As strong as teeth are, it is by no means indestructible. A cracked, chipped or even broken tooth are common dental injuries. These type of injuries are not always considered to be a dental emergency and it may not be necessary to have the tooth extracted. It depends on the severity of the injury and the promptness of treatment. Even without the attention of a dental professional, you can temporarily manage a chipped, cracked or broken tooth until you can seek dental treatment.
Causes of Chipped Teeth
The outer surface of the tooth is known as the enamel. It is a very hard substance, even harder than bones. Beneath it lies the softer dentin portion. In the middle is the area known as the pulp. It contains the nerve endings and blood vessels that provide sensation and nutrition to the tooth. Often injuries and diseases of the tooth are ignored until it reaches the deeper tissue like the pulp where it elicits pain.
Although the enamel can withstand wear and tear for long periods of time, eventually it can weaken and the teeth may be prone to cracking, chipping or breaking. This may happen by:
- Biting a hard object/food
- Falling and hitting the face
- Blow to the mouth
Some type of force is necessary to chip or crack the tooth. Weakening may also occur with tooth decay (cavities) and old amalgam fillings that no longer fill the entire cavity.
Types of Injuries
There are a number of different types of dental injuries. When it comes to cracks, chips or broken teeth, it may be one of the following:
- Cracks: Minor cracks, also known as craze lines, where the crack is only on the surface (enamel). Major cracks where the crack extends from the outermost surface all the way down to the nerve.
- Chips: Minor chips where only a small portion of the enamel breaks off. Broken cusp where one of the pointed surfaces of the tooth breaks off.
- Breaks: Deep breaks that extend all the way to the root but the tooth is not separate. Split tooth where the break runs all the way down the tooth vertically, separating it in two parts. Split root where the break starts from the lower part of the tooth (root) all the way up towards the chewing surface.
Signs and Symptoms
A chipped, broken or cracked tooth may not always be painful. The sharp edge or crack may be felt by the tongue despite there being no pain. However, the lack of pain does not mean that the injured tooth should be ignored. Even a small crack can lead to complications over time. Sometimes the pain is not constant but only felt when biting down or while releasing a bite. Extremes of temperature such as cold or heat (foods or drinks) may also elicit pain.
Over time food and bacteria will collect in the injured area and this can lead to tooth decay. The formation of a tooth cavity will allow the food and bacteria to hide away out of reach of a toothbrush and further worsen the decay. It may be seen as a dark brown to black spot which will expand over time and become extremely painful in due course. Tooth decay can also contribute to bad breath. The remaining part of the broken or chipped tooth can also break away over time making the initial injury worse.
It may not always be possible to see a dentist immediately. A few simple measures can be helpful in minimizing the symptoms and complications until professional dental treatment can be sought.
- Rinse your mouth with salt water or an antibacterial mouth wash to prevent an infection from arising.
- Wax paraffin or sugarless chewing gum can be used to temporarily cover jagged edges and prevent it from cutting the cheek or tongue.
- Soft foods should be eaten without biting down on the injured tooth.
- Do not brush the damaged tooth vigorously until it has been repaired.
- Use over-the-counter medication like acetaminophen for pain relief.
- Do not try to insert a toothpick, matchstick or any other small object to clean the area.
The measures above are only useful for a short period of time. Professional dental treatment is necessary and should not be delayed.
The treatment for a cracked, chipped or broken tooth depends on the severity of the injury. The presence or absence of pain is not always a reliable indicator of the severity and it is advisable to seek the advice of a dental professional.
Minor cracks may not need treatment although the rough areas may be lightly polished. A major crack may be repaired with filling material and a crown. If the crack is deep where it reaches the nerve tissue then a root canal may be necessary. Small chips may be polished down or repaired with filling material while a broken cusp may need a crown.
Broken teeth are usually more serious. It requires more extensive treatment that chips or cracks. A root canal treatment followed by a crown may be done for a deep break and a split tooth. With a split root the tooth is usually removed (extracted). An implant may then be considered in the near future.
Dental injuries are not always preventable like when it occurs with a fall or blow to the face during an assault or car accident. However, many injuries can be prevented with simple precautions.
- Always use a mouth guard or other protective head gear when playing contact sports.
- Do not bite down on hard foods or use your teeth for activities like removing a bottle cap.
- Practice good dental hygiene to prevent tooth decay which can weaken teeth.
- Do not clench or grind your teeth. If you do it while sleeping then it is best to ask a dentist for a retainer or mouth guard.
- Visit a dentist regularly to isolate any tooth problems and replace old fillings that may be worn out as this can weaken teeth.