A broken tooth, ranging from a tiny chip to a complete fracture, is a common and often alarming dental injury. Modern restorative dentistry offers a high success rate for repairing broken teeth, provided the damage is assessed and treated quickly. Ignoring a broken tooth, even a minor one, can lead to increased sensitivity, infection, and significantly more complex treatment later on. Seeking prompt professional attention is the best first step to determine the specific damage and the most effective path toward repair.
Classifying the Severity of Damage
Dentists classify the type and extent of the damage, as this diagnosis dictates the appropriate repair technique. The least severe injury is the presence of craze lines, which are superficial cracks limited to the outer enamel layer. These fine vertical lines often do not require treatment. More significant damage involves a fractured cusp or chipped enamel, where a piece of the biting surface breaks off without exposing the inner pulp tissue. These breaks affect the dentin layer, often causing sensitivity to temperature changes or pressure. The most severe forms are complicated crown fractures or vertical root fractures that extend deep into the tooth structure. These breaks often involve the pulp (the soft tissue containing nerves and blood vessels) and carry a much higher risk of infection and tooth loss.
Treatments for Chips and Minor Breaks
When a break is confined to the outer layers of the tooth, repairs focus on aesthetic restoration and protecting the underlying dentin. For a minor chip, a dentist may perform enamel shaping, also known as contouring or polishing. This procedure involves gently smoothing and reshaping the remaining enamel to eliminate sharp edges and blend the damaged area into the tooth’s natural contour. Dental bonding is a common method for repairing small-to-moderate chips, which uses a tooth-colored composite resin. The dentist applies this resin directly, molds it to match the tooth’s shape, and then hardens it with a curing light. This procedure is minimally invasive, typically completed in a single visit, and provides a seamless, natural-looking restoration. For front teeth with more noticeable chips, custom-made porcelain or composite veneers may be recommended. These thin shells are bonded to the entire front surface of the tooth and offer a highly durable and aesthetic fix.
Restoring Structure After Severe Fractures
Severe fractures that compromise the structural integrity of the tooth require extensive restorative procedures. When a fracture extends deeper than the dentin or involves a large portion of the tooth, a dental crown is often the treatment of choice. A crown (or cap) is a custom-made restoration that covers the entire visible portion of the tooth above the gum line, restoring its original shape, size, and strength. The tooth is prepared by removing a small amount of structure so the crown can fit over it, providing full protection against further breakage.
If the fracture has exposed or infected the pulp, a root canal procedure must be performed before the tooth is crowned. This process involves removing the damaged pulp tissue, disinfecting the inner chamber, and filling it with an inert material to save the natural tooth. Because this procedure can make the tooth more brittle, a crown is routinely placed afterward to prevent subsequent fracture. For damage too large for a filling but not requiring a full crown, inlays and onlays are used as intermediate solutions. An inlay fits within the cusps of the chewing surface, while an onlay extends over one or more cusps, preserving more natural tooth structure.
When Extraction Becomes Necessary
There are limits to a tooth’s capacity for repair, especially when the fracture is severe and deep. The primary reason for recommending extraction is a severe vertical root fracture, which is a crack that begins in the root and travels upward. This type of fracture often leads to infection and bone loss, making the tooth non-restorable. Damage that extends far below the gum line, particularly when accompanied by extensive decay, can also make a tooth unsalvageable because it prevents a stable foundation for a crown or other restoration. In these situations, removing the tooth becomes necessary to prevent the spread of infection and preserve the surrounding jawbone. Once an extraction is performed, the space should be addressed with a replacement option, such as a dental implant or a bridge, to maintain bite alignment and facial structure.