I slipped and fell on the ice last weekend. Unfortunately, my face broke my fall. I wound up with a black eye and a serious chunk of one of my front teeth missing. I went to the emergency dentist to have it checked out. He took x-rays and told me the tooth looked like it was ok structurally. Then, he patched it up and told me to follow up with my regular dental office to have it permanently fixed and checked on again later. I don’t want to waste time and money on another appointment if it isn’t necessary and it looks like he used the same stuff that’s usually used in fillings. Do I really need to go back or can I just let this one be? The patch job by the emergency dentist looks just fine to me.  — Don

Dear Don,
Glad to hear you’re mostly ok after the fall. As for the tooth, the emergency dentist probably did use the same composite material that’s normally used in fillings. If that’s the case, it could last years, perhaps even decades.

With that said, there’s probably more to this than simple bonding. First of all, the tooth was traumatized. Sometimes when a tooth is injured by blunt force, it doesn’t give off any symptoms right away. However, the blood flow to the tooth could have been cut off and that wouldn’t show up on x-rays. If this is the case, the tooth could be dead or dying, and it will eventually need a root canal. Unfortunately, the first sign this has happened is often pain or an abscess, though sometimes the person notices discoloration as well. Anytime you see an emergency dentist, he’ll refer you back to your regular office for a follow-up. In cases with trauma, having the dentist check out the tooth again later could save you a lot of pain and trouble.

As for your comment about having the tooth permanently fixed, could he have mentioned to you that the tooth needed a crown? If the chip was severe, the bonding won’t be adequate and the tooth will need all-around protection. Your best bet is to follow the advice of the emergency dentist and schedule a visit with your regular office to get it checked out. If you’re still wary, you can always call the office that did the work and clarify why he wanted you to follow up.

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