A broken molar, located in the back of the mouth and used for grinding food, can be a startling experience. Although the hard, outer enamel layer is strong, it can fracture due to trauma, biting down on hard objects, or being weakened by decay or large fillings. When a piece breaks off, it exposes the softer, sensitive inner layers. This leaves the remaining structure vulnerable to further damage and potential infection, requiring prompt professional attention to protect the tooth’s health and function.
Immediate First Aid and Pain Management
The first step following a broken molar is to gently rinse the mouth to clear the area of any blood or debris. Rinsing with warm water, or a solution of warm water mixed with a half-teaspoon of salt, helps cleanse the site and soothe irritated gum tissue. Avoid aggressive swishing, which could worsen bleeding or dislodge a clot.
If you locate the broken fragment, retrieve it carefully and keep it moist, as the dentist may be able to reattach it. Store the piece in a small, sealed container completely submerged in milk, or in your own saliva, until you reach the dental office. The pH balance in milk helps preserve the cells on the fragment’s surface, aiding potential reattachment.
A broken tooth often leaves a sharp or jagged edge that can cut the soft tissues of the tongue or cheek. To protect the mouth, temporarily cover the rough edge with a piece of softened dental wax or sugar-free chewing gum. This creates a smooth barrier that prevents irritation until a dentist can smooth the surface or provide definitive repair.
To manage immediate discomfort, take an over-the-counter pain reliever such as ibuprofen or acetaminophen according to package directions. Ibuprofen is often preferred because it also helps reduce inflammation around the injured area. Applying a cold compress or an ice pack wrapped in a cloth to the outside of the cheek near the break can minimize swelling and numb the area temporarily.
When and How to Contact Your Dentist
While every broken tooth should be addressed quickly, the severity of symptoms determines the urgency of the appointment. A minor chip affecting only the enamel and causing no pain or bleeding may be scheduled during regular business hours. Conversely, a severe fracture causing intense, unmanageable pain, continuous bleeding, visible exposure of the tooth’s inner pulp, or a crack extending below the gum line is a true dental emergency requiring immediate after-hours care.
When contacting the dental office, be prepared to provide specific details to help staff assess the need for urgent treatment. Clearly describe the extent of the break, noting if it is a small chip or if a large piece of the tooth is missing. Also, rate the level of pain on a scale of one to ten, and note any factors that worsen the pain, such as temperature sensitivity or biting pressure.
Inform the office if you have located and preserved the broken fragment, as this may influence the treatment plan. Be ready to share any relevant medical history or current medications, especially if you have allergies or conditions that could affect emergency procedures. This information allows the dental team to prepare for appropriate and timely care, whether scheduling a same-day visit or giving instructions for managing the situation overnight.
Common Repair Options for a Broken Molar
The treatment chosen for a broken molar depends on the depth and location of the fracture. For minor chips where only a small amount of enamel is lost, the dentist may recommend dental bonding. This procedure involves applying a tooth-colored composite resin to the damaged area, sculpting it to match the tooth’s natural shape, and hardening it with a specialized light, often completed in a single visit.
If the break extends deeper into the dentin (the layer beneath the enamel) but has not reached the pulp, a standard dental filling may be sufficient. The dentist uses a composite material to restore the tooth’s structure, sealing the exposed dentin to reduce sensitivity and prevent bacterial invasion. For breaks involving a cusp (the chewing surface point of the molar), a more substantial inlay or onlay may be necessary. These are lab-fabricated restorations that fit precisely into the missing tooth structure.
For more significant structural damage where a large portion of the tooth is compromised, a dental crown is the preferred solution. A crown is a tooth-shaped cap that completely covers the remaining natural tooth structure above the gum line, providing strength and protection. The remaining tooth is prepared to allow the crown to fit over it, preventing the weakened molar from fracturing further under chewing pressure.
If the fracture is deep enough to expose the dental pulp (which contains nerves and blood vessels), root canal therapy becomes necessary to save the tooth. The exposed pulp is vulnerable to bacterial contamination, leading to infection and severe pain. During the procedure, the dentist removes the infected pulp tissue, cleans and disinfects the inner chamber, and seals it with gutta-percha. Since a tooth that has undergone root canal therapy loses its internal source of nourishment, it is almost always covered with a dental crown to protect the now-brittle structure from splitting.