Fractured and Broken Teeth

The most robust and complex body organ is the tooth enamel or surface. However, it has its limitations, as it can fracture or break when eating, when you suffer mouth trauma, or due to aging. A broken or cracked tooth is a prevalent dental emergency that requires immediate attention from a dental expert. The common signs of broken or fractured teeth include sudden pain when biting, lingering sensitivity to cold or warm substances, inflammation of the gingiva tissue, inflammation around the fractured tooth, and gradual pain that comes and fades away.

Learning the nature of fractured and broken teeth, identifying the symptoms, knowing the actions to take, and understanding the available remedies for the dental problem are critical in maintaining a healthy, beautiful, and functional smile. At Socal Dental of Valencia, we are equipped to deal with all dental emergencies, making us suitable to treat your fractured teeth.

Overview of the Tooth Structure

Before explaining the causes of fractured and broken teeth, it is crucial to learn the structural layers of the teeth. Your teeth have three layers. The first is the tooth enamel, the outermost layer of the tooth surface. It is white in color and the most complex body organ. However, it is breakable and lacks nerve supply.

The second layer is the dentin, which comes below the enamel. This one is softer than the tooth enamel but less breakable or fragile. Besides, it has microscopic tubules that link nerves to the tooth.

The third and innermost layer of the tooth is the pulp. It is found at the tooth's core and contains nerves, supportive tissue, and blood vessels. The pulp is the tooth’s only living part.

Any of these layers can be affected when your tooth breaks or fractures. Your fracture's severity depends on the fracture's depth and the break's orientation.

Broken and Fractured Teeth Causes

Typically, the teeth are robust, but this does not mean they are unbreakable. They have limits when extreme pressure is applied, exceeding the force the tooth can support, leading to breakage and fracturing. The common causes of tooth fractures and breakage are:

Trauma or Physical Injuries

Facial trauma or physical injuries to the mouth are a common cause of fractured teeth. The common mouth traumas that can cause the teeth to break or crack are:

• Sport injuries, like receiving a direct blow to the mouth from a hockey stick or a ball
• A fall, which is prevalent among children and senior citizens, is due to instability
• Car accident
• Physical fight

When you fracture or crack your teeth after a physical injury, you should visit an emergency dentist immediately for an evaluation to determine the extent of the damage.

Biting or Chewing on Hard Unexpected Objects

Food digestion starts with chewing in the mouth to reduce food into small particles that are easy to swallow. Your teeth are robust enough to break food into small particles. However, unexpectedly chewing or biting a hard substance in the mouth can cause cracking or fracturing. Also, forming a habit of biting on complex substances like ice cubes or using your teeth to open soda bottles makes you susceptible to tooth breakage.

Bruxism

Also called chronic teeth clenching and grinding, bruxism is a habitual parafunction entailing unconscious grinding or clenching of teeth when deep asleep or awake. The habit exerts extreme force on the teeth enamel, creating micro-fractures that grow bigger with time, eventually causing large cracks in the enamel.

Structural Weakening of the Teeth

The risk of breakage or fracture is elevated when the tooth's structure becomes compromised. Dental procedures like dental fillings and root canals commonly weaken tooth structure. Oral issues like tooth decay can also weaken your teeth.

If the dental fillings are too large, you have lost most of your natural teeth. The filling material does not naturally bond with the remaining tooth structure, creating unequal force distribution. The imbalanced pressure distribution causes pressure points that cause the cusps to crack.

Root canal also weakens the tooth structure, as it entails extracting the damaged pulp materials, like nerves and blood vessels, meaning the dentine and enamel do not receive any minerals, water, or blood. Without these crucial elements, the tooth weakens over time and becomes prone to fractures and cracks.

Aging

Another factor that contributes to tooth fractures and breakage is aging. As you age, the tooth enamel begins to wear and tear because of the years of chewing, grinding, clenching, and exposure to acidic substances. This explains when tooth fractures are prevalent among senior citizens.

Thermal Cycling or Abrupt Temperature Fluctuation in the Mouth

A sudden temperature change in the mouth can cause tooth cracks. Your teeth can fracture when you introduce an ice pack in the mouth to soothe a sore tooth or when taking hot substances. Besides, the continuous use of hot and cold substances over the years creates micro-fractures in the teeth due to the repeated expansion and contraction. With time, the fractures widen, leading to breakage.

A fractured tooth, regardless of the cause of the damage, is a dental emergency that requires immediate attention from an experienced dentist. Minor breakages or fractures do not require treatment, but it is vital to see the dentist to determine the extent of the damage. If the damage is significant, there are several treatments or remedies the dentist can apply to restore the appearance and functionality of the teeth.

Recognizing Teeth Breakages and Fractures

Not all fractures are recognizable. Fractures without symptoms can be risky because they can lead to the development of other dental problems. So, it is recommended to visit the dentist frequently, at least twice annually, even when you do not have any recognizable oral problems, to enable the dentist to identify underlying issues that could lead to cracks in the teeth. Tooth infections can cause harmful bacteria to produce acidic substances that erode the enamel, causing cracks.

The symptoms you will experience vary depending on the fracture or breakage type. There are hardly any signs of mild fractures, although you might notice crazes and vertical lines on the tooth surface. These do not cause discomfort, although they can affect your smile.

The common symptoms when you have moderate fractures that cause tooth cracks and cusp fractures are:

• A sharp, piercing pain when biting that fades away immediately when you release pressure from the bite. The symptom could indicate cracks that flex during biting, irritating the core of your teeth.
• Cutting or transient sensation to cold or hot substances. The sensitivity happens because the cracks on the enamel allow cold or hot content to reach the dentin or even the pulp, causing short, piercing pains that subside when the trigger is removed from the cracks.
• Localized discomfort whose location is challenging to identify
• Rough edges that the tongue can feel

Some fractures are severe to the extent that they can split the tooth. The damage from these fractures typically extends to the pulp or below the gumline. If you have such a fracture, the symptoms you will experience are:

• Persistent, dull, or throbbing pain caused by pulp inflammation, called pulpitis, or dead pulp called necrosis.
• Lack of sensitivity or pain to hot stimuli is a sign of necrosis
• Gum inflammation due to infection spreading from the dead pulp
• A detached tooth
• Pain that becomes excruciating when you release pressure or a bite

Fractured and broken teeth can have intermittent symptoms that come on some days. This can lead to the assumption that the pain will eventually disappear. However, do not leave anything to assume. Even if you believe the fracture is minor, as it does not cause pain, visit an emergency dentist for an evaluation. Even if the fracture has only caused rough edges, it is good to seek treatment so that they can be smoothed to avoid injuring the tongue or other soft tissues in the mouth when biting or talking.

Deep fractures that extend to the pulp and gumline can cause cutting pain and could result in tooth loss if not addressed early. Therefore, visit your emergency dentist immediately after noticing a tooth fracture or breakage, so that measures can be taken to save the tooth.

Immediate Action to Take After Breaking or Fracturing Your Teeth

Time is essential when handling a tooth fracture or breakage. Your immediate action can significantly impact the prospect of the tooth. When you crack or break your teeth, the action you should take includes:

• Stay calm and evaluate your situation. Are you in pain? Is the tooth bleeding? Is there a loose part?
• Call an emergency dentist and explain your symptoms. The dentist will guide you on the following steps based on the symptoms and even arrange a same-day meeting, as a tooth fracture is a dental emergency.
• If the split part of the tooth has fallen, pick it up and place it in a clean jar with saliva, milk, or a saline solution of your choice. The dentist could refix it later when you visit for treatment.
• Rinse your mouth using warm salty water to clean the hurt area and soothe the gingival tissue.
• If you are bleeding, place gauze on the area and apply pressure to stop the bleeding.
• Place an ice pack or cold compress on the cheek adjacent to the damaged tooth to control the swelling.
• Cover the cracked or broken tooth using saliva or an alkaline solution of your choice
• Use over-the-counter pain relievers if the pain is severe
• If the fracture has left sharp edges, use an orthodontic wax or sugarless chewing gum to momentarily cover the rough edges and prevent injuries to the tongue and soft tissues.
• Adjust your diet. Use soft foods and avoid sticky or hard foods. Additionally, avoid chewing on the side with the fractured tooth and eliminate foods with extreme temperatures from your diet.
• Visit the dentist after performing first aid

A broken or cracked tooth is a dental emergency. However, it is good to take some immediate action before visiting the dental clinic to improve the prospects of the tooth or teeth when you seek treatment. Do not panic after a fractured tooth because several treatments or remedies are available to restore aesthetics and performance.

Restorative Solutions and Remedies for Fractured and Broken Teeth

Your emergency dentist's treatment hinges on the fracture severity, tooth location, and fracture type. Minor fractures will be addressed on a single visit, while the severe ones, especially those impacting the pulp, will require multiple appointments and complex procedures. Before recommending a remedy, your dental expert will:

• Ask about your dental history and if you suffer from chronic clenching, as it could be a cause of the tooth fracture
• Apply a special dye on the fractures to clear crack visibility
• Examine the gum tissue around the fractured tooth to look for swelling, as it could indicate the fractures extend to the gums.
• If you have no visible signs of tooth breakage, the dentist will request you to bite on a gauze to establish if you will experience discomfort when you release the pressure.
• Use a magnifying glass to identify tiny cracks that are not visible to the naked eye

The special tools your dentist can use to diagnose are a dental explorer, X-rays, a special biting stick, or even cone beam computed tomography (CBCT). X-rays help examine the pulp's health, but might not show any cracks. However, the CBCT scan can give a detailed  3D image of the cracks, enabling the dentist to decide on the best remedy or treatment. The remedies that the dentist will adapt depending on your situation are:

1. Tooth Enamel Shaping

Some patients do not seek treatment when small pieces of the enamel chip off, as they do not experience any pain. However, the sharp edges caused by the chipping can injure the tongue, so even with these minor chips, an appointment with an emergency dentist is necessary. During the appointment, the dentist contours and shapes the rough edges, smoothing the surfaces and restoring the tooth’s shape.

2. Dental Bonding

Depending on the type of chip, the dentist might include other complementary procedures like dental bonding. The procedure involves applying or cementing a tooth-colored composite resin material to the chipped area. If you have cracks, the dentist etches them using a phosphoric acid solution before cementing. The dentist then sculpts the chipped tooth to achieve the contour of the existing healthy natural teeth. Once the desired shape, width, and size are achieved, the dentist uses a special UV light to harden the resin material. Bonding is easy and affordable and can be completed on a single visit.

3. Use of Dental Crowns

Dental crowns or caps are a restorative solution your dentist can use to protect the cracked or broken tooth, restoring its functionality and appearance. If your dentist determines that your tooth fractures or fractured cusps require dental crowns, you will need two appointments.

In the first appointment, the dentist reshapes or trims the affected tooth to enable it to accommodate the crown. Once the tooth is shaped, the dental expert utilizes a mold to take an impression of the affected teeth. The impressions fabricate a crown with new length, shape, and alignment. Tooth shaping for crowns is extensive, so the dentist will administer anesthesia to keep you comfortable.

After the chipped or broken tooth is shaped and impressions are sent to the dental lab, the dentist will give you temporary crowns to wear as you await the final ones. Dental crown fabrication can take two or three weeks, after which you will return for a second appointment. During the visit, the dentist removes the temporary restorations and replaces them with permanent ones.

Today, some dental clinics have adopted CAM/CAD technology, enabling same-day crown design and fabrication. So, if your emergency dentist uses this technology, you will only require a single appointment to complete treatment.

Dental crowns are used for severe oral problems. Therefore, your dental expert will only recommend that they fix significant tooth breakages or fractured cusps. However, a more complex procedure like a root canal might be necessary when the cracks extend to the gum margins or pulp, causing necrosis.

4. Root Canal

When your fractures run vertically from the chewing surface to the pulp or gum margins, your dentist’s goal will be to hold the split tooth together and use a dental crown if the pulp is not damaged. However, if the fracture has damaged the pulp and the damage is irreversible, the dental expert will recommend a root canal procedure.

Fractures extending to the tooth core and roots cause throbbing pain. The pain is severe because of the several nerves and blood vessels that link the pulp and the tooth root. When the pulp material is damaged beyond repair, the dentist will use root canal therapy, which entails extracting all the dead pulp material to prevent bacterial growth.

Previously, root canal procedures devastated patients because of the excruciating pain associated with the therapy. However, technological advancements have made the treatment virtually painless and minimally invasive.

Cracks that extend to the pulp, causing damage, are emergencies because if you delay treatment, the cracks can leak harmful bacteria into the pulp, causing a severe infection. The infection kills pulp materials and causes inflammation, making your pain more severe.

When your dentist determines that you require a root canal procedure, they will prescribe antibiotics for a few days to the therapy to kill any infections on the tooth. During the procedure, they will isolate the tooth and then administer local anesthesia to numb the fractured tooth. They can also use sedation to keep you relaxed if you are anxious. 

The next step involves drilling the tooth using a dental drill to access the pulp chamber. They will then use nickel-titanium files the size of the needle to extract the pulp material and debris. What follows is cleansing to remove any remains of infection.

Once all the material and infection traces have been removed, the dentist disinfects the pulp chamber and fills the hollow using biocompatible material. Some bond the hole using a composite resin material. Filling the hollow prevents reentry of bacteria.

Root canal is a complementary therapy when it comes to fracture treatment. Even after the pulp chamber is filled with bonding material, the split or fracture will still be there, and you will need a restorative solution, such as a dental crown, to retain, strengthen, and improve the tooth's appearance.

If you delay seeking treatment and the pulp becomes infected or the cracks split the tooth entirely, a root canal will no longer be an option. The dentist will be forced to remove the tooth and replace it with an implant or dental bridge to restore appearance and functionality.

5. Emergency Tooth Removal or Extraction

After the dental experts have exhausted all the available options for saving your fractured and broken teeth, they will turn to emergency extraction as the last resort. Before a tooth removal procedure, the endodontist will inquire about your dental history and, in some instances, order an X-ray to obtain images that will aid the extraction process.

When the tooth is broken or fractured above the gum line and the dentist has a clear view of the remaining piece, they will conduct a simple tooth extraction procedure. Under this extraction, the dentist numbs the extraction site, then uses dental forceps to loosen the tooth root and pull it out. After the extraction, you can return later to replace the missing tooth, as leaving the socket open could lead to other dental issues like misalignment and jawbone resorption.

If the remaining piece of the fractured tooth is not visible through the gum margins, a surgical removal will be necessary. This procedure is highly invasive and lengthy and requires the use of sedation alongside a local anesthetic to keep you calm and comfortable.

Do not be scared of a surgical extraction, as technological advancements in dental equipment have made the procedure less dreadful. You should find the right dental clinic with the right equipment and experienced dentists for the extraction.

Find an Experienced Emergency Dentist Near Me

Do not panic or feel hopeless when you experience a dental emergency, like a fractured or broken tooth. Advanced dentistry provides multiple diagnostic tools and treatments for fractured or cracked teeth. However, to save the broken tooth, you must act swiftly by identifying the cause of the fracture, recognizing the symptoms, knowing the actions to take at home, and seeking help from an emergency dentist.

At SoCal Dental of Valencia, we can schedule an appointment on the same day, help you navigate the procedure, develop a treatment plan or remedy to save your tooth, and transform its aesthetics and functionality. Call us at 661-554-4545 to schedule an appointment.