Broken Tooth – What now?

A guide to broken teeth

This may seem rather obvious, but a broken tooth or filling isn’t going to miraculously heal itself!

Ignoring it is only going to cause further problems and lead to more expensive and extensive treatments.

It’s quite common for a patient to present, only when the tooth starts hurting, which may be immediately or maybe 4 months down the track.

Pain is not a good symptom and suggests some form of treatment or diagnosis will need to be considered. In many circumstances, if left for too long, a tooth may not be saveable and require an extraction…so, pick up the phone and get it checked as soon as possible. It’s no good thinking, “If only I’d gone to the dentist sooner…” Life has a habit of distracting us with many other things!

Why choose Dr Workman to look after you?

Not only is Dr Workman a very good dentist, he has genuine caring nature and always makes sure you feel truly looked after. This is why he has such a loyal following of, families, young professionals right through to our older generation. With over 12 years experience, he is young, passionate, great at what he does and has an excellent aesthetic eye. If you would like a dental professional you can really trust,  who places your health, happiness and comfort as an absolute priority, then you would be hard pushed to look any further. If you have typed ‘dentist near me’ then our state of the art Maroubra dental practice won’t be far away.

If I have a broken tooth, what should I do?

If coming to see us or another dentist is not possible right away, there are a few things you can do at home to help. These are however temporary fixes and booking a dental appointment is essential. If you are in pain with a tooth, we’ll always squeeze you in: if you aren’t experiencing pain, then it’s OK to wait for a more convenient time, and carry out the following procedures:

• Keep the tooth as clean as possible with brushing and flossing.
• Avoid chewing on the affected area and favour the other side..
• If the tooth is sensitive, get some Colgate pro-relief or Sensodyne and apply this to the area morning and night.
• Take painkillers such as paracetamol of ibuprofen if necessary (assuming it’s safe for you to do so)
• If the tooth or filling is sharp, cover it with a bit of chewing gum, or a little soft wax.
• If it has already caused an ulcer, treat this with bonjela, oro-base or Kenalog.
• Oil of cloves has a small analgesic effect and can sometimes help.

Why do I have a broken tooth?

Despite being the hardest part of your body and designed to withstand a lot of wear and tear, teeth are exposed to considerable attack- day in, day out – with chewing, eating, drinking, clenching, grinding, brushing, extremes of hot and cold and all sorts of other things.

Natural, virgin teeth are less likely to break, but we have seen heavy grinders split teeth clean in half and require an extraction. As a general rule, the more work you have had done on your teeth- fillings, restorations etc. the more likely a chip, fracture or broken tooth is to occur.

Similarly, the more pressure you put on the teeth, the more likely they are to break; this might be grinding at night, clenching or simply because you have had some teeth taken out and the remaining teeth are absorbing more pressure than they would normally expect.

You can also break a front tooth or filling if you get a knock or bash to the face. Whilst this sometimes is unavoidable like a fall or a slip, if you are involved in activities that are high risk, such as contact sports, then getting a properly fitted professional dentist mouthguard is essential.

If you have decay in a tooth, there will come a point at which the hole gets so large that the tooth caves in. Fluoride does a great job of re-surfacing and hardening the enamel, but it also masks the decay that can occur underneath; hence the importance of x-rays to pick this problem up early.

Once a portion of the tooth collapses, the decay will be significant and the very large hole it leaves may require a root canal.

Classic stories regarding tooth breakage include: biting on olive stones, popcorn kernels, nuts, bones in chicken, and seeds in bread. Strangely however, it’s sometimes something quite soft- in which case- it was inevitable that it was going to happen.

A broken tooth can take the form of a cavity, a fractured cusp, a cracked tooth, a split tooth, or a broken filling.

A cracked tooth is often painful to hard foods, because the pressure of biting causes the two sides to skew, setting off the nerve inside. Softer foods tend not to do this.

Whilst sometimes tricky to diagnose, as cracks don’t show on x- rays, it is important to see a dentist if you suffer from these symptoms…eventually a piece of the tooth or filling (or both) will come away and the pain from biting will stop. Unfortunately, if the crack continues to propagate through the tooth it may involve the nerve, or continue under the gum. Treatment will simply get more time-consuming and more expensive…a root canal may be needed where the prognosis is very poor, repairing it effectively may not be possible and the tooth will then need to be removed.

If the tooth has already split fully into two separate pieces down the centre, it is unlikely it can be saved- except in occasional circumstances. This state of affairs is most likely to be accompanied by pain, soreness and often infection.

Sometimes a patient will have observed fine lines or cracks running through their front teeth. These ‘craze lines’ are very superficial lines that look like cracks but are of little significance. They are formed during development and often only visible (unless they have become stained) in a bright light. Most people have them if you look hard enough: they don’t cause any pain, and they don’t generally require any treatment.

On the other hand, a fractured cusp happens when a piece of the tooth’s biting surface breaks off. This usually happens to the tooth around a filling.

When this happens the dentine is exposed and the tooth is often sensitive. Since dentine connects to the pulp- even if it isn’t sensitive- you’ll need to see a dentist as soon as possible to try and protect the nerve inside.

What signs or symptoms will you notice?

When a tooth or filling breaks, you may notice/experience one or more of the following:

Sensitivity– due to exposed dentine; hot, cold and sweet things may trigger this problem.

Food packing– if the front or back of a tooth breaks, this may lead to food getting stuck; this can cause an ache in the gum. It’s really important to keep this area clean and get it fixed as soon as possible, or it may lead to further decay.

Roughness– your tongue is masterful at detecting even the most minimal changes to your teeth and mouth. Think about how different it feels once you have had a clean. Often things feel considerably larger than the reality but you still need to get it checked out.

Sharpness– sometimes the fracture leaves a sharp edge that will cut into your cheek or tongue and rapidly cause ulceration.

Pain– this could come from decay or a crack affecting the nerve and causing pulpitis. The tooth may also be tender to bite on.

How can I prevent getting a broken tooth or filling?

Whilst getting a broken tooth or filling is not completely avoidable or preventable there are certain things you can do to minimise your chances of it happening. Begin by looking after your teeth, as the less filling you have, the less chance of something breaking or chipping.

Have regular dentist visits to identify cavities early and treat them whilst they are small. If you are grinding which you may or may not be aware of, it is vital you wear a protective night splint to ensure minimal pressure is exerted on your teeth during these times and to minimise wear.

If you are involved in contact sports, a properly fitted custom mouthguard is a must.

If you lose a tooth, it is important to fill the space so the extra forces aren’t transmitted to the remaining teeth thus causing further problems. Always proceed with caution when eating popcorn and olives and avoid habits like chewing pens, ice and hard candies.

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How do you treat a broken or cracked tooth?

How to best treat a broken tooth or filling depends on a number of factors. The main factors are: how much of the tooth has been lost or damaged and what is the condition of the nerve of the tooth. The main options are:

• A Dental Filling– if just a small part of your tooth has broken or chipped, a filling can often be used to restore the tooth. We use a tooth-coloured composite resin which blends in like a natural tooth. On your front teeth, this may be called a bonding but it’s essentially the same thing.

• Inlays and onlays- if a larger portion of the tooth has been lost, instead of directly filling the tooth, an impression can be taken and a piece of porcelain or gold can be placed to restore the integrity of the tooth. White fillings are good for small to medium fillings, but because they shrink on setting, this can set up unfavourable forces on the remaining tooth: an inlay or onlay solves this problem.

• Crowns – This treatment is carried out when a larger area of tooth needs restoring- be it decay, a large piece of tooth that has broken, or the presence of a large existing filling of poor quality. This is a long-term solution to protect a tooth that has been significantly compromised: it involves filing the tooth down and cementing a tooth coloured cap over the top.

• Veneers – if the chip or fracture is on a front tooth, then a porcelain veneer or composite veneer may be used to restore the tooth. Whether a veneer, or bonding is carried out, will depend on the other teeth and the amount of tooth structure remaining.

• Root canal – If the break or decay has compromised the nerve, a root canal treatment may be needed before restoring the tooth. If a molar tooth needs a root canal, a crown is required to protect the tooth long term as molars become more brittle once the blood supply is removed. If it is a front tooth then sometimes a filling is adequate; it depends on the amount of tooth that is missing.

Summary box:

Treatments Dental filling | Inlays and onlays |Crowns |Porcelain veneers
Cost See treatment page for details

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