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Also known as a tooth fracture, a broken tooth is a break or a crack in the tooth's hard shell (enamel). A dentist or endodontist can diagnose a fractured tooth through a clinical examination and radiography (x-rays).
Tooth fractures are encountered by dentists daily and happen more frequently in mandibular molars (back teeth). They occur more often in patients over 40 years old and affect women more often than men.
A broken tooth is a dental emergency if the patient is also experiencing pain or bleeding, a significant break beyond the tooth enamel, or if the tooth has been completely knocked out. If these symptoms are present, the broken tooth is a dental emergency, and the patient should immediately go to an emergency dentist.
In cases involving dental trauma, a severe impact can break the jaw. If the patient cannot bring their upper and lower teeth together when closing the mouth, they should see a dentist immediately or go to the emergency room.
If there is no pain or bleeding and the tooth has only sustained a small amount of damage to the enamel, the patient may be able to wait for a day or so, as long as they practice proper oral hygiene.
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While a broken tooth may not always require immediate attention, it's best to have it treated as soon as possible. If the damaged tooth is left too long without treatment, the crack can deepen, and the patient could lose the tooth.
If the only damage is on the surface of the tooth, it may not be an emergency. If the root is not exposed, and there is no pain or bleeding, the patient may be able to delay going to a dentist for a day. But a cracked tooth should be examined by a dentist as soon as possible to avoid further damage.
Treatment to fix a broken tooth will depend on the size and location of the crack or break. Here are the six most common dental procedures used to repair a broken tooth:
If the tooth’s crack extends below the gum line, the tooth cannot be saved and will need to be extracted (removed). Extraction is usually the only option when the crack is vertical, below the gum line, involves the roots, and when pieces are mobile.
After the tooth is extracted, a dental implant is surgically inserted into the jawbone. After the site heals, a crown, bridge, or denture is attached.
For situations where only a small piece of enamel has chipped off, a dentist can repair the damage with a dental filling. Dental fillings can be made of a white composite resin or silver amalgam (mercury mixed with silver, tin, zinc, and copper). Fillings close the hole and restore the function of the tooth. If a tooth is missing a large portion, a dental inlay can replace the missing part of the tooth. This restoration is often stronger and more durable than a dental filling.
If the chip is on the front tooth or visible when smiling, the dentist will likely use a bonding technique. When bonding the tooth, the dentist uses ultraviolet light to bond a tooth-colored composite resin to the tooth's surface.
If the tooth's damage is only a small chip, a dentist can correct the issue by reshaping the tooth or smoothing and polishing the affected area.
If the chip is small and only causes cosmetic damage, dental veneers may be recommended. A dental veneer is a layer of porcelain or composite resin that completely covers a natural tooth. If placed over a broken frontal tooth, a dental veneer can make it appear whole and healthy again.
Dental veneers are commonly used in cosmetic dentistry to fix the appearance of teeth. To apply a veneer, the dentist will remove enamel from the tooth's surface. They will make impressions and send them to a dental laboratory, which will make the veneer to be placed over the remaining tooth at a later appointment.
A large fracture that involves multiple cusps of the tooth may require a crown, which is a cover or "cap" that fits over the damaged tooth's remainder.
If the chip exposes the dentin or the pulp, bacteria in the mouth could infect the pulp. If the pulp is irreversibly damaged and dying, a root canal may be necessary. A root canal involves removing the pulp and replacing it with a plastic filling called gutta-percha. After the root canal procedure, a dentist will place a crown to protect the tooth.
While the crown is being prepared, the dentist can patch the chipped tooth or place a temporary crown to protect the tooth until the permanent crown is ready.
A dentist may use a dental onlay on molars that have lost a significant portion of their substance or have a large crack. Dental onlays are made of porcelain or zirconia ceramics like a crown or veneer, created in a lab.
A tooth splint may be a possible solution for a cracked tooth if there is damage to the surrounding bones and gums. A tooth splint can bond a damaged tooth to an adjacent healthy tooth. This procedure allows the bones and gums around the teeth to recover from trauma.
Depending on the break's severity, the cost to fix a broken tooth varies from $300 up to $2,000 without insurance. In some cases, fixing a broken tooth can cost up to $10,000 without insurance, especially when extensive work, including extraction, an implant, and a crown, is needed.
After suffering a broken tooth, here are the steps patients can take to reduce additional damage before going to the dentist:
A cracked or chipped tooth is rarely life-threatening, but it does need to be addressed immediately. An untreated cracked tooth will progressively worsen, eventually resulting in tooth loss.
If you notice any chipping or cracking, call your dentist office right away. Early diagnosis can minimize damage, allow for more treatment options, and prevent further damage and additional dental care costs.
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