Injuries to the teeth are common in collision cases. Whether by direct impact or by bite-down damage, the teeth can easily be loosened or fractured in an accident. To understand the nature of damage to the teeth, we must first consider dental terminology, the characteristics of teeth, and their relationship to the tissue and bones of the mouth.
Periodontal tissue is the delicate tissue that covers the bones inside the mouth. This tissue is integral in supporting and maintaining the teeth in the oral cavity. Wounds inside the mouth are very intricate and difficult to repair. Fortunately, this tissue is quick to heal and, while these injuries are painful, tissue repairs are typically effective toward a full recovery. Periodontal tissue is integral in supporting and maintaining the teeth in the oral cavity. The teeth are anchored into the bones of the mouth by periodontal ligaments. These ligaments allow for slight movement of the teeth within the bones and are sensitive to the pressure applied to the teeth. Severe damage to periodontal ligaments will result in loss to the affected teeth.
Two arches form the shape of the mouth: the maxillary arch and the mandibular arch. The maxillary arch is the front portion of the skull that forms the upper jaw, which holds the upper teeth in place. The maxillary arch also connects to the left and right cheeks, or zygomatic bones.
The mandibular arch is made up of the mandible or lower jawbone. This bone is the largest bone in the face and holds the lower teeth in place. Damage to either primary arch typically requires surgery. This damage also can cause permanent damage to the teeth.
Most collision-related dental injuries are to the central incisors and lateral incisors. These are the frontmost teeth. Although all teeth differ in size and shape, their basic structure is the same. There are three primary parts of a tooth: the crown, the neck, and the root. The crown is the part of the tooth visible above the gum line. The neck of the tooth is a constriction separating the crown from the root of the tooth. The root is the invisible portion of the tooth below the gum line that anchors the tooth into the jaw.
Tooth damage ranges in severity depending on the extent of the surface fracture and the extent of effect on the pulp, which lines each tooth. The pulp is a combination of living tissue, nerves, and blood that nourishes and provides sensation to the tooth’s structure. If damage extends only to the enamel, which is the outer visible surface of the tooth, repairs are typically simple and cosmetic in nature. If damage reaches the inner layer (called the dentin) or exposes the pulp, removal or replacement of the tooth is typically necessary.
Dental injuries are permanent injuries and most repairs will not last the patient’s lifetime. Attorneys and victims must always secure narrative opinions from the dentist, oral surgeon, or orthodontist to confirm the likely future treatment needs of the patient over the course of his or her remaining life span. These charges should be paid at settlement by all of the parties and insurance carriers that are responsible for the victim’s injuries. Also the anxiety and pain associated with root canals, tooth removal, facial surgery, and other invasive dental treatment should be highlighted to secure proper compensation for pain and suffering.