There are many reasons why we might have a broken tooth. So many, that they are one of the most frequent problems in the ER and dental clinics. Sometimes a broken tooth generates a lot of pain. It is also a cause for concern, since nobody likes to go through life with a broken tooth and it can have negative consequences on oral health. The good news? Most of the time a broken tooth has a solution.

In this article from Dentaly we will inform you of everything you need to know if you have a broken tooth. We will explain the differences between a mild, moderate and severe dental fissure, as well as the different treatments to repair each injury. In addition, we will answer the most frequent questions in these cases, such as what to do when a tooth is broken, how to fix a broken tooth?

Causes of Dental Injury

Did you know that tooth enamel is the strongest tissue in our body? It is. It’s even harder than our bones. Still, a tooth can break or crack for a variety of reasons. Among them:

  • Chewing on something hard like ice, nuts or candy.
  • Biting into something unexpectedly hard, like an olive pit.
  • Using your teeth for things you shouldn’t use them for. For example, opening a bottle or cutting a string.
  • Getting hit in the face or mouth.
  • Falls and other accidents.
  • Mouth damage that weakens the teeth.
  • Erosion of the enamel caused by eating or drinking certain foods.
  • Old tooth fillings that no longer support the tooth Either because of old age, or because of the extent to which these fillings have reached If there is more proportion of filling than tooth structure, then there is more risk of fracture.

When the tooth enamel is weakened or the tooth is deteriorated below the surface, it will be more susceptible to damage.

Therefore, treatment options for a dental injury will depend on how severe it is. A mildly chipped tooth is easy to treat, usually by polishing or filling it. But a severely damaged tooth with an extensive subgingival fracture, or one that involves the root of the tooth, has to be extracted in most cases.

No matter what type of dental injury we have, the important thing is that we go to our dentist as soon as possible, even if we don’t feel pain. The reason? Without proper treatment the tooth may suffer more or cause more damage to the mouth.

What do we do if we break a tooth?

The first thing to remember before proceeding with any first aid measures is to stay calm. Normally this type of situation is quite upsetting, but as long as we remain calm and follow the recommendations we leave you with, everything will be easier.

Secondly, it is important that we are proactive and once that first moment of urgency has passed in which we must act quickly, go to our dentist as soon as possible. Keep in mind that a broken tooth is not something that will put us at risk (immediately) and can be rebuilt or replaced.

Now you’re talking: what do you do when you break a tooth?

  • Pick up the tooth or tooth fragment and wash it under running water (if we don’t recover the part that broke off, there are solutions to rebuild it). We do not recommend transporting it in water. The reason? Water is the least suitable means of transport, as it is hypotonic and triggers cell lysis. If it is stored in water for more than twenty minutes, it causes large root resorption. Saliva is not very suitable either, both because of its osmolarity and pH, and because it contains a large amount of bacteria. However, if the tooth is placed under the tongue or in the oral vestibule, the fibroblasts can remain vital for about two hours. However, both water and saliva (due to salivary enzymes and germs) alter the structure of the fibroblast, so they are not advisable as a means of transporting the tooth, although they are certainly better than dry.
  • Place it in a glass of milk. Your dentist may be able to put it back in place with a dental adhesive.
  • It can also be placed in saline or Hank’s Solution, although the latter is a less accessible medium.
  • Rinse your mouth with warm salt water to prevent infection
  • If the tooth has come loose completely, cover the cavity where it was with a gauze pad to stop the bleeding.
  • Place a cold cloth on the site of the fracture on the face to reduce swelling
  • Avoid eating, and if we do, choose only soft foods and don’t bite with a broken tooth.
  • If we are worried that the sharp edge will cut our tongue or mouth, cover it with dental wax.
  • Go to the emergency room or to a dentist on duty or make an appointment with our dentist for the solution and treatment to be followed. It will depend on the severity and dental parts that have been compromised
  • In the meantime, it will help us to take a painkiller such as paracetamol, to control the pain threshold.

It is important to go quickly and get to the dentist as soon as possible.

Different types of dental fractures

Just as there are several causes for a broken tooth, there are also many different names for them and we will find several technical names for the same problem.

Even a small crack can be noticed when we smile
Although the World Health Organization proposes its own classification of the different types of dental fractures, medical terminology basically classifies them into: minor, moderate and severe fractures. The difference is that they involve different components of the tooth.

Therefore, the options for repairing a broken tooth as well as the treatment to be followed will be determined by the severity of the impact and the consequences it may generate.

Next we will see each type of fissure, how to fix them and the appropriate treatment for each case.

Chipped tooth

A chipped tooth is probably one of the most common cases for a general dentist. It is usually a slight crack or small fissure in the enamel, which is painless and almost imperceptible. Sometimes there is also loss of some dentine. But if the fissure has exposed the nerve of the tooth, it is probably very painful.

A chipped tooth must be repaired especially when:

  • It causes pain
  • Has left a sharp edge or surface that can cut through the soft tissues of the mouth
  • The softer layer of the inner dentine is exposed and at risk of deterioration
  • It affects our aesthetics and we don’t like the way it looks

How to fix a chipped tooth?

In the case of very small fissures, as they do not generate pain or sensitivity to temperature, most of the time no medical treatment is required and they are the easiest to repair. If a sharp edge is left, it can be polished by smoothing out the rough areas to prevent it from causing injury in the mouth.

In the case of larger fissures, the tooth can be filled or reconstructed with dental resin (also called composite) covered with a dental crown, or with a porcelain veneer. Any of the three solutions can adopt the colour of the rest of the teeth so that it looks natural and the difference is not noticed.

The dental bonding procedure will usually not require anesthesia and consists of hardening the tooth surface with a gel and then adding adhesive. This process is called the acid etching technique and is based on the effect the acid etch produces when it contacts the tooth, either in enamel or dentin.

When the solution contacts the tooth enamel, the acid selectively dissolves the hydroxyapatite crystals. This effect is determined as a selective demineralization, since it creates irregular surfaces on the enamel and also provides the increase of energy of the surface.

In addition, acid etching can demineralise both the central region of the prisms and their peripheral part, creating micro-spaces or roughness on the enamel surface and thus leaving the surface ready for the adhesive and composite. The restorative is then applied and shaped into the desired shape. Finally, it is cured with LED or halogen light.

In this video we can see how the repair of a broken tooth can be, in addition to a medical procedure, a work of art. The results are fascinating.