Chipped, cracked or broken?
The words get used as if they mean the same thing, but for the tooth they are different problems:
- A chip is a small piece of enamel gone from an edge or a corner. It may feel sharp to your tongue, but it often does not hurt.
- A crack is a line running into the tooth. The tooth can look whole, yet hurt sharply when you bite down or let go, and sometimes with cold. See the signs of a cracked tooth.
- A break means a bigger piece has come away, sometimes a whole corner, sometimes down to the gum. If you can see pink or red in the middle of the tooth, the nerve is exposed.
What to do if you break a tooth
These steps protect the tooth and keep you comfortable until you are seen:
- Keep any pieces you find and bring them with you.
- Rinse your mouth with warm water.
- Cover a sharp edge with a piece of sugar-free gum or some dental wax from the pharmacy, so it does not cut your tongue or cheek.
- Hold a cold compress against your cheek to keep the swelling down.
- Chew on the other side, and avoid very hot, very cold or hard food until the tooth is repaired.
- If it hurts, take an over-the-counter pain reliever as the label directs.
How is a broken tooth fixed?
The repair depends on how much tooth is gone and whether the nerve is involved. We look at the tooth, take a digital X-ray, and explain the options and what each costs before anything is done. Broadly, it goes like this:
- A small chip can usually be rebuilt with a tooth-colored filling matched to the tooth, and a very small one may only need smoothing.
- A larger break or a crack usually needs a crown, which fits over the whole tooth and holds it together.
- An exposed or infected nerve needs a root canal first, then usually a crown to protect what is left.
- A tooth that has split down below the gum line usually has to come out, because there is nothing sound left to hold a repair. We talk through what goes in its place, such as a dental implant, before it does.
Why a broken tooth should not wait
A chip that does not hurt can seem like something to live with, and sometimes it is. But a broken tooth has lost part of its hard outer layer, and a crack tends to spread as you chew. A crack that reaches the root can cost you the tooth, when the same tooth seen earlier might have been held together with a crown.
Waiting also gives bacteria a way in. Once decay or infection reaches the nerve, a repair that could have been a filling becomes a root canal. And a sharp edge can cut your tongue or cheek in the meantime.
When to go to the emergency room first
If the tooth broke in a fall, a car accident or a blow to the face, check for other injuries before anything else. Go to a hospital emergency room for a head injury, a suspected broken jaw, difficulty breathing or swallowing, swelling that is closing an eye or spreading down the neck, or bleeding that will not stop after firm pressure. Call us afterward and we will take care of the dental side.
If the whole tooth has come out, go straight to what to do for a knocked-out tooth. Time matters far more with that one.
What happens when you call
Call 540-921-3323. Scheduling is available 24/7, so you can call the moment it happens rather than waiting for office hours. Tell whoever answers what has happened and they will get you seen.
When a repair needs numbing, the tooth is numbed properly first. We explain each step before we take it, and nitrous oxide is available if you are nervous. If it has been a while since you last saw a dentist, that is fine. It is a common reason people call, and nobody here will make you feel bad about it.
Questions patients ask
Do I need to be seen for a small chip?
Yes, though a chip that does not hurt is not usually an emergency. A quick look tells us whether it needs smoothing or a filling before it catches or chips further. Pain, a sharp edge or a large missing piece makes it more urgent.
Why does my broken tooth hurt with cold?
A break can expose the dentin, the softer layer under the enamel, which carries sensation toward the nerve. Cold and sweet things then reach it more easily. If the pain lingers after the cold has gone, or the tooth throbs on its own, the nerve itself may be involved, so say so when you call.
Will a broken tooth need a crown?
Not necessarily. A small chip can often be smoothed or repaired with a tooth-colored filling. A crown is for a tooth with too little left to hold a filling, or a crack that needs holding together.
What if my broken tooth does not hurt?
It still needs looking at. A tooth can break without pain, especially one with a large old filling or a root canal, and the break still leaves it weaker and open to decay.