So you have broken your front tooth, or more worryingly, your son or daughter has fallen over, and chipped or broken their front teeth – What should you do?
First things first…
Any impact to your head can cause other damage, and if this is the case, then its important to address these. The priority is to see a medical doctor, especially if you were sick, dizzy, confused shortly after the incident that caused the tooth to break.
If your tooth broke in half, then it might be worth trying to find the fragment that broke, but don’t worry too much if you cannot find this. If the whole tooth came out, then spend a little longer finding this! (but this post is about if you just broke the tooth… )
So, how much broke?
Inside the tooth is a nerve, and whether this nerve is exposed will dictate your best options.
If the nerve is exposed, you will see a spot of blood in the middle of the broken part of tooth, and this is the nerve.
The first two in these photos should easily be repaired. The third is most likely going to need a little extra work!
The key thing your dentist is going to want to know at this stage is, “is the nerve affected?” This is found by doing some tests, and the most common test is to put something cold on the tooth, to see if you feel anything. If you feel the cold, then the tooth is alive.
Other tests include just tapping the tooth, applying heat, applying a gentle electric current and x rays. Each test will give more information.
If the tooth is alive
If the tooth is alive, then the treatment is quite simple, the aim is to rebuild the tooth, and this can usually be done with a white filling, or a porcelain veneer.
White fillings can look good initially, and in most cases last a long time. They are also the least costly option. There is a white filling on the ‘severe’ image, on the tooth to the left of the broken one. To be fair it looks like its been done badly, and not polished in, which is why there is a dark stain around it.
Porcelain veneers will last longer, look better for longer, but are a little more expensive. Be sure to see the dentists previous work, as this is the front of your mouth, and if you are having something done, you want it too look good. This is what veneers can look like (of course – these are veneers which I did!):
What if the tooth is dead?
If the nerve has been affected, then you will probably need some additional treatment before rebuilding the teeth. You will probably need root treatment, and possibly a post, then a crown.
Root canal treatment is when the infected nerve is removed, and the tooth is cleaned and sealed. Some people say its painful, in my experience, this is the treatment where my patients are most likely to fall asleep – it takes a long time, and there is very little noise!
If the tooth is so broken, that a crown (this is like a veneer, but covers the whole tooth) has nothing to grip on, then you will need a post, which is placed into the treated root canal. The post is usually made from a hard plastic material, but can also be made from metal. The post gives the new crown something to grip to, and helps ensure that the crown doesn’t keep coming off every few months!
What if I am less than 18 years old?
If you have broken your teeth, and you are still growing, you can have any of the treatments discussed, the only thing is that the crowns and veneers may not look that great in 5-10 years – this is because the gum will probably shrink a little, showing the junction between the crown or veneers.
My advise would be to do the root treatment if needed, and have a nice white filling put on. Then, once you are (I normally recommend 21 years), then upgrade to a porcelain veneer or crown.
If you have a porcelain veneer or crown on day one, then you may need to change it later down the line.
The key thing is to see your dentist as soon as you can, but if you had severe head injuries – see a doctor first. When you see your dentist, there are a variety of things they can do, but the first is to get you out of pain and stabilise the tooth, so it doesn’t get worse. Then you have options to rebuild the broken teeth.