Back to Basics: Dental Fractures

Fractures involving Enamel Only (Ellis I): Considered cosmetic only; can file down sharp edges; non-urgent dental referral

Fractures involving Enamel and Dentin (Ellis II): "yellow hue" of dentin visible; increased sensitivity; cover the exposed dentin with calcium hydroxide paste; follow-up within 24 hours

Fractures involving Enamel, Dentin and Pulp (Ellis III): pinkish hue or bleeding; considered "tooth threatening" fracture; ideally, immediate dental consultation, however, reasonable to treat similarly to Ellis II with follow-up as soon as possible.

Alveolar Ridge Fractures: require rigid splinting of the affected segment; ideally, consult dental in the ED, however, if fracture is small, not grossly mobile, follow-up within 24 hours is reasonable




Pedigo, Ryan. Dental Emergencies: Management Strategies that Improve Outcomes. Emergency Medicine Practice. June 2017. Volume 19, Number 6.

Go, Steven. Oral and Dental Emergencies in Emergency Medicine: Just the Facts, 2nd Edition. McGraw-Hill Companies. 2004.