A dental crown is a tooth-shaped cap placed over a damaged tooth to restore its shape, size, strength, and appearance. Crowns cover the entire visible portion of a tooth, starting from the gum line. While crowns provide significant protection, the natural tooth structure underneath can still fracture or break. A broken tooth under a crown requires professional attention.
Recognizing a Broken Tooth Under a Crown
Identifying a broken tooth beneath a crown can be challenging as damage is not always visible. Signs include sharp, sudden pain when chewing or biting, or sensitivity to hot, cold, or sugary foods, indicating pulp exposure. Discomfort when biting, a shifting or loose sensation, or swelling, tenderness, or throbbing pain around the gum line may also suggest a crack. Visible changes to the crown, such as discoloration, chips, a noticeable gap, or the crown feeling loose, can also occur.
Common Reasons for a Tooth to Break Under a Crown
Several factors can contribute to a tooth breaking beneath a dental crown. Untreated tooth decay, present before or progressing after crown placement, can weaken the tooth and increase fracture risk. Trauma or injury to the mouth, such as from an accident or fall, can also crack the underlying tooth, even with a protective crown in place. Habits like teeth grinding or clenching (bruxism) exert significant forces, stressing the tooth structure over time. Biting into excessively hard foods like ice or popcorn kernels can also put too much pressure on the crowned tooth, leading to cracks.
Immediate Steps and Seeking Professional Care
If you suspect a broken tooth under a crown, contact a dentist promptly. Delaying professional assessment can lead to further damage and complications. While waiting for your appointment, manage discomfort by applying an ice pack to the outside of your mouth to reduce swelling. Rinsing with salt water can help clean the area. Over-the-counter pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs), can alleviate pain and swelling. Avoid self-treatment and always seek professional dental care for an accurate diagnosis and treatment plan.
Dental Assessment and Repair Options
A dentist will conduct a thorough examination to diagnose a broken tooth under a crown, asking about symptoms and potential causes. They may ask you to bite down on a stick to pinpoint pain or visually inspect the tooth and gums for cracks, inflammation, or damage. Digital X-rays are often taken to evaluate the tooth structure and detect cracks, bone loss, or decay underneath. Sometimes, a staining dye or transillumination may be used to make fine cracks more visible.
Treatment options depend on the crack’s severity and location. For small, superficial cracks, dental bonding with a tooth-colored resin or crown replacement might suffice. If the crack extends into the tooth’s pulp, a root canal procedure is necessary to remove infected tissue and save the tooth, followed by a new crown. For severe cracks extending below the gum line or extensively damaging the tooth, extraction may be the only option. In these cases, tooth replacement options like a dental implant or bridge would be discussed.
Consequences of Untreated Broken Tooth
Leaving a broken tooth under a crown untreated can lead to negative outcomes. The crack allows bacteria to enter inner tooth structures, causing decay and infection. This can progress to a painful dental abscess.
Untreated infections cause increased tooth sensitivity and pain, making eating and drinking uncomfortable. The tooth becomes more vulnerable to further damage, potentially leading to its complete loss. In rare cases, bacteria from an infected tooth can enter the bloodstream, potentially leading to systemic health issues.