A few years ago I received a call from one of my patients who is a golfer.  He reported that he had been playing golf about an hour away from Atlanta. While driving his cart, a golf ball came sailing through the air and hit him in the face. His upper left canine was pushed back in the socket, and the upper left first premolar was smashed. He was surprisingly calm when he reported this  accident. He visited an emergency oral surgeon where the accident occurred, and then returned to my office.

He was pretty black and blue from the accident and still sore from the surgery that he had on top of that. The final result was that he needed a root canal on the canine tooth but no further treatment there. The first premolar area received bone grafting to make sure there was enough bone to hold an implant, and the site was allowed to heal. Then a dental implant was placed and a crown cemented on top of that. All of this treatment was quite unremarkable but did take some time go to completion.

He maintained a good attitude and said if the golf ball had hit an inch higher he would have lost his left eye.

On a similar note, I had a female patient, mid 20’s, who was eating in a pizzeria. She had to use the restroom where a janitor had been cleaning the floor. Unfortunately there was no sign announcing the wet floor. She proceeded to slip, fall on her face and break 3 beautiful front teeth. Two of the teeth could be restored with filling material until they could be crowned, but the third tooth fractured at the gum line, the root had fractures in it, and it simply could not be restored. Her treatment followed a similar path but the end result was fine.

Dental Treatment Choices

Patients have some choices of what to do with teeth that are no longer restorable. The choice recommended by dentists at this point in time is to have a dental implant placed and have an esthetic crown placed over it. Before implants were so predictable, there were choices of a dental bridge (where the teeth on either side of the missing tooth are drilled for a crown, and a missing tooth is attached to crowns on either side of the space), or a removable tooth. Most times the removable tooth has to be made until everything heals.