How a Tooth Fracture Is Treated - A Dentist Explains

When you get a tooth fracture, it comes as a bit of a shock, even if it's painless. I can remember very well when I first noticed that I had a broken tooth; a piece of tooth enamel came off one of my bottom front teeth.

To my tongue, it felt like half the tooth had gone! I rushed to the bathroom to check in the mirror, and thankfully it was just a small chip. But I have always remembered that initial sense of shock when I first felt the tooth fracture.



It's not unusual for a broken tooth to be painless. It depends on how big the broken bit of the tooth is, and where the fracture line runs. At one extreme, it could be as simple as a small chip of enamel off a corner of a big molar. At the other extreme it could be a front tooth broken off at gum level, say from diving into a swimming pool and hitting the bottom. Ouch! A fracture like this can let bacteria into the tooth nerve, resulting a painful pulpitis.

You can read more about this painful condition at pulpitis.

Tooth Fracture - What are the most common types?

The most common type of broken tooth that I see is where the side of a tooth has broken away from a big filling. Usually, the tooth has had a large filling in it for many years, without any problems. Then, all of a sudden, a lump of tooth breaks off while you are eating.

Either you accidentally bit on something hard, like a cherry stone, or else the tooth had a crack in it already, and it only took something relatively soft to complete the fracture. Usually, the big filling is still in place, and there is no pain except maybe a sharp corner on the tooth that rubs on the tongue.

The other type of broken tooth that I see is where there has been an accident of some sort, and a front tooth has been knocked in some way. For example, I saw a gentleman the other day who had tripped going down some stairs outside his house. As he fell down, he knocked his front teeth on one of the steps, breaking the tip off an incisor.                Tooth Fracture

Kids also frequently get their front teeth knocked, by falling off a bike or skateboard, or getting accidentally hit with a baseball bat or something like that.

What should you do?

I hope you won't be surprised when I tell you that the first thing you should do is to try to get an appointment with your dentist as soon as possible!

In the meantime, there are a few tricks that might help you. You can read more about this at toothache home remedies.

What treatment options might there be?

It depends on a couple of things. How big is the tooth fracture? Is there any decay or is it a clean break? Is there a crack or a fracture in the root? Is there pulpitis?

Here is a list of the most common treatments, starting with the simplest;

  • Smooth off any rough edges, and polish the tooth. This can be an option if the chip is very small, there is no decay and no sensitivity.

  • Add a small amount of filling material to the chipped area, to build up the tooth to it's original shape and to protect the exposed dentine underneath. This is suitable where the broken bit is too big to be simply polished off, and there is some sensitivity to cold air, but NO sign of any decay.

  • If there is any sign of decay at all, the only choice is to remove all old filling material and any decay, and build up a new filling to restore the tooth to it's original shape and appearance. Sometimes this does not give the best cosmetic appearance.

  • Put a cap (or a "crown" - they are the same thing) over the tooth. This is stronger than a big filling, and can give the tooth it's original appearance back. This is frequently the next step after the treatment in the line above.

  • Root canal treatment - if the tooth nerve inside the tooth has been affected by the tooth fracture, or there is pulpitis, it will need root canal treatment. Read more about this HERE. Then the tooth can be re-built with a cap or crown.

  • If the root is cracked or broken, then the only treatment is to remove the tooth, and replace it with a denture, a bridge or an implant. Obviously, removing the tooth is the last resort. Read more about this at getting a tooth pulled.

What if you leave it? Will it be OK?

Unless the tooth fracture is very small, only a tiny chip, it will probably NOT be OK to just leave it. There is a good chance that more will break off, or decay will get into the tooth. Both these things could lead to having to get the tooth removed later.

So get that broken tooth checked and fixed as soon as possible!