One of the most common dental emergencies suffered by patients is a broken tooth. A tooth can break as a result of pressure from hard foods or from trauma during accidents such as sporting injuries. A tooth can also be weakened by dental caries and this can make it more prone to tooth fracture.
If you do suffer a broken tooth, it is advised to see an emergency dentist immediately as a fractured tooth if left untreated could result in further tooth deterioration. The dentist will need to assess the tooth to see if the tooth is restorable or not.
If the tooth fracture is superficial and not extensive, the dentist can use composite dental bonding to restore the tooth to its former shape and contour. If the tooth has suffered cuspal fracture, then the tooth is likely to need a dental crown to protect the remaining cusps from further fracture.
If the broken tooth has fracture to below the gum level known as the subgingival level, it will then need to be assessed with an X-ray to see if the tooth can be saved. 1-2mm below the gum level tooth fractures can usually be treated by gum re-contouring to allow the restoration margin to become at the gum level and the tooth saved.
3-4mm below gum level tooth fractures will need crown lengthening surgery to reposition the bone level further apically and allow the crown margin to be positioned further down on the root surface and thereby save the broken tooth.
Greater than 5mm subgingival tooth fractures, will usually need the tooth to be either extracted or treated by orthodontic extrusion to bring the remaining sound root further up towards the gum level and allow the tooth to be saved with a dental crown.
If the trauma suffered by the tooth has caused pulpal involvement, the tooth will usually need root canal therapy to prevent infection and pain occurring. Root canal treatment has a success rate of around 70% and will need to be followed by a crown to prevent further tooth fracture. It is worth knowing that a root filled broken tooth will eventually discolour and if the tooth is an anterior tooth this could become a concern for you. If a broken tooth does discolour after root canal, we can usually either do internal teeth whitening or place a crown over it to hide the tooth discolouration.
Some people due to dental neglect or dental phobia have multiple broken teeth in their mouth which have become a source of infection. Often nervous patients leave these teeth in their mouth untreated due to lack of any symptoms. It is worth noting that broken teeth if left un-treated can cause chronic infection which can spread and damage the remaining bone and even cause cyst and abscess formation. Lack of symptoms should not be an excuse to leave broken teeth as they are as they can silently cause severe problems for the patient in future.
