A broken tooth, which can range from a minor chip in the enamel to a severe fracture exposing the inner nerve, constitutes a dental emergency. The protective layer of the tooth is compromised, leaving the underlying, sensitive structures vulnerable to bacteria and further damage. Seeking professional care immediately is paramount, as the timeliness of your response can significantly influence the potential for successful treatment and tooth preservation.
Immediate First Aid and the Brushing Question
You should not brush a broken tooth with a toothbrush, as this risks worsening the injury. Brushing can force bacteria and debris deeper into the fracture line, potentially contaminating the dental pulp where the nerves and blood vessels reside. The physical pressure of the bristles could also cause the remaining structure to splinter further or irritate an exposed nerve, leading to intense pain.
Instead of brushing, gently rinse the mouth with warm water or a mild saline solution to clear the area of blood and loose fragments. If minor bleeding is present, apply gentle pressure with a clean piece of gauze or a soft cloth until the bleeding slows or stops. Over-the-counter pain medication, such as acetaminophen or ibuprofen, can be taken to manage discomfort and reduce swelling before you reach the dentist.
Protecting the Tooth and Managing the Injury
After initial cleaning, the priority shifts to preserving the tooth structure and protecting the soft tissues inside your mouth. If a fragment has broken off, retrieve it carefully, handling it only by the crown. Store the fragment in a moist environment, ideally a small container of milk or the patient’s own saliva. These mediums help preserve the viability of the cells, increasing the chance the dentist can reattach it.
A broken tooth often leaves a sharp edge that can easily cut the tongue, cheek, or lip. To protect these soft tissues, cover the sharp edge with dental wax, a temporary dental filling material, or a piece of sugar-free chewing gum. For pain and to reduce swelling, apply a cold compress or an ice pack wrapped in a cloth to the outside of the cheek closest to the injury for 15-minute intervals. Do not apply cold directly to the tooth, as this may increase sensitivity if the inner layers are exposed.
What to Expect at the Dentist
Contacting a dental professional immediately is necessary for any broken tooth, regardless of how minor the damage may seem. The dentist will perform a thorough examination, typically including X-rays to assess the extent of the damage to the tooth root and surrounding bone. They will also check for signs of nerve involvement or pulp exposure, as this dictates the urgency and type of treatment.
Treatment options are determined by the severity and location of the fracture. For minor chips affecting only the enamel, the dentist may smooth the rough edge or use dental bonding, which involves applying a tooth-colored composite resin to repair the appearance. A more moderate break that does not affect the nerve may be repaired with a filling, a porcelain veneer, or a full crown to restore the tooth’s shape and function. If the fracture extends deep enough to expose or damage the pulp, a root canal procedure will likely be required to remove the infected tissue and save the tooth before a crown is placed.