The direct answer is that while an orthodontist is a dental specialist, the physical repair of a chipped tooth is not within their primary scope of practice. Their expertise focuses on correcting the alignment of teeth and jaws, not the structural restoration of an individual tooth surface. This type of restorative work falls under the umbrella of a general or cosmetic dentist.
Defining Dental Specialties
Orthodontists specialize in the diagnosis, prevention, and treatment of dental and facial irregularities, often referred to as malocclusions. They undergo extensive post-dental school training, typically two to three years, to become experts in the mechanics of tooth movement and jaw alignment. The tools of their trade include appliances like braces, clear aligners, and retainers, all designed to move teeth into their proper positions.
The general dentist, or restorative dentist, is the first line of defense for overall oral health, prevention, and the physical repair of dental structures. This includes treating decay, performing root canals, and restoring teeth damaged by trauma, such as chips or fractures. They are the professionals who possess the training and materials to physically rebuild or cover missing tooth structure.
A cosmetic dentist is a general dentist who has taken additional training to focus specifically on the aesthetic aspect of restorative procedures. They frequently handle complex cases that involve veneers or highly visible bonding to achieve an optimal appearance.
Common Methods for Repairing Chipped Teeth
The method a restorative dentist chooses to repair a chip depends on the size and location of the damage. For minor chips, dental bonding is typically the procedure of choice. This involves applying a tooth-colored composite resin material directly to the tooth, where it is sculpted to match the tooth’s natural shape and hardened with a specialized light. Bonding is the most conservative option, requiring little to no removal of the existing tooth structure.
When the chip is moderate or if the patient desires a highly durable aesthetic result, a dental veneer may be recommended. Veneers are thin, custom-made shells, often crafted from porcelain, that are permanently bonded to the front surface of the tooth. This process usually requires the removal of a small amount of enamel, about half a millimeter, to accommodate the veneer’s thickness. Porcelain offers excellent stain resistance and can last ten years or more with proper care.
For severe chips or fractures that compromise the tooth’s structural strength, a dental crown is often necessary. A crown is a cap that covers the entire visible portion of the tooth above the gum line, restoring its full shape, size, and strength. This procedure is the most invasive, requiring the dentist to reduce the tooth on all sides to create a stable base. The crown protects the remaining tooth structure from further damage and can last for many years.
When Orthodontics and Restorative Care Intersect
While an orthodontist does not perform the physical repair, their role is important in coordinating treatment, especially when a bite problem has contributed to the damage. Malocclusion, such as a deep overbite, can cause the lower teeth to repeatedly strike and chip the lingual (tongue) side of the upper teeth. In these instances, the orthodontist corrects the underlying alignment to prevent future damage after the tooth has been restored.
If a chip is small and purely cosmetic, the repair may be deferred until after the orthodontic appliances are removed. This allows the restorative dentist to ensure the final bonding or veneer fits the tooth’s ultimate, aligned position, guaranteeing a perfect aesthetic outcome.
If a tooth is severely chipped or fractured, exposing the underlying dentin or pulp, immediate attention is required to prevent infection or sensitivity. The general dentist will perform a temporary or permanent restoration, sometimes requiring the orthodontist to temporarily remove an archwire or bracket to facilitate access. The two professionals must communicate closely to ensure the restoration does not interfere with the movement plan or the fit of retainers once treatment is complete.