Time is NOT the best healer for a broken tooth. In fact, the earlier you act, the easier it might be to treat a broken tooth.
A broken tooth has multiple treatment options depending on how it broke and in which area did it break. Also in some rare conditions the entire tooth might just fall off from its socket. You are in for a surprise for the treatment of that.
Why should I bother if I have a broken tooth?
Right from being not very pleasing visually, to having problems in chewing and being the source of infections in the mouth, broken teeth can be a cause of serious health issues in the mouth and the entire body.
Unaesthetic: This is especially applicable for the front teeth including the premolars. These teeth are the most common to break. Being visible when you speak and smile, if such a tooth is partially or completely broken it makes the smile unpleasant.
Mouth ulcers: A broken tooth generally breaks with a sharp edge. This edge constantly cuts the lips or the cheek (depending on which tooth has broken) causing the lip/cheek area to ulcerate. A long standing ulcer due to continuous wounding of the area can turn into a cancerous ulcer as well.
Difficulty in chewing: Applicable more to the back teeth (these teeth are generally used for chewing food), a broken tooth can cause difficulty in chewing from that side due to multiple reasons.
b) A broken tooth reduces the tooth chewing surface, making the entire chewing process less efficient.
c) The area of the broken tooth is where the food gets stuck while chewing. This causes multiple symptoms ranging from sensitivity, to a sharp shooting pain when the food gets stuck to finally a severe infection in the tooth and the surrounding regions.
Easy mouth infections: The open area of the broken tooth can be a passage from the mouth (which is full of bacteria) to the underlying bone in which the tooth is attached. This can cause easy infection around the tooth which is extremely painful.
Bad Breath: Due to the food and the bacteria lodged in the open space. Broken tooth can be a reason for bad breath too.
Why do teeth break?
1. Falling: A very common reason for the tooth to break. The upper front teeth are most commonly broken due to this reason. In some cases of fall the tooth can also dislodge completely from the socket as well.
2. Intentional violence: Any hit on the lower face can result in the teeth breaking. Also more common with the front teeth as these teeth are thin and have only one root.
3. Cavities: A large tooth cavity results in the tooth to break. This is more common in the back teeth and when the cavity is between two teeth. Such cavities aren’t identified easily and result in undermining the overlying tooth structure which might suddenly break.
4. Wearing of teeth: A form of wearing off of teeth causes the outermost layer (called the enamel) to chip off. This would initially cause sensitivity and becomes a site which is more susceptible to cavities.
5. Encountering something hard while chewing on soft food: This is when you bite on a piece of remnant bone while eating boneless meat or on as hard stone while eating soft foods. The front teeth would again be more susceptible to fracture in such a case
6. Huge cavities: In this a part of the tooth or the entire crown portion (the area of the tooth seen in the mouth) breaks off.
What is the best treatment for me?
All broken teeth DO NOT require removal. A tooth that has completely come out of its socket can also be placed back.
The treatment of a broken tooth depends on factors like
In which area of the tooth is the fracture line
Is the tooth moving or is it firmly attached to an underlying bone?
What is the condition of the bone?
Is there any associated infection that needs to be cured first?
Treatment based on the area of tooth that is fractured:
Being the most important factor in determining the treatment, you could get an initial hint by checking the bleeding. (this could be tricky as the bleeding could be from soft tissue injury or the tooth and requires a dental evaluation to be determined correctly
If the fracture is in the outer layers of the tooth (the enamel or dentine), the broken tooth can be completely restored using a filling.
If the fracture involves the pulp (in which case, you would observe tooth bleeding) the treatment would involve root canal treatment
If the fracture is in the root of the tooth (the area of the tooth that is attached to the bone) the treatment could involve joining the crown of the broken tooth with the adjacent teeth. This is a treatment that is similar to as done in bone fractures and involves stabilizing the tooth and avoiding movement so that the fracture line heals by itself.
The only difference is that after the fracture is healed, a root canal of the tooth is done, as since the fracture line passes through the pulp (the living tissue inside the tooth) it kills the pulp and not removing it would lead to infection.
Treatment based on the movement of the tooth
The first factor to determine is that is the break in the tooth or in the bone that results in the tooth to move. This can only be evaluated by a dentist.
A fracture in the jaw bone requires a totally different treatment than a fracture of the tooth, and thus if you feel any movement of the teeth after a fall or an injury get it evaluated immediately.
If the movement is due to fracture in the tooth, it is classified into 3 grades. Higher the grade of movement, lower are the chances that the tooth can be retained in the mouth and would require removal.
Based on the condition of the bone or any persistent infection, the treatment might require to first resolve the issue before treating the broken tooth.
Special situation: If the entire tooth come out of the mouth. This tooth can be REPLANTED in the mouth, provided a protocol is followed.
1. Find the tooth
2. Hold it with the crown (white portion of the tooth)
3. Rinse in cold tap water (do nor rub the tooth)
4. Follow one of the following option
a) Try to place the tooth back in the mouth
b) Place the tooth in a cup of milk
c) Place the tooth in a container with the person’s own saliva