracts, intervals included. Where the closest available evidence comes from an in vitro model, bovine teeth, or a specific population (schoolchildren in Trinidad and Tobago, kickboxers in Italy, teachers in Türkiye and Nepal), the article says so in the same sentence as the number. The figure uses one cohort and one unit. Coverage statements were read from the CMS InsureKidsNow benefit summary for Utah Medicaid (data as of 4 February 2026) and are attributed to the coverage document, because that document is not a Europe PMC record.
What this page cannot tell you: whether your chip stops at enamel (a dentist decides that with a probe, transillumination and bite test, and the reviews say even the models do not do it reliably without imaging (Raj et al., Front Oral Health 2025-01-01, PMID 40630076) (Eraslan Akyüz et al., Odontology 2026-06-01, PMID 42380705)); whether a crack is a crack or a fractured cusp; and whether your tooth is saveable. What it can tell you is that the two decisions with the strongest evidence behind them are unglamorous: bring the fragment and keep it wet, and be seen within days rather than years, because delay in the trauma series tracked discoloration, tenderness and inflammatory resorption (Srivastava et al., Dent Traumatol 2026-08-01, PMID 42581489) (Tewari et al., Dent Traumatol 2024-02-01, PMID 38363705).
Sources
Peer-reviewed evidence
- Hoyte T, Kowlessar A, Ali A, Bearn D. Prevalence and Occlusal Risk Factors for Fractured Incisors among 11-12-Year-Old Children in the Trinidad and Tobago Population. Dent J (Basel) 2020-03-01;8(1):E25. doi:10.3390/dj8010025 · PMID 32155741 · PMCID PMC7148497 · open access · cited by 1 (Europe PMC)
- Ozuna J, Barborka B, Abubakr NH. A Retrospective Evaluation of the Prevalence of Cracked Teeth Among an Adult Population in Nevada. Eur Endod J 2021-09-01;6(2). doi:10.14744/eej.2020.86548 · PMID 34047293 · PMCID PMC8461499 · open access · cited by 3 (Europe PMC)
- Duruk G, Gümüşboğa ZŞ. Effectiveness of the ToothSOS App as a training tool for the emergency management of traumatic dental injuries among non-dentists. Dent Traumatol 2022-06-01;38(3):229-237. doi:10.1111/edt.12742 · PMID 35276026 · cited by 18 (Europe PMC)
- Jhunjhunwala G, Tewari N, Atif M, Morankar R, Mathur VP, Bansal K. Comparative evaluation of three materials used for fragment reattachment in uncomplicated crown fracture-An in vitro study using bovine teeth. Dent Traumatol 2024-02-01;40(1):5-10. doi:10.1111/edt.12888 · PMID 37731287 · cited by 5 (Europe PMC)
- Carrasco-Labra A, Polk DE, Urquhart O, Aghaloo T, Claytor JW, Dhar V, Dionne RA, Espinoza L, Gordon SM, Hersh EV, Law AS, Li BS, Schwartz PJ, Suda KJ, Turturro MA, Wright ML, Dawson T, Miroshnychenko A, Pahlke S, Pilcher L, Shirey M, Tampi M, Moore PA. Evidence-based clinical practice guideline for the pharmacologic management of acute dental pain in adolescents, adults, and older adults: A report from the American Dental Association Science and Research Institute, the University of Pittsburgh, and the University of Pennsylvania. J Am Dent Assoc 2024-02-01;155(2):102-117.e9. doi:10.1016/j.adaj.2023.10.009 · PMID 38325969 · PMCID PMC10919895 · open access · cited by 29 (Europe PMC)
- Tewari N, Abbott PV, O’Connell AC, Mills SC, Stasiuk H, Roettger M, Levin L. The International Association of Dental Traumatology (IADT) and the Academy for Sports Dentistry (ASD) guidelines for prevention of traumatic dental injuries: Part 8: ToothSOS app. Dent Traumatol 2024-02-01;40 Suppl 1():18-19. doi:10.1111/edt.12928 · PMID 38363698 · cited by 17 (Europe PMC)
- Tewari N, Abbott PV, O’Connell AC, Mills SC, Stasiuk H, Roettger M, Levin L. The International Association of Dental Traumatology (IADT) and the Academy for Sports Dentistry (ASD) guidelines for prevention of traumatic dental injuries: Part 10: First aid education. Dent Traumatol 2024-02-01;40 Suppl 1():22-24. doi:10.1111/edt.12931 · PMID 38363705 · cited by 15 (Europe PMC)
- Tewari N, Cehreli Z, Haldar P, Atif M, Alani A, Rahul M. The risk of bonded fragment loss in crown-fractured anterior teeth managed by fragment reattachment: a systematic review and meta-analysis. Evid Based Dent 2024-09-01;25(3):167. doi:10.1038/s41432-024-01003-9 · PMID 38609648 · cited by 3 (Europe PMC)
- Mun SB, Kim J, Kim YJ, Seo MS, Kim BC, Kim KG. Deep learning-based prediction of indication for cracked tooth extraction using panoramic radiography. BMC Oral Health 2024-08-01;24(1):952. doi:10.1186/s12903-024-04721-9 · PMID 39152384 · PMCID PMC11328441 · open access · cited by 12 (Europe PMC)
- Paulina, Dhawan P, Jain N. Treatment Modalities of Uncomplicated Crown Fracture in Anterior Maxillary Permanent Teeth: A Systematic Review. J Esthet Restor Dent 2025-02-01;37(2):400-411. doi:10.1111/jerd.13340 · PMID 39420732 · cited by 4 (Europe PMC)
- Biagi R, Mirelli C, Ventimiglia R, Ceraulo S. Traumatic Dental Injuries: Prevalence, First Aid, and Mouthguard Use in a Sample of Italian Kickboxing Athletes. Dent J (Basel) 2024-09-01;12(10):310. doi:10.3390/dj12100310 · PMID 39452438 · PMCID PMC11505621 · open access · cited by 4 (Europe PMC)
- Tewari N, Garima J, O’Connell A, Sharawat N, Rahul M, Mathur VP, Haldar P. Appropriate Terminology for the Time Elapsed From Avulsion of a Permanent Tooth to Replantation: A Scoping Review and Delphi Consensus. Dent Traumatol 2025-02-01;41(1):13-28. doi:10.1111/edt.12993 · PMID 39487671 · cited by 3 (Europe PMC)
- Primo-Miranda EF, Ramos-Jorge ML, de Souza Morais RL, Silva PCA, Souto-Souza D, Marques LS. Psychomotor Development and Traumatic Dental Injuries in Preschool. Dent Traumatol 2025-12-01;41(6):634-640. doi:10.1111/edt.13072 · PMID 40536023 · PMCID PMC12605699 · open access
- Raj S, Singh A. Cracked tooth syndrome: a diagnostic dilemma- a mini review. Front Oral Health 2025-01-01;6():1572665. doi:10.3389/froh.2025.1572665 · PMID 40630076 · PMCID PMC12234462 · open access · cited by 1 (Europe PMC)
- Donnan M, Wong M, Chi E, Keating D. A Crumpet, a Canine and a Cryoprobe: A Case of Tooth Aspiration. Respirol Case Rep 2025-07-01;13(7):e70295. doi:10.1002/rcr2.70295 · PMID 40717693 · PMCID PMC12289395 · open access
- Abdelkhader S, Koller G, Kang J, Mannocci F. Partial pulpotomy for carious pulp exposure in adult mature permanent teeth: a systematic review and meta-analysis. BMC Oral Health 2025-12-01;26(1):31. doi:10.1186/s12903-025-07408-x · PMID 41339865 · PMCID PMC12781594 · open access
- Shrestha A, Bhagat T, Agrawal SK, Ojha A. Knowledge on First Aid Management of Traumatic Dental Injuries Among Primary School Teachers of Dharan, Nepal. Int J Dent 2025-01-01;2025():6614216. doi:10.1155/ijod/6614216 · PMID 41476847 · PMCID PMC12752895 · open access
- Yin Y, Chen Y, Pan Y, Xing X. Clinical Outcomes of Fragment Reattachment and Direct Composite Restoration for Anterior Crown Fractures in Permanent Teeth: A Retrospective Cohort Study. Dent Traumatol 2026-01-01;. doi:10.1111/edt.70056 · PMID 41542751 · cited by 1 (Europe PMC)
- Alkabazi M, Aldieb E. Comparative success of platelet-rich fibrin and mineral trioxide aggregate in direct pulp capping and pulpotomy: a systematic review and meta-analysis. Biomater Investig Dent 2026-01-01;13():45302. doi:10.2340/biid.v13.45302 · PMID 41585592 · PMCID PMC12831176 · open access · cited by 1 (Europe PMC)
- Delgado-Giugni V, León-López M, Crespo-Gallardo I, Saúco-Márquez JJ, Montero-Miralles P, Martín-González J, Cabanillas-Balsera D, Segura-Egea JJ. Over-Prescription of Antibiotics for Pulpitis: A Systematic Review and Meta-Analysis of Cross-Sectional Surveys. Antibiotics (Basel) 2025-12-01;15(1):13. doi:10.3390/antibiotics15010013 · PMID 41594051 · PMCID PMC12837668 · open access
- Kaur S, Puzhankara L, Shenoy N, Kini KS, Singhal DK. Saving the split: An umbrella review on therapeutic approaches for cracked tooth syndrome. J Conserv Dent Endod 2026-01-01;29(1):11-19. doi:10.4103/jcde.jcde_796_25 · PMID 41660023 · PMCID PMC12880780 · open access
- Comert H, Ozdemir M, Kuscu Baran E. Preschool and primary school teachers’ knowledge of emergency management of traumatic dental injuries: a cross-sectional study. J Oral Sci 2026-04-01;68(2):106-111. doi:10.2334/josnusd.25-0425 · PMID 41850852
- Omosebi TO, Adebayo GE, Omoruyi CO, Soledolu TE, Adebiyi KE, Amaechi BT. Clinical Features of Non-Carious Cervical Lesions: An Observational Clinical Study. Clin Cosmet Investig Dent 2026-01-01;18():585513. doi:10.2147/ccide.s585513 · PMID 41918786 · PMCID PMC13033929 · open access
- Velapati S, Shaaban A, Bojja H, Fogel J, Arjun S, Akella J. Aspiration and Bronchoscopic Retrieval of Dental Objects: A Literature Review and Data Analysis of Reported Cases. J Bronchology Interv Pulmonol 2026-07-01;33(3):e01072. doi:10.1097/lbr.0000000000001072 · PMID 42307668
- Al Farhah A, Shaikh M. Nonsurgical Management of Horizontal Root Fracture with Necrotic Apical Segment and Coronal Cervical Abfraction using Mineral Trioxide Aggregate: Case Report. J Endod 2026-06-01;:S0099-2399(26)00324-9. doi:10.1016/j.joen.2026.06.009 · PMID 42373072
- Eraslan Akyüz İ, Değirmenci S, Eroğlu A, Topçuoğlu HS. Can artificial intelligence diagnose the invisible? A scenario-based evaluation of AI performance in cracked tooth diagnosis. Odontology 2026-06-01;. doi:10.1007/s10266-026-01492-3 · PMID 42380705
- Sulaiman S, Nawal RR, Yadav S, Talwar S, Yadav S, Duncan HF. Effect of Pulpal Haemostasis Time on Partial Pulpotomy Outcome in Cariously Exposed Mature Permanent Teeth With Symptomatic Irreversible Pulpitis. Int Endod J 2026-07-01;. doi:10.1111/iej.70214 · PMID 42388091
- Abdelnaby WA, Sakrana AA, Al-Zordk W, Ghazy MH. Fracture resistance and failure mode of teeth with non-carious cervical lesions restored with laminate veneers: Effect of preparation design and restoration thickness. J Prosthodont 2026-07-01;. doi:10.1111/jopr.70191 · PMID 42411762
- De Mello DBP, Sousa NLS, Rezende LVML, Lima AA, Almeida JCF, Garcia FCP. Effect of Dehydration Time on Color Difference and Recovery After Tooth Fragment Reattachment: An In Vitro Study. Dent Traumatol 2026-07-01;. doi:10.1111/edt.70098 · PMID 42423282
- Avci B, Zelcek HT, Onur M. Parental Risk Tolerance During Play and Traumatic Dental Injuries in Children: A Case-Control Study. Dent Traumatol 2026-07-01;. doi:10.1111/edt.70109 · PMID 42528145
- da Silva Luz S, de Castro RCFR, Flório FM. Prevalence of Noncarious Cervical Lesions and Associated Factors After Orthodontic Treatment: A Long-Term Follow-Up. Int J Dent 2026-01-01;2026():5560362. doi:10.1155/ijod/5560362 · PMID 42534398
- Srivastava S, Tewari N, Mathur VP, Rahul M, Bansal K, Tsilingaridis G. Descriptive Evaluation of Medium- and Long-Term Complications of Traumatic Dental Injuries in Children and Adolescents Reporting to a Tertiary Care Hospital. Dent Traumatol 2026-08-01;. doi:10.1111/edt.70112 · PMID 42581489
Additional documents
- InsureKidsNow (CMS). Summary of Benefits Report for Utah, Medicaid — dental (data as of 04 Feb 2026, print date 03/02/2026) — the children’s dental benefit has no line named «broken tooth», and the words trauma, mouthguard, sports and avulsion do not appear in the document at all: those are verified absences, and they tell you which line to ask for. What the document does set out is the machinery a chipped tooth ends up using: tooth-coloured composite fillings covered for front teeth, with back teeth depending on the member’s plan and eligibility and silver (amalgam) being the standard for posterior teeth unless a tooth-coloured filling is medically necessary, all subject to the same two-year limit per tooth surface; stainless steel crowns allowed once every two years per tooth, covered for children to protect teeth with large cavities or after a nerve treatment (pulpotomy); root canals on permanent teeth without prior authorisation when medically necessary to save the tooth, with x-rays included in the global fee; a pulpotomy covered for infected baby teeth without prior authorisation, limited to once per tooth and not covered for teeth already loose and about to fall out or too damaged to be repaired with a filling or crown (PDF)
- InsureKidsNow (CMS), same report — the lines that decide the emergency arithmetic after a dental injury: «Care of abscesses» is covered and emergency treatment for an abscess or acute infection does not require prior authorisation, including an emergency exam, diagnostic x-rays and incision and drainage of the abscess to relieve pain and infection; «Emergency room services provided by a dentist» is covered; «Treatment of fractures» is marked No, with treatment of fractures covered by the medical plan, and the same split applies to biopsy of oral tissue; inpatient hospital services are No, with the facility fee and room billed to the medical plan. Metal and metal-porcelain crowns are covered for permanent teeth only with prior authorisation, once every five years per tooth; nitrous oxide analgesia is a non-covered service, behaviour management is not covered, orally administered sedation medications go through the Medicaid pharmacy programme by prescription only, and general anaesthesia with intravenous conscious sedation is covered only when a child cannot be treated safely under local anaesthesia because of physical or mental disability or another complex medical condition, documented in the record. Bitewing x-rays are allowed twice per calendar year and a full set once every two years, and a panoramic image taken the same day as bitewings is folded into that single limit and cannot be billed separately (PDF)
Bibliographic records above were retrieved and verified programmatically from Europe PMC (authors, journal, volume, pages, DOI, PMID, citation count). Coverage, guideline and regulatory statements are quoted from the cited public documents with their dates; verify against the current version before relying on them. This article is not medical or dental advice.