Although teeth are remarkably strong, they can chip, crack (fracture) or break. This can happen in several ways:

• Biting down on something hard
• Getting hit in the face or mouth
• Falling
• Having cavities that weaken the tooth

When a tooth chips or breaks, it may not hurt. However, your tongue usually finds the sharp area quite quickly. Minor tooth fractures usually don’t cause pain, but if you break off a large piece of the tooth, it can hurt. The pain occurs because the nerve inside the tooth may be damaged. If it gets exposed to air, or hot or cold foods or drinks, it can be extremely uncomfortable.

Pain from a broken or cracked tooth may be constant or it may come and go. Most people only feel pain when they chew because chewing puts pressure on the tooth.

What You Can Do

Cracked (Fractured) Teeth
It’s impossible to treat a cracked tooth at home. You need to make an appointment so Dr.Powell can check your tooth.  The tooth may look fine, but it can hurt only when you eat or when the temperature in your mouth changes, due to hot or cold food or drinks. If your tooth hurts all the time, it may have a damaged nerve or blood vessels. This is a serious warning sign, and you need to make an appointment to have us check the area.

Broken Teeth
If you have a broken tooth, see us as soon as possible. Dr. Powell can figure out if the break was caused by cavities, and if the tooth’s nerve is damaged. A damaged nerve usually will require root canal therapy.

Until you get to our office:

• Rinse out your mouth with warm water.
• Apply pressure with a piece of gauze on any bleeding areas for about 10 minutes. If this doesn’t work, use a tea bag with pressure on the area to stop the bleeding.
• Apply a cold pack to the cheek or lips over the broken tooth, to help reduce swelling and relieve pain.
• If your unable to get to our office right away, cover the broken tooth with temporary dental cement. You can find the cement at a local drugstore.
• Take an over-the-counter pain reliever if needed.

What Dr. Powell Will Do

Fractured Teeth
There are several types of tooth fractures and breaks, each of which requires different treatments. These include:

• Minor cracks — Also known as “craze lines,” are surface cracks that affect only the outer white surface of the tooth, called the enamel. Minor cracks don’t usually require treatment. However, your dentist may lightly polish the area to smooth out any rough spots.
• Chips — Minor chips don’t always need treatment. Your dentist may recommend repairing the damage with filling material to prevent it from getting worse. A filling could also make the tooth look and feel better. If the chip is very small, the dentist may just polish and smooth out the chipped area.
• Broken cusp — These breaks affect the pointed chewing surfaces (the cusps) of the teeth. They usually do not go deep enough to affect the pulp and are unlikely to cause much pain. Your dentist may repair the damage to restore the tooth’s shape. Frequently, however, an onlay or crown will be required, because you will need a strong material to withstand biting pressure.
• Cracked tooth — This type of fracture involves the whole tooth, from the chewing surface all the way down to the nerve. The pieces may remain in place, but the crack will gradually spread. Cracks can sometimes be repaired with some type of filling material. The tooth will usually need a crown to prevent the crack from getting worse. If you have damaged the pulp, which includes nerve and other live tissues, you may need a root canal as well.
• Serious breaks — These breaks go deep enough to expose the nerve. They almost always cause pain with the tooth and become very sensitive. Usually, the broken part of the tooth will bleed. You will need root canal therapy to remove the exposed nerve and probably have a crown placed to restore the tooth to normal function so you can eat and chew properly.
• Decay-induced break — In this case, the tooth has broken because a cavity weakened it from the inside out. Your dentist will need to evaluate the cavity and recommend the best way to restore the tooth. In some cases, the decay may be too extensive and go down to the bone, then tooth may have to be removed.
• Split tooth — This means that the tooth has split vertically into two separate parts. Some teeth, such as your molars, have more than one root. It may be possible to keep one of the roots, which will then be covered with a crown. First, you will need root canal treatment. Second, the dentist will remove any roots that cannot be kept. Third, you will need a crown to cover the root and replace the tooth. Sometimes if the root cannot be saved, the tooth will need to be extracted.
• Vertical breaks or split root — These cracks start in the root of the tooth and extend upward toward the chewing surface. These breaks are often painful because the area around the root may be inflamed or infected. In most cases, the tooth will have to be removed.

Yes. A tooth could be reimplanted if you act quickly.

Plants that are pulled up by the roots may survive if they’re put back into soil right away. The same is true of teeth. Teeth are alive and can often be saved as long as you act quickly.

The blood vessels and nerves in knocked-out teeth (also called “avulsed” teeth) are usually damaged beyond repair. But microscopic ligaments in the jaw may reattach to the root of the tooth once it’s put back into place.

The odds of saving a tooth are highest in young children, but adult teeth can be saved as well. Even if the tooth reattaches, however, you most likely will need root canal treatment to clean out the damaged nerve. We have seen several of these cases in our office, after root canal is done we can sometimes bleach the tooth from the inside and simply fill. No crown required.

To improve the chances of saving the tooth take these steps:

• Handle the tooth carefully. Avoid touching the root of the tooth (the part of the tooth that was embedded in the gum) because it can be damaged easily.
• If the tooth is dirty, hold it by the upper part (the crown) and rinse it off with milk until most of the dirt is washed away. If you don’t have any milk available, then it is best to leave the tooth alone. Wiping it off with a handkerchief or shirttail may cause additional damage.
• It is important to keep the tooth moist. If possible, drop it into a glass of milk. If no milk is available, then place the tooth in the mouth between the cheek and gum.
• A young child who has had a tooth knocked out may not be able to safely “store” the tooth in his or her mouth without swallowing it, so don’t give the tooth to a young child for safe-keeping in his or her mouth. Place the tooth in milk or have the child spit into a container and place the tooth in the cup with the saliva. The most important thing is to keep the tooth moist. Use a cup of water if nothing else is available.
• Get in to see Dr. Powell as quickly as possible. If getting into our office immediately after a tooth has been knocked out is impossible, then you may want to try slipping the tooth back into its socket. In many cases, it will slip right in. Make sure it’s facing the right way. Don’t try to force it into the socket. If it doesn’t go back into place easily and without pressure, then it’s better just to hold it between the cheek and gum or to keep it in milk, saliva or water.