Warning Signs Of Gum Disease Identified

HealthDay (12/10) states that “gum disease develops when the tissues surrounding your teeth become inflamed,” adding that it may result in tooth loss. According to the article, the ADA identifies some warning signs of a problem, including “gums that bleed easily,” and “gums that are tender and may be red or swollen.” The ADA provides additional information on gum disease at MouthHealthy.org.

Sugar-free drinks can cause dental erosion

The chemical mix of acids in sugar-free soft drinks and sports drinks can cause as much dental erosion as sugared sodas, according to researchers in Australia. Consumers should be made aware of this problem, they noted. Researchers from the University of Melbourne Oral Health Cooperative Research Centre tested eight sports drinks for their impact on tooth enamel. All but two of the drinks caused significant enamel surface loss and enamel surface softening. As a comparison, researchers also tested a major cola brand and bottled spring water. While the cola produced the highest amount of surface loss, both the cola and the majority of the sports drinks caused enamel hardness to decrease by 30% to 50%, the researchers found. They published their findings in a briefing paper  (November 26, 2015). More information can be found here.

ADA Spokesperson Discusses Link Between Oral Health And Overall Health.

In response to a question from a Medicare recipient with Sjogren’s syndrome about dental care options,Kaiser Health News (12/8, Andrews) states that “Medicare only covers dental care in very limited circumstances,” adding that a few options remain for Medicare recipients seeking dental care, such as community health centers and dental schools. Dr. Matthew Messina, a consumer adviser for the American Dental Association, explains the challenges people face who have a medical condition affecting their teeth. In healthcare, “somehow the mouth got disassociated from the rest of the body,” Dr. Messina says. “Oral health is a significant component of whole body health.”

Some Consider Tooth Polishing Unnecessary, Although Not Detrimental?

In response to a reader’s question about polishing teeth, The New York Times (12/4, Saint Louis) “Ask Well” blog stated “the procedure isn’t necessary.” Marcia Lorentzen, the dean of the Fones School of Dental Hygiene at the University of Bridgeport in Connecticut, said that although the procedure does not pose “a significant risk” to enamel, scaling should be used to remove dental stains. However, the article said that “not using a soft toothbrush or brushing too hard daily can damage the softer structures of the teeth, including the cementum, the surface layer of the tooth root.” Blogger's note In my years of practice following the same patient I have not seen  any loss of tooth structure from polishing of teeth with a rubber cup and prophy paste. DKMacLeod

Study Finds Americans Skipping Dental Visits Due To Cost.

Study Finds Americans Skipping Dental Visits Due To Cost.

In its morning broadcast, ABC News (10/7) reported that a new study shows that 23% of Americans have no plans to see the dentist in the next 12 months, citing the American Dental Association as its source. ABC News adds that “almost half of them that say cost is the number one reason why.” Health savings adviser Jason Szczuka provided advice for saving on dental care. He recommended that people compare prices, negotiate discounts, pay cash, or consider receiving services at a dental school.

My comments: in this age with a search on google one can find dentist who for under $100 will do a cleaning , exam and x-rays??

ADA Spokesperson Says Acids In Wines Can Dissolve Enamel.

In an article examining how wine consumption affects dental health, the New York Magazine (9/11, Rinkunas) reports that Dr. Matthew Messina, a spokesperson for the American Dental Association, said that “red is more directly staining,” although pink and white wine varieties can still discolor teeth through secondary staining due to wine’s acidity, which can dissolve enamel. When drinking wine, “the best-case scenario is to have wine with a meal (versus sipping it throughout the night), drink water to moisten your mouth and wash away what’s on the surface of your teeth, wait 30 minutes for saliva to do its thing, and then brush,” the article reports, adding that Dr. Messina recommends using an ADA-approved fluoride toothpaste to help strengthen teeth.

Parents Advised To Provide Early Care For Children’s Baby Teeth.

The Urbana/Champaign (IL) News-Gazette (8/19) recommends children start receiving dental care very early, stating that many parents may not realize how important it is to care for baby teeth. According to the article, dentists recommend children visit the dentist when their first tooth appears, and no later than their first birthday, adding that one Illinois dentist said this helps establish a positive relationship between the child and the dentist. Caring for baby teeth is important because the teeth not only help children chew, but also help form a path for permanent teeth to follow, according to the American Academy of Pediatric Dentistry. In addition, the article reports that the American Dental Association advises parents to schedule a morning visit for their child and avoid using dental visits as a reward or punishment.

Tennessee Department Of Health: Fluoridated Community Water Is Improving Dental Health.

In a statement carried by Clarksville (TN) Online (8/4), the Tennessee Department of Health discusses how Tennesseans have benefited from fluoridated community water, saying, “Comparisons of dental health before and after fluoridation in Tennessee showed a 75 percent decline in decay of children’s permanent teeth from the early 1950s to the late 1980s.” According to the statement, community water fluoridation costs “approximately 50 cents per person, per year,” a fraction of what it costs to repair one cavity.

Employers Encouraged To Evaluate Dental Coverage Options.

With more people seeking benefits packages that include dental coverage,BenefitsPro (8/4) discusses items employers should know and evaluate concerning dental coverage, such as being aware that some medical plans on the ACA exchange may include dental benefits for children, although the medical plans do not all cover children’s benefits equally, while standalone dental carriers can provide adult dental coverage. According to the article, “Dental coverage encourages regular preventive dental check-ups, which not only helps protect dental health but also can detect as many as 120 different diseases in their earliest stages, when they are most effectively treated.”

Dental Treatment With Local Anesthetics Is Safe For Pregnant Women.

HealthNewsDigest (8/4) reports that a new study published in the August issue of the Journal of the American Dental Association suggests that dental treatment with local anesthetics is not harmful for pregnant women. Study author Dr. Aharon Hagai said, “Our study identified no evidence to show that dental treatment with anesthetics is harmful during pregnancy, and yet so many pregnant women avoid going to the dentist.” Dr. Hagai added, “Dentists and physicians should encourage pregnant women to maintain their oral health by continuing to receive routine dental care and seeking treatment when problems arise.”

NYTimes “Well” Blog Considers Whether To Floss Or Brush First.

The New York Times (5/29, Saint Louis) “Well” blog considered the question of whether to floss before or after brushing the teeth. Although “flossing first isn’t necessarily better for oral health than the other way around” ADA spokesman and professor of restorative dentistry at UCLA Dr. Edmond R. Hewlett “recommends flossing first” because that way you “get the unpleasant task out of the way to avoid the temptation to not do it,” as the Times put it. The Times went on to point out that flossing is less important for cavity reduction than it is as a method of maintaining proper gum health. Said Dr. Hewlett, “Gingivitis is the first step in losing your teeth,” adding, “The nice thing about catching inflammation when gums are bleeding is you can reverse it then, if that’s all that’s going on,” with proper flossing and brushing.

        Drawing on the New York Times coverage, the Today Show Online (6/1) reported that “one spokesman for the American Dental Association told the Times...that it’s preferable to floss first” because “people will be less likely to skip flossing than if they wait until after brushing.” Additionally, the Today Show reported that as long as patients floss “at least once every day, you’re going to minimize the nasty bacteria clinging to your teeth, says Matthew J. Messina an American Dental Association spokesperson and private practice dentist in Cleveland.”

Mouth Changes An Often Ignored Sign Of Cancer.

The Chronicle (GHA) (6/5) listed 15 cancer symptoms men ignore; one of the signs is “white or red patches inside your mouth or on your lips.”

ADA, AAPD Recommend Parents Take Children To Dentist No Later Than First Birthday.

The Pocono (PA) Record (6/5, Leap) reported on ADA and AAPD recommendations on children’s oral healthcare, including that parents should bring children to see a dentist at the emergence of their first teeth or by their first birthday. Additionally, the article reports that the ADA “recommends young children see a pediatric dentist rather than a general or regular dentist, where the majority of patients are adults.” The article goes on to report that parents should help their children avoid dental disease by implementing a proper oral health routine, including regular dental visits. Finally, the Pocono Record reports that there is no standardized time for the first set of dental X-rays, instead, “the doctor will determine any abnormality in the face, jaw or teeth, as well as the need for the x-ray.”

Critical Summary: Assessing Local Antimicrobials for Chronic Periodontitis

Critical Summary: Assessing Local Antimicrobials for Chronic Periodontitis

A new critical summary by Dr. Robert Durand shows that adjunct local antimicrobials provide statistically significant benefits over subgingival debridement alone in patients with chronic periodontitis.

This is a critical summary of Matesanz-Pérez P, et al. A systematic review on the effects of local antimicrobials as adjuncts to subgingival debridement, compared with subgingival debridement alone, in the treatment of chronic periodontitis. J Clin Periodontol. 2013;40(3):227-241.

To learn more, visit ADA Center for Evidence Based Dentistry.

Article Considers Optimal Frequency Of Dental X-Rays.

The Huffington Post (CAN) (5/28) reports on how frequently patients need to have dental X-rays. Though X-rays are an important tool for dentists in determining difficult-to-see dental decay, the Huffington Post points out that dentists should generally use the ALARA – as low as reasonably achievable – principal in prescribing X-rays. The Huffington Post also reports that “a document produced for the American Dental Association suggests that an adult with good oral health and low risk of dental problems should have x-rays taken at intervals of every 24 to 36 months.”

Dentists Recommend Replacing Toothbrush Every Three Months At Least.

YourTango (4/15, Drouillard) explores tattoos and body piercings ritualistic and symbolic meaning to those who choose to modify their body in such a way. The article notes that the American Dental Association “opposes tongue, lip or cheek piercing,” and reports that the Mayo Clinic found that 17 percent of college students with piercings “suffered a medical complication such as infection or tearing” as a result of their piercing.

ADA Does Not Recommend Oil Pulling.

In its “Health with Dr. Paula” segment, WTVM-TV Columbus, GA (4/15) reports that despite claims that “oil pulling” offers oral health benefits, “the American Dental Association cautions that because of a lack of evidence, they do not recommend oil pulling as a replacement for standard oral health care such as flossing and teeth brushing.”

Dentists Warn Of Risks Associated With Poor Dental Implant Care.

BBC News (4/14) reports that according to results published in the British Dental Journal, some dentists have warned that they are seeing an increase in peri-implantitis in patients with implants because “patients are often not aware of how to maintain them.” BBC News adds, “If an infection is allowed to take hold around an implant inserted in the gum, the jaw bone around the implant can also become affected and begin to waste away.” The dentists stress that caring for dental implants is no different than practicing regular oral hygiene, despite the perception that dental implants are indestructible, and should include regular flossing, brushing, rinsing with mouthwash, and cleanings by a dentist.

Dislodged Tooth Should Be Placed In Milk Or Patient’s Saliva In Transit To Dentist.

A CBS’ The Doctors (4/7) segment on first aid “dos and don’ts” offered patient advice on what to do if a tooth is dislodged. During the segment, Reader’s Digest editor-in-chief Liz Vaccariello discussed several first aid situations, noting that a tooth that has been knocked out should not be washed or put in any alcohol or peroxide solution. Instead, patients should place the tooth in a container with a small amount of their own saliva or milk. Moreover, during the segment host Dr. Travis Stork advised patients to “get to your dentist as soon as possible, because that tooth could literally be re-implanted and potentially survive if you do the right thing with it.”

Smokeless Tobacco Risks Noted During Oral Cancer Awareness Month.

The Bradenton (FL) Herald (4/14, Dymond) reports that while only a small percentage of dental patients still chew tobacco, about 20 percent still smoke. One local dentist “uses his charm and wit to urge patients to give up” the habits “due to the dangers of both,” especially during April, which is Oral Cancer Awareness Month. Another Florida dentist points out that three of four people she sees who say they use smokeless tobacco present with pre-cancerous lesions in their oral cavity. The Herald reports that the scale “began tipping against dipping after the 2014 death of former San Diego Padre Hall of Famer Tony Gwynn, who contracted salivary gland cancer and attributed it to his habit of using chewing tobacco.” Gwynn was 54.

        Meanwhile, also as part of Oral Cancer Awareness Month, the Athens (GA) Banner-Herald (4/13) reports that North Athens Implant and Family Dentistry is offering free oral cancer screenings through April 17. “People who use tobacco, including smoking cigarettes, and who drink alcohol heavily are at increased risk for oral cancers,” the article notes, adding that such cancers are most prevalent in people over 40.

Surgeon Recommends Regular Dental Visit To Prevent Oral Cancer.

On its website, KOMO-TV Seattle (5/22) profiles public speaker and author Robert Haase, who had successful tongue reconstruction surgery following a diagnosis of tongue cancer. His surgeon, Dr. Robert Bayles of Virginia Mason Medical Center, “said for prevention, people should follow good hygiene habits and see a dentist regularly,” as regular exams can detect oral cancers.

Upper left 2nd molar RCT or Implant

I have been getting different answers by two of my personal dentists (both general DDS) on treatment of my upper left 2nd molar that has sensitivity. Planning ahead I have asked my uncle (DDS, doesn't do implants) and he said that he normally doesn't do RCT on upper 2nd molar because of location and multi canals. My normal doctor said she will refer me out if I want an implant, but can do a RCT. Is this odd? My uncle's not willingness to do RCT. Is it a sign that a Endo should do it? Can general DDS do implant upper 2nd molar?

Before determining treatment, one must  determine the pulp status of the tooth. How many seconds does the  pain to cold linger after ice is put on it then removed? If 3-5 seconds try a desensitizing toothpaste that has 5% Potasium Nitrate, if pain lingers 15-20 seconds the pulp is dying and a root canal or extraction can be done. If the dentists you have seen have not properly tested the tooth ( hot, cold, Elec Pulp Test, percussion, Xray) have them do these tests or see an endodontist who should do them as a standard routine. Once you know that the tooth pulp needs treatment you can decide RCT vs Extraction then decide if you want to replace #15 or not. Good Luck

Skipping Dental Visits, Preventive Health Check-Ups May Prove Expensive

US News & World Report (4/8, Pant) covers five scenarios in which being overly frugal may cost more in the long run. One of those cases is when it comes to a patient’s health, as it “might be tempting to skip a doctor’s appointment or forgo getting your teeth cleaned at the dentist.” However, avoiding preventive care “is ‘false savings,’” since “catching an illness or treating an injury early on is better for your net worth and your well-being,” US News reports. “Visit the doctor and the dentist,” the article says.

ADA Does Not Recommend Oil Pulling.

LiveScience (5/21) reports on oil pulling, noting that the ADA does not recommend oil pulling “as either a supplementary oral hygiene practice, or as a replacement for standard oral health behaviors” due to “a ‘lack of science.’” The ADA “criticizes existing studies” on oil pulling “as ‘unreliable’ for a number of reasons.” LiveScience adds that “possibly the greatest risk of oil pulling is using it to replace time-tested treatments,” though other heath risks are also significant. For instance, Harvard Medical School “found that one out of five Ayurvedic herbal medical products produced in South Asia and available in Boston South Asian grocery stores contains potentially harmful levels of lead, mercury and/or arsenic,” and the ADA “also reported that oil pulling could cause lipoid pneumonia,” diarrhea or stomach upset.

Considers Causes Of Tooth Sensitivity.

Citing ADA spokesperson Dr. Matt Messina extensively, TIME (5/21) reports on why people suffer from tooth sensitivity. Citing Dr. Messina, TIME reports that short-lived cold-induced pain may not be cause for alarm, “but if the pain is persistent and confined to a specific tooth or area of your mouth,” it may be an indicator of a micro-crack, a degraded filling, or a cavity, all of which require a dentist’s attention. If a person has sensitivities to cold, hot and biting pressure “we could also be talking about some sort of infection in the tooth,” Dr. Messina said. Sensitivity may be the result of issues with the gums, as “brushing too forcefully, chewing tobacco or allowing the buildup of plaque can all cause your gums to “run away” from your teeth, resulting in temperature sensitivity, Messina says.” Dr. Messina also said, “The solutions are often simple, but only if we address the problem early.”

ADA Consumer Advisor Discusses Methods For Avoiding Halitosis.

Drawing on comments from ADA consumer advisor and dentist Dr. Sally J. Cram, Men’s Journal (5/7) reports on ways to avoid halitosis. Namely, Men’s Journal reports that Dr. Cram advises patients maintain proper oral hygiene, use a soft bristle toothbrush, use fluoride toothpaste, eat a diet rich in greens, and scrape or brush the tongue. Regarding toothpaste, Dr. Cram said, “It’s also very important to chose toothpastes that have the American Dental Association Seal of Acceptance. This shows that it has been evaluated by someone other than the manufacturer and is safe and effective.”

Prevention, Dental Visits Key To Maintaining Oral Health.

WTVT-TV Tampa, FL (5/7, Chmura) reports on five steps people should take in order to improve and maintain their oral health. “According to a list of prices posted by the American Dental Association, fillings average more than $100 while crowns top $1,000,” although dentists “say those expensive trips could be avoided if only we would do a better job caring for our teeth,” WTVT reports. The steps the article advises include brushing for two minutes twice a day, using a soft-bristle brush, using correct brushing technique, and flossing at least once per day “to prevent an ugly, painful, time-consuming, and likely expensive alternative.”

Study Highlights Need To Rinse, Replace Toothbrush.

Women’s Health (5/5) reports that a study from researchers at the University of Manchester found that “the average toothbrush can contain 10 million or more bacteria,” including E.coli and Staph. The article reports that the study illuminates the importance of properly rinsing and storing one’s toothbrush, as well as replacing it at the proper interval. The article cites American Dental Association spokesperson and dentist Dr. Maria Lopez Howell, who explained that people should rinse their brush thoroughly after use, replace it when the bristles become frayed or after three months of use, and to store it in an upright position “in a spot that gets enough air for it to dry between brushings.”

HHS Lowers Recommended Drinking Water Fluoride Level.

An announcement from the Department of Health and Human Serivices recommending that the optimal level of fluoride in drinking water be set at .7 milligrams per liter saw wide coverage, including reports from two national nightly news broadcasts, a news wire, and national blogs and websites.

        NBC Nightly News (4/28, story 7, 0:30, Holt) reported, “Federal health officials are lowering the recommended level of fluoride in drinking water for the first time in more than 50 years.”

        The CBS Evening News (4/27, story 13, 0:30, Pelley) reported that on Monday, the Federal government “said that less fluoride should be added to the drinking water.” Currently, 75 “percent of Americans have fluoridated water. The Department of Health and Human Services said that fluoride is already in toothpaste and mouth wash and too much fluoride can discolor children’s teeth.”

        The Washington Post (4/28, Bernstein) “To Your Health” blog reports that HHS now recommends that “drinking water contain .7 milligrams of fluoride per liter,” representing a change in the previous recommendation of “a range of .7 to 1.2 milligrams per liter” set in 1962.

        The Nightly Business Report (4/27, Mangan) reports that Deputry Surgeon General Boris “Lushniak called the new standard ‘the correct measure to help prevent tooth decay and reduce the prevalence of fluorosis.” The Nightly Business Report adds that while the new standard “is only a recommendation,” it is “likely to be taken seriously by the approximately 75 percent of community health systems nationwide that currently” fluoridate their water “to lower the rate of tooth decay in the populations.”

        Several news organizations refer to the ADA’s support of the announcement. The AP (4/28, Stobbe) reports that “water fluoridation has been a public health success, and communities should keep adding fluoride, said Kathleen O’Loughlin, the American Dental Association’s executive director.” O’Loughlin joined Lushniak when the new standard was announced yesterday.

        The NPR (4/28) “Shots” blog and “All Things Considered” radio program reports that Dr. Lushniak said, “The new recommended level will maintain the protective decay prevention benefits of water fluoridation and reduce the occurrence of dental fluorosis.” NPR adds that “the decision was welcomed by groups such as the American Dental Association.”

        CNN (4/28) reports that HHS said on Monday that dental fluorosis in the US “appears mostly in the very mild form – as barely visible lacy white markings or spots on the enamel,” adding that severe dental fluorosis is rare in the US. CNN also reports that the ADA “says the new recommended levels will still reduce tooth decay but minimize fluorosis,” stressing that it continues to support community water fluoridation. HHS assistant secretary for health Dr. Howard Koh said, “One of water fluoridation’s biggest advantages is that it benefits all residents of a community,” adding, “And fluoridation’s effectiveness in preventing tooth decay is not limited to children, but extends throughout life, resulting in improved oral health.”

        Noting that Tucson, Arizona is only one of six US cities that does not provide optimal levels of fluoride in the drinking water – one of which is actually in the process of beginning fluoridation – the Arizona Daily Star (4/28, Innes) also reports on the HHS announcement. “According to the American Dental Association, fluoride supplementation should be considered for children who drink water with less than 0.6 milligrams per liter,” the Daily Star reports. Moreover, “Many health experts say that drinking water with below optimal fluoridation levels puts residents at an increased risk for cavities.”

        Meanwhile, the ADA News (4/28) reports, “The Association commended the U.S. Public Health Service for issuing a final recommendation April 27 for the optimal level of fluoride for community water systems and said the ADA supports the new target.” ADA president Dr. Maxine Feinberg said, “It has now been 70 years since Grand Rapids, Mich., became the first U.S. city to begin adding fluoride to its water system,” adding, “Since then, decades of studies and the experience of tens of millions of people have affirmed that water fluoridation helps prevent cavities in both children and adults.”

        In a second, much more brief article, the ADA News (4/28) reports that the CDC has posted a frequently asked questions (4/28) page on community water fluoridation. The ADA News notes that the CDC’s FAQ features a “break out box” for health professionals.

        Also reporting on the story are The Hill (4/28, Ferris), Congressional Quarterly (4/28, Gustin, Subscription Publication), TIME (4/28, Sifferlin), the Washington Examiner (4/28, King), the Wichita (KS) Eagle (4/28, Dunn), and HealthDay (4/28, Thompson).

Flossing Is Good For You, Easy, Simple And Cheap

In his “Healthful Hint” column for the Winona (MN) Daily News (4/27), Dr. Frank Bures writes that flossing “is good for you,” is easy, simple and cheap, “and once it becomes part of your unconscious daily routine, it feels kind of good to floss.” Dr. Bures considers the history of flossing, concluding that “flossing is a small thing that can contribute” to overall health “in a big way.”

No Evidence To Support E-Cig Safety

In his “Dentist’s Chair” column for the Reading (PA) Eagle (4/26), Dr. John Reitz wrote that because e-cigarettes are not currently regulated by the FDA, many teens have easy access and believe they are safe due to the lack of health warning. However, “according to the National Institute of Dental and Craniofacial Research, e-cigarette vapor can contain propylene glycol, glycerine, formaldehyde, acetaldehyde, acrolein, toluene, nitrosamines, nickel, cadmium, aluminum, silicon and lead,” some of which “have been shown to cause cancer.” Dr. Reitz went on to write that “there is no evidence to support the safety of e-cigarettes,” and encourages parents to discuss the risks with their kids.

Dentists Recommend Replacing Toothbrush Every Three Months At Least.

The Atlanta Journal-Constitution (4/15, Cattel) carries a Greatest.com article considering when the appropriate time to replace a toothbrush is. The article reports that an American Dental Association spokesperson said, “If the bristles are splayed or frayed, they won’t be pointing in the same direction, and they’re not as effective at cleaning your teeth.” Dentists recommend replacing the toothbrush every three months, or as soon as the bristles show noticeable wear. The article advises writing the expected date of replacement on the back of a new toothbrush upon opening it as a simple way to remember when it needs to be replaced.

Grooves in your teeth abfraction lesions

3 Warning Signs of Impacted Wisdom Teeth

Wisdom teeth are something most people may have to deal with at some point. If the wisdom tooth is a full impacted ( totally under the tissue) it may not become an acute problem. 

On the above x-ray  the impacted tooth on the lower left (patients right) is a problem that needs to be dealt with as the "area" (black spot) around the crown may be a cyst that is growing larger destroying teeth and bone.

On the above x-rays,  the partially impacted teeth should be removed  between ages 18-22
to prevent future problems for the patients.
Symptoms of wisdom teeth that need attention are listed below.

• Red or swollen gums.
• Tender or bleeding gums.
• Jaw pain.
• Unable to close teeth together without biting swollen gum around wisdom tooth
• Swelling around the jaw.
• Bad breath.
• An unpleasant taste in your mouth.
• Difficulty opening your mouth.

The Ultimate Toothpaste Guide

There are literally dozens of toothpaste variations, and this can be confusing for untrained consumers. A post that breaks them all down, explains the differences, how each one benefits users, and what types of teeth need which variation would be a great post to attract prospective patients who want to improve their dental hygiene. When they read your post, they build trust with your practice and may be encouraged to make their next cleaning appointment with your practice. 

A patient told me of an event that happened to him where he was eating. He bites into a hard object within the food he was eating. He was concerned that he had a broken tooth. The object looked like a piece of tooth but when he inspected his teeth with his tongue he said that all the teeth felt the same.

This sometimes happens when the food a person is eating has an object in it that is hard and happens to hit on top of a tooth. If the tooth breaks it will have a different shape and may be sharp edges. If the tooth seems not to have changed there may not be a problem. Depending how hard the patient hit the tooth,  the periodontal ligament may be bruised if so this will usually resolve in 2-3 days. If it does not you should contact your dentist.