Broken Teeth

Broken Teeth

Is a Broken Tooth a Dental Emergency?


Your tooth can break from anything as simple as biting into an apple to something as traumatic as an accident.  Broken teeth may or may not necessarily cause immediate pain.  If the break has extended into the nerve, you might experience occasional discomfort when chewing, or severe sensitivity to hot and cold.  In most instances, however, fractures or chipping of teeth do not cause much discomfort aside from sharp edges that may be uncomfortable to your cheeks and tongue.  Whether you are in pain or not, all breaks should be evaluated by our office as soon as possible in order to check the health and structural integrity of the tooth, and to provide necessary treatment to prevent further complications from occurring.

If you have chipped or cracked a tooth, it may be a dental emergency, or it may not. Some damage to your tooth needs to be looked at as soon as possible, but other times you can postpone treatment for a chipped tooth until it’s convenient.  But how do you know which is which? Here are some factors and guidelines to consider.


First, How serious is the injury?  


If your broken, fractured, chipped or cracked tooth is the result of trauma to your head or face and it is accompanied by bleeding from the nose or ears, loss of memory or consciousness, dizziness, disorientation, severe head or ear ache or if your teeth do not fit together properly after the trauma, go to a hospital emergency room for evaluation immediately.  It is imperative that you rule out any possible injury to your brain, jawbones or surrounding soft tissue.  If that is noted to be the case, you will require immediate emergency medical care to address your injuries first.  Don’t bother calling our office first, have an emergency physician evaluate you right away.

Fortunately, most injuries are much less severe.  If you’re experiencing any one of the following situations, you can safely wait to call our office during normal business hours and we’ll get you in right away in order to evaluate and treat the situation promptly:

  • Craze lines – If you notice a subtle hairline craze on the surface of your tooth, don’t panic.  This does not mean your tooth is about to break in half.  These minor cracks typically only affect the enamel, or the very outer layer of the tooth.  Often times they are shallow and cause no symptoms whatsoever.  They develop from a number of causes including excessive forces on the tooth (grinding or clenching of teeth, eating hard foods etc.) or from the presence of large old fillings that have weakened the surrounding tooth structure.

Depending on the condition of the rest of the tooth, they may be an early sign that the tooth is weakening and may require dental treatment to prevent a more complex fracture from occurring.  When they occur on anterior teeth, they can be unsightly when smiling and present an aesthetic concern.  For this reason many patients may want to consider treatments such as porcelain crowns or veneers to help strengthen and enhance the esthetic appearance of those teeth.

  • Chips – Minor chipping of teeth is quite common and typically occurs on the edges of front teeth and the pointy chewing surface of molars.  Like craze lines, they typically occur from excessive wear and tear or chewing forces.  Unlike craze lines, an actual small portion of the tooth breaks off.  The portion that breaks off is usually small in size and oftentimes easily repaired with conservative treatment such as a white filling.  They don’t cause any pain, but if they leave behind a sharp edge, it can cause a significant amount of irritation if it rubs against the cheek or tongue and will require prompt treatment in order to avoid developing an ulceration.  When they occur on front teeth, they are more of a cosmetic emergency and will also require prompt treatment in order to correct the appearance of the tooth.  
  • Fractured Tooth – When a substantial portion of the tooth breaks off, we consider the tooth to be fractured.  Fractured teeth can involve one whole side of the tooth breaking off, a severely broken cusp or a large crack running through the entire thickness of the tooth.  What you feel will be depend on the extent and depth of the fracture present as well as any possible nerve involvement.  

It is very common in most cases, despite how large the size of the fracture may be, not to have any discomfort at all.  In some cases, fractured teeth may cause some sensitivity to hot or cold because the enamel that was once there is not present anymore.  This leaves the more sensitive inside layer of your tooth, the dentin, exposed to the outside environment.  Feeling some slight to moderate sensitivity in this case is normal and expected.  In both cases, the tooth can wait to be addressed at a more reasonable time and it is very unlikely that any further damage may occur during this short delay.  These teeth will need crowns for additional support but, depending on other relevant circumstances, may avoid root canal treatment.

If the extent of the fracture is very deep and encroaches upon, or extends into the nerve of the tooth, patients will experience more severe discomfort.  In this case, the fracture not only breaks off a portion of the tooth but is deep enough to expose the nerve and irritate it causing more intense symptoms.  If this is the case, often times the broken part of the tooth may bleed.  This is a more urgent situation and If you notice a large portion of the tooth missing with bleeding present, it is important to contact our office right away in order to help control symptoms.  Even if after hours, we will call in a prescription for antibiotics for you to help stave off any possibility of infection.  Treatment will involve Root Canal therapy in addition to a crown if nerve involvement or infection is indeed confirmed.  


What to do if you break your tooth


Until you can get to our office, there are some things you can do to ease any pain or discomfort that might be associated with the tooth.  

  • For starters, rinse your mouth with warm salt water.  Swishing with warm salt water every couple of hours will help remove any debris present and keep the area clean to prevent any further inflammation from occurring.  More importantly, if any sharp edges are present that may be irritating the cheeks or tongue, the solution will help sooth these sore areas.  To make a saltwater solution, mix about 1/2 teaspoon of salt per 8 ounces of warm water.  Be careful to ensure the solution is warm and not too hot or too cold in which case can cause further inflammation.  Gently swish the solution in your mouth for anywhere between 20-45 seconds before spitting out.
  • Take an over-the-counter pain reliever, like Tylenol or Motrin.  Follow the manufacturer’s instructions on the bottle by taking the medicine every four to six hours as needed for pain, so long as you do not have any pre-existing medical condition that makes taking OTC pain relievers unsafe. Never put the pill directly on the tooth or gums.  This may cause burning or even more damage.
  • Stick to a soft diet.  It’s important to minimize stress and pressure on the tooth as it is now compromised and we don’t want to risk any further breakage.  Habits like chewing ice should be avoided in addition to hard or excessively chewy foods such as hard bread, candies or bagels.  
  • To prevent a sharp or jagged edge from cutting your tongue or cheek, cover the broken tooth with a piece of wax paraffin or sugar-free chewing gum if you’re in a bind.  If you have access to a local drug store or pharmacy, purchasing dental temporary cement to cover the tooth will also work.  

Treatment for fractures and broken teeth: What To Expect Next


Teeth with minor chips on the edges usually don’t cause any pain or problems, but to maintain the integrity of your tooth we may suggest a repair by smoothing the edge or placing a tooth-colored filling. This will prevent the rough edge from cutting your lips or tongue and preserve the aesthetic appearance of the tooth in question.  In addition, if numerous chips and craze lines may be present and compromising the appearance of your front teeth, you may want to consider esthetic treatments such as porcelain veneers to not only help strengthen your teeth but to also enhance their aesthetic appearance.

Heavily fractured and seriously broken teeth may require more complex treatments, as these problems may be due to dental decay or other underlying issues. A large cavity can cause fractures and, if left untreated, can become extremely painful and result in further tooth breakdown.  In cases where the fracture is deep enough to involve the nerve, root canal treatment may be necessary. Cracks and breaks that expose your nerve endings, result in infections or make the teeth extremely sensitive to hot and cold will be indicted for root canal therapy along with a crown.

Root canal treatment isn’t always necessary for cracked and chipped teeth, however. Where there’s no pain, infection, or nerve involvement, fractured and cracked teeth can be treated with a full coverage crown to reinforce and strengthen the tooth. Crowns are also used as an integral strategy against preventing further cracks by restoring and maintaining the structural integrity of the tooth. 


Can A Fractured or Broken Tooth Always Be Saved?


Unfortunately, not every case of a fractured tooth can be saved.  A tooth with a crack that extends well beneath the gum line and into the roots cannot always be saved.  A tooth that has fractured into two separate pieces will also have to be extracted and replaced.  In both these cases, our primary immediate goal is to get you comfortable, out of any pain and stabilize the situation.  We will then formulate a treatment plan, including appropriate replacement options that suits you best, and coordinate a plan of action with our surgical specialists to have the tooth removed and properly replaced.


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