You're crunching ice or a piece of hard candy when you notice something hard in your mouth that doesn't melt or dissolve. You get a sick feeling as you realize what it is -- a piece of broken tooth.
Although the enamel that covers your teeth is the hardest, most mineralized tissue in the body, its strength has limits. Falling, receiving a blow to the face, or biting down on something hard -- particularly if a tooth already has some decay -- can cause a tooth to chip or break. If you discover you have broken or chipped a tooth, don't panic. There are many things your dentist can do to fix it.
How to Care for a Chipped or Broken Tooth
If your tooth is broken, chipped, or fractured, see your dentist as soon as possible. Otherwise, your tooth could be damaged further or become infected, possibly causing you to end up losing the tooth.
In the meantime, try the following self-care measures:
- If the tooth is painful, take acetaminophen or another over-the-counter pain reliever. Rinse your mouth with salt water.
- If the break has caused a sharp or jagged edge, cover it with a piece of wax paraffin or sugarless chewing gum to keep it from cutting your tongue or the inside of your lip or cheek.
- If you must eat, eat soft foods and avoid biting down on the broken tooth.
Treatment for a broken or chipped tooth will depend on how severely it is damaged. If only a small piece of enamel broke off, the repair can usually be done simply in one office visit. A badly damaged or broken tooth may require a more lengthy and costly procedure. Here are some ways your dentist may repair your broken or chipped tooth.
Dental Filling or Bonding
If you have chipped off just a small piece of tooth enamel, your dentist may repair the damage with a filling. If the repair is to a front tooth or can be seen when you smile, your dentist will likely use a procedure called bonding, which uses a tooth-colored composite resin.
Bonding is a simple procedure that typically does not require numbing the tooth. To bond a tooth, the dentist first etches its surface with a liquid or gel to roughen it and make the bonding material stick to it. Next, the dentist applies an adhesive material to the tooth followed by a tooth-colored resin. After shaping the bonding material to look like a natural tooth, the dentist uses an ultraviolet light to harden the material.
Dental Cap or Crown
If a large piece of tooth breaks off or the tooth has a lot of decay, the dentist may grind or file away part of the remaining tooth and cover it with a crown, or tooth-shaped cap, made to protect the tooth and improve its appearance. Permanent crowns can be made from metal, porcelain fused to metal, all resin, or all ceramic. Different types have different benefits. All-metal crowns are the strongest. Porcelain and resin crowns can be made to look nearly identical to the original tooth.
If the entire top of the tooth is broken off but the root is still intact, the dentist or an endodontist (a dentist who specializes in root canals) may perform root canal therapy and place a pin or a post in the canal, and then build up enough of a structure onto which a crown can be made. Later, the dentist can cement the crown over the pin or post-retained restoration.
Getting a crown usually takes two visits to the dentist’s office. During the first visit, your dentist may take X-rays to check the roots of the tooth and surrounding bone. If no further problems are detected, the dentist will numb the tooth and surrounding gum and then remove enough of the remaining tooth to make room for a crown. If a break or chip has left a large piece of the tooth missing, your dentist can use a filling material to build up the tooth to hold the crown. Next, your dentist will use a putty-like material to make an impression of the tooth receiving the crown as well as the opposing tooth (the one it will touch when you bite down). The impressions are sent to a lab where the crown is made. In the meantime, your dentist may place a temporary crown made of acrylic or thin metal.
During the second visit, typically 2 to 3 weeks later, your dentist will remove the temporary crown and check the fit of the permanent one before permanently cementing it in place.
Some dental offices have special digital milling technology that enables them to make a crown the same day without taking a putty impression. They may also have intra-oral scanners that create a digital impression that is sent to a lab in an electronic file.
If a front tooth is broken or chipped, a dental veneer can make it look whole and healthy again. A dental veneer is a thin shell of tooth-colored porcelain or resin composite material that covers the whole front of the tooth (much like a false nail covers a fingernail) with a thicker section to replace the broken part of the tooth.
To prepare your tooth, your dentist will remove about 0.3 to 1.2 millimeters of enamel from its surface. Next, the dentist will make an impression of the tooth to be sent to a dental laboratory, which will make the veneer. When the veneer is ready, usually a week or two later, you'll need to go back to the dentist to have it placed. To place the veneer, your dentist will first etch the surface of the tooth with a liquid to roughen it. The dentist then applies a special cement to the veneer and places the veneer on the prepared tooth. Once the veneer is in position, your dentist will use a special light to activate chemicals in the cement to make it harden quickly.
Root Canal Therapy
If a tooth chip or break is large enough to expose the pulp -- the center of the tooth containing nerves and blood vessels -- bacteria from the mouth can enter and infect the pulp. If your tooth hurts, changes color, or is sensitive to heat, the pulp is probably damaged or diseased. Pulp tissue can die and if it's not removed, the tooth can become infected and need to be extracted. Root canal therapy involves removing the dead pulp, cleaning the root canal, and then sealing it.
Root canal therapy may be performed by general dentists or endodontists. Most root canal therapies are no more painful than having a cavity filled. In most cases, the remaining tooth must be covered with a crown to protect the now-weakened tooth.
Treatment for Broken or Knocked-Out Teeth
Call 911 if the person has a serious injury or is unconscious.
A knocked-out permanent tooth is a dental emergency. Knocked-out teeth can be reimplanted in many cases. A permanent tooth that is reimplanted within 30 minutes has the highest chance of success.
1. Collect Teeth or Teeth Fragments
- Handle teeth carefully because damage may prevent reimplantation.
- Touch only the crown, the top part of the tooth. Do not touch the root of the tooth.
- Rinse the tooth gently in a bowl of lukewarm water for no more than 10 seconds only if there is dirt or foreign matter on it. Do not scrub, scrape, or use alcohol to remove dirt.
2. Re-Insert or Store Teeth
- Rinse mouth with warm water.
- If possible, reinsert permanent teeth into the correct sockets and have the person bite on a gauze pad to hold teeth in place.
- If you can't reinsert permanent teeth, or for baby teeth or teeth fragments, store them in whole milk or between your cheek and gum to prevent drying.
3. Treat Symptoms
- Control bleeding with sterile gauze or cloth.
- For pain and swelling, apply a cool compress. Encourage a child to suck on an ice pop.
- For pain, take acetaminophen or ibuprofen.
4. Get Help
- For teeth that have been knocked out, see a dentist or go to an emergency room right away. Take the teeth or teeth fragments with you. Even if the teeth have been reinserted, you should see a dentist.
- For chipped or broken teeth, call a dentist.