There are a number of systems used for the classification of tooth fractures. Most are based upon how far the fracture extends into the tooth structure. Prognosis of a fracture treatment is dictated by whether the pulp was exposed by the fracture and the extent of damage to the root and coronal portion (the part covered by enamel) of the tooth.
See Diagram 6

Fractures of front teeth are most common among children. In most cases when only the enamel is involved there is little cause for immediate concern. While there maybe acute pain initially, it usually subsides. The exception to this is when there is an unseen fracture of the root or bone. Observe the edge of the fracture, if it appears that the fracture is in the all white enamel and there is no transition to the yellow of the dentin, or to the pink to red color of the pulp (innermost portion where the nerve and blood vessel terminate), the tooth will probably be find. However, the tooth should also be checked for movement particularly if it's an adult tooth. If mobility exists there may be a root or bone fracture.

If there is no exposure of the dentin or pulp chamber the sensitivity associated with the trauma will generally subside. In many cases a dentist will smooth out any jagged areas to prevent damage to the tissue or perform a cosmetic procedure to restore the appearance of the tooth. Little can be done at home other than use of an analgesics for pain relief. A dentist should be consulted immediately to rule out possible root or bone damage.

If the fracture of a tooth extends into the dentin, the tooth can often become very sensitive to hot and cold even when there is a substantial amount of dentin between the fracture and innermost portion of the tooth the pulp. If only a small amount of dentin remains, the possibility of bacteria reaching the pulp is increased, and the tooth may die.

As with fractures of the enamel, pain relieving analgesics may be helpful until a dentist can be seen. Another suggestion that may aid to reduce sensitivity if the fracture contour will allow it, as with a fracture associated with a lost filling, is to use of one of the over the counter temporary filling materials, such as Tempanol (U.S. DenTek Corporation) or Dentemp (Majestic Drug Company Inc.). Both contain the pain relieving substance eugenol. When placed over the fractured area these medications may protect the tooth from air and bacteria until a dentist can be seen.

1. Dry the tooth thoroughly,
2. place the medication over the fractured area.
3. Using a cotton gauze to separate the fractured area from the opposing tooth, and preventing moisture contamination, bite down gently.

Fractures involving the pulp (terminating area of the principle blood vessel and nerve) are usually easily seen as red or bleeding areas in the center of the tooth. These fractures can be extremely painful, and the use of the aforementioned medications may or may not be helpful. Consult with a dentist without delay, saving the tooth is directly related to early diagnosis and treatment.