When a piece of tooth cracks and starts flexing upon biting, it could result in pain. Sometimes, you may experience sharp pain when sweets, heat, or cold seep into the crack. A fractured or broken tooth does not heal. Initially, the crack will seem unobtrusive and small, but if left untreated, it may progress deeper into or across your tooth. Therefore, the earlier the crack is treated, the higher the chances of saving your tooth. At Northridge Emergency Dentist, we can correct the condition using different options such as root canal therapy, extraction, or putting a crown around and over the tooth.
What is a Fractured and Broken Tooth?
A broken or fractured tooth is a crack or break in the enamel. Enamel is the part of your tooth that protects the soft inner tooth pulp that contains blood vessels and nerves. Although your enamel is the most mineralized and hardest tissue in your body, it has limits. Depending on the category of the fracture, you may or may not experience any pain or problem.
Common causes of fractured teeth include:
- Cavities that weaken teeth
- Biting down hard substances like candy, nuts, bone, or ice cube
- Hard hit or trauma to your mouth or face (It could happen after an auto accident, fall, a fistfight, or sporting injury)
- Bruxism (extreme teeth grinding)
- Age (teeth cracks are more prevalent among persons above fifty years of age)
- Abrupt temperature changes in your mouth (For instance, from consuming hot food and then cooling the mouth using ice water)
- Poor oral hygiene puts you at an increased risk of suffering a fractured tooth particularly if your enamel is already thinning or damaged
- Large fillings that weaken your teeth's integrity
5 Main Types of Tooth Fractures
Any person can have fractured teeth, but they are more prevalent among patients above twenty-five years of age. According to the American Association of Endodontists, there are five (5) categories of tooth crack. Identifying and understanding the categories below can offer direction for treating your cracked tooth.
Sometimes called enamel infractions, craze lines fractures are small fractures of your enamel. The fractures are only contained in the enamel and don't penetrate your dentin layer.
It is worth noting that all your teeth have these fractures. The craze line fractures are mostly seen in the front teeth as vertical striation in the enamel. You can see them on a trans-illumination or marginal ridges.
These micro-fractures are caused by tooth trauma. The trauma could be due to recurrent functional force like parafunction or bruxism or blunt force.
Typically, craze lines have no symptoms. Treatment could be for cosmetic purposes, and prognosis is recommended. You should also avoid parafunction, excessive trauma caused by occlusal forces, and bruxism.
A fractured cusp is an incomplete or complete tooth crown's fracture that extends beyond the subgingival. The level of this type of fracture varies. The most prone areas are the buccal cups of the upper molar and lingual cusps of the lower molars.
Typically, the crack starts on the occlusal surface and later extends along the lingual or buccal groove and the distal marginal ridge or mesial. Occlusal force or trauma is the main contributor to this type of fracture. It could also be as a result of overlooked cusp from previous restorations.
The fractured cusp could break and then separate during a traumatic occurrence. The remaining tooth segment attached to your gingival tissues should be removed. You may experience pain during compression or release when biting. Also, the exposed tooth is sensitive to temperature.
Transillumination is helpful as far as broken cusp identification is concerned. The trans-illuminated light doesn't enter beyond the fractured part into your tooth. A prognosis can help retain the tooth. However, this is dependent on the fracture's degree. Crown lengthening procedure can be used if the level of the broken cusp is substantial. It is recommended to undergo a cusp coverage if your teeth show early symptoms.
This type of fracture is an incomplete crack starting from your crown and extends beyond the subgingival. Usually, the break is in the mesial-distal direction and could spread through both proximal surfaces or a marginal ridge.
The crack can be found entirely within your tooth's crown or could spread vertically into your tooth root. Unlike the fractured cusp, this fracture is centered. Since the cracked tooth could also progress apically, you can experience pulpal and periapical pathosis.
It is hard to determine the extent and location of the tooth crack. Some cracks can be seen easily because bacteria migration has stained them or through magnification. You can also identify the cracks using a dental explorer since they cause an enamel separation.
Common causes of tooth cracks include:
- Extreme occlusal forces
- Weaken tooth structure
- Overlooked marginal ridges and cusps
Treatment options for a cracked tooth fracture depend on your symptoms, crack extent, and operator experience and judgment.
This is a complete fracture that starts from your crown extending beyond the subgingival. Typically, it spreads through proximal surfaces and marginal ridges to the proximal root.
It's the outcome of the cracked tooth, and tooth pieces are completely detached. The split could happen suddenly due to long-term evolution from the incomplete crack. Moreover, habits like ice chewing, bruxism, or parafunction cause crack spread and, eventually, a split tooth.
Sometimes this fracture could happen when only one root is affected. In this case, you can remove the root and then save the remaining teeth. One of the most effective options after your tooth is removed, is tooth root replacement.
Vertical Root Fracture
This fracture is an incomplete or complete root fracture in a buccal lingual direction. It can extend to the root. Not all patients experience symptoms. In most cases, patients learn about the fracture through periapical x-rays.
These fractures are related to the root canal therapy history. The presence of a vertical periodontal pocket or sinus tract on the root surface could be the main contributor.
The prevention of this type of fracture is critical. Reducing dentin removal at the time of root canal treatment will offer improved structural integrity for your tooth longevity.
Common Symptoms of a Fractured Tooth
A fractured tooth won't necessarily have symptoms, and often people have fractured teeth without realizing it. These cracks are harmless and don't require medical attention.
However, if you notice the symptoms below, you may have an extensive kind of crack that needs immediate treatment:
- Swollen gums around the broken tooth
- Experience pain when biting or chewing
- Teeth which have become suddenly sensitive to cold or hot foods, or sweetness
- Pain which comes and goes
- Discomfort which is challenging to pinpoint around your gums and teeth
- Slights cracks on your teeth
The longer the break remains untreated, the harder it could be for your dentist to save your tooth. It could also result in complications like infections.
Managing Fractured or Broken Tooth Symptoms
A chipped tooth is not always painful, or the pain could persist. And if you've exposed dentin or nerves, your tooth could be sensitive, particularly to cold beverages. A chipped tooth with sharp edges, on the other hand, could cut your cheek and tongue.
Until you visit your doctor, there are methods to manage pain from the tooth at your home. Although these methods will make you feel more comfortable for some time, they should not replace visiting your doctor.
Rinse to Clean the Mouth
Make sure you rinse the mouth gently every time you consume food to remove debris from the fractured tooth. You can choose to use a rinse that is consists of an equal ratio of hydrogen peroxide and water or saline water or warm water.
Do not swish too hard; it will assist prevent more pain and infection.
Use Ice to Lessen Swelling
In case your face is swollen, apply ice in fifteen-minute intervals as many times as you want. Cover a cold pack or ice cubes using a towel and hold it to the swollen part. If the broken tooth is due to a sports injury or impact, it might take a couple of days before the bruising and swelling improve.
Be Cautious with the Foods You Consume
Your chipped tooth might expose nerve hence making you sensitive to temperatures and certain foods. You should avoid:
- Alcohol, coffee, and acidic soda
- Cold beverages that can result in sore zinging in the exposed nerve
- Celery and nuts because they may stick in the small cracks in your tooth
- Chewy substances like candy, jerky, steak, and gum because they put pressure on your tooth
- Fruits that contain seeds in them such as raspberries and strawberries
- Sugary foods since sugar allow organisms in the mouth to grow and can cause tooth decay
It is wise to consume soft and nutritious foods like roasted vegetables, soup, and smoothies.
Placing a clean gauze in the mouth near the affected part reduces bleeding. Replace your gauze once it is filled with blood.
Chew using the Other Side of the Mouth
Avoid putting a little pressure onto the fractured tooth by chewing food using the other parts of the mouth.
Use Over-the-counter Teeth Repair
In case the tooth is chipped and has a sharp edge, you can use a temporary tooth filling to soften the edge. You can purchase the tooth filling at your local pharmacy.
It is a temporary solution. However, you should seek immediate medical care if the tooth has been chipped as a result of an injury or extreme trauma.
Anti-inflammatories like naproxen or ibuprofen can help ease swelling and pain. Make sure you follow the label or your dentist's instructions.
Do not apply the medication directly to the gum. It might burn your tissue. Also, do not give medicines with benzocaine to a minor below two years of age.
How to Tell You Have a Fractured Tooth: Diagnosis
It is not easy to diagnose a fractured tooth. X-rays do not always reveal fractured teeth, not forgetting that not all patients experience typical symptoms. If the crack isn't visible, your dentist will first try to make a diagnosis by inquiring about your dental health history as well as the symptoms you are experiencing.
The dentist will then examine your tooth using either of the following methods:
- Making visual examinations using a magnifying glass
- Feel the crack by running a dental explorer around and over your tooth
- Using a dental dye to make the crack more visible
- Check your gums for inflammation signs; cracks tend to irritate gums. This method is essential in detecting vertical cracks
- Ask you to bite down on something. It will help the dentist in identifying the source and location of the pain
- Take an x-ray of the tooth. The x-ray will not reveal the location of the crack but can disclose issues in the tooth pulp. If your tooth pulp looks unhealthy, it could suggest the presence of the crack.
Broken or Fractured Tooth Treatment
If a tooth is chipped, fractured, or broken, you need to visit a dental expert immediately. Otherwise, the tooth will be damaged more or infected, resulting in losing the tooth.
Treatment options for chipped or broken teeth depend on the location and how severely the tooth is damaged. In case only a tiny piece of the enamel breaks off, the condition can be corrected in a single visit to the dentist. A severely broken or damaged tooth could need a more costly and lengthy procedure. Discussed below are different ways used to repair broken teeth:
Bonding or Dental Fillings
If only a tiny piece of your tooth enamel has chipped off, the dentist could repair the tooth using a filling. If the affected tooth is seen whenever you smile or is a front tooth, most likely, the dentist will use bonding. Bonding is a procedure that uses a tooth-colored composite resin. It doesn't require tooth numbing.
First, your dentist will etch the tooth's surface using a gel or liquid. This not only makes the surface rough but also the bonding material stick to the tooth.
Then the doctor will apply the adhesive material to your tooth and later the tooth-colored composite resin.
The next step involves shaping the resin to resemble your natural tooth. Finally, the dentist will harden your bonding material using an ultraviolet light.
Dental Crown or Cap
If your tooth has a cavity or a huge piece of the tooth chips off, your dentist could file or grind away a section of the remaining part and then cover it using a cap or crown designed to protect and boost the appearance of the tooth.
Permanent crowns come in different materials like all-resin, metal, all-ceramic, and porcelain merged with metal. An all-metal dental crown is the strongest, while resin and porcelain can be customized to look like your original tooth.
In case the whole tooth's top has broken, but its root is intact, your endodontist could perform a root canal procedure, place a post or pin in your canal and build up an adequate structure where the crown will be made. Finally, the endodontist may cement the dental crown over your post or pin-retained restoration.
Usually, getting the crown requires two (2) visits to your endodontist's office.
- Initial Visit
During the initial visit, the root canal expert will take an x-ray to check your tooth's root and the neighboring bone. In case no further issues are identified, the doctor will numb your tooth and the neighboring bone before removing a part of your remaining tooth. Hence creating room for the crown.
If the chip or break has left a huge piece of your tooth missing, the dentist will use a filling material to build up your tooth to hold the dental crown.
Next, the dentist will make impressions of both the tooth getting the crown and the opposing tooth. Impressions will be made using a putty-like material. Then the impressions will be taken to a laboratory where the dental crown is made. For the time being, the dentist will place the temporary crown that is made of thin metal or acrylic.
- Second Visit
After two (2) or three (3) weeks, the doctor expert will remove your temporary crown, check how the permanent crown fits before cementing it permanently in place.
You could have your crown made the same day without taking the putty impression. Thanks to digital milling technology.
In case your front tooth has chipped off, a veneer could help make the tooth look healthy and whole again. The veneer is a shell of a tooth-colored resin or porcelain material. It covers the entire tooth front (the same way false nails cover fingernails) with a segment to replace the chipped tooth's section.
To repair the tooth, the doctor will remove approximately 0.3 millimeters of enamel from the tooth's surface. Then the doctor will have the tooth's impression taken to a lab that will make your veneer.
After one week or two, the veneer will be ready, and you'll be required to visit the dentist's office to have the veneer positioned. When placing it, the doctor will make the tooth's surface rough. It is achieved by etching the surface with a liquid. Then your dentist will apply cement to your veneer and place the dental veneer onto the tooth. After your veneer is placed, the doctor will harden the chemicals found in the cement using light.
Root Canal Treatment
If the broken tooth exposes your pulp, bacteria in your mouth could enter and infect the pulp. The pulp is the center of your tooth that contains blood vessels and nerves. If the tooth hurts, is sensitive to temperature, or changes color, probably your pulp is diseased or damaged. As a result, the pulp tissue dies, and if it isn't removed, your tooth will be infected and should be extracted. This treatment involves taking away your dead pulp, cleaning the root, and finally sealing it.
The therapy is not painful. Often, the remaining tooth should be covered using a crown. The crown protects the healthy tooth.
If the crack spreads below your gum line, the tooth is not treatable and cannot be saved. As a result, you will require a tooth extraction where your tooth will be pulled. Then you will undergo a dental implant procedure to replace the natural tooth.
A dental implant functions the same way as your natural tooth's root. It is placed into your jawbone and can last for more than fifteen years.
How a Dental Implant is Placed
- Titanium screws are placed into the bone in your jaw and serve as your tooth's root. The bone requires enough time to fuse with the screws. This creates a strong and lasting foundation.
- After twelve to sixteen weeks, your dentist will take an impression of the teeth. The dentist will customize the abutment and make a dental crown that will be placed on top of your implant.
- During your last appointment, your dentist will place a permanent crown as well as make sure you have a secure and comfortable fit.
If you do not have adequate bone to place the implant, you will be required to undergo bone graft surgery first.
What to Do if Your Baby Breaks or Chips a Tooth
The steps involved in handling a child with a broken tooth is the same as it is for an adult. Although the situation in most cases is not an emergency, your child must be checked out. The dentist checks will be made based on the level of the damage and consideration for treatment.
Tiny chips could be filed to soften the edges, whereas a break could be filled or shaped. The tooth could also be extracted if it is a baby tooth.
Contact A Northridge Emergency Dentist Near Me
Even though a tiny chip may not look like an emergency, a broken tooth should not be ignored. It not only changes your smile but also puts your tooth at risk of tooth loss or infections. Fortunately, at Northridge Emergency Dentist, we offer a thorough examination of the tooth as well as provide various repair options to assist you in repairing your smile and teeth. Call us today at 818-928-5854 for an appointment. Our skilled dentists can see you the same day for an emergency dental condition.