Figure 6-6.—Types of tooth fractures. Signs Upon examination of a type I fracture, you may observe: A slight chip or fracture of the tooth enamel layer only, or with possible minimal dentin involve- ment No exposure of the dentin or pulp Treatment Perform the emergency treatment guidelines. The following is a typical treatment plan that a dental officer might authorize you to perform to treat a type I fracture: 1. 2. Smooth sharp edges of the chipped area with sandpaper  strips  or  disk  to  eliminate  irritation  of the tongue and lips. Carefully dry the chipped area with a cotton roll or  pellets. 3. 4. Apply  small  coats  of  cavity  varnish  over  the chipped area with cotton forceps and cotton pellets. Instruct and caution the patient not to consume hot or cold liquids and food. Extreme heat or cold may damage the tooth pulp. Symptoms (Type II—Enamel/Dentin Fracture) A  patient  with  a  type  II  tooth  fracture  may complain of the following: Very rough or sharp edges Severe pain from heat, cold, or air Toothache Signs Upon examination of a type II fracture, you may observe the following: Extensive  fracture  involving  the  enamel  and dentin layers No pulp exposure Treatment Perform emergency treatment guidelines. Except in rare cases, the dental officer will provide emergency treatment. If for some reason he does not treat the patient, the dental officer could authorize the assistant to cover the exposed dentin with a temporary type paste or place a temporary crown. The procedures for covering a type II with zinc oxide and eugenol paste or other temporary paste are as follows: 1. 2. 3. 4. 5. Isolate area with cotton rolls. Carefully dry the fractured tooth off with cotton rolls or 2 x 2 gauze. (Do not use direct air with the 3-way syringe.) Coat all exposed dentin with a zinc oxide and eugenol paste or other temporary material, including light cured glass ionomer cement. Advise the patient that this is a temporary procedure to relieve pain and sensitivity. The coat of zinc oxide and eugenol may come off the fracture. Instruct  patient  to  eat  a  bland  diet  and  avoid extremely hot and cold foods, liquids, or sticky foods, and not to chew on the fractured tooth. 6-8