The Challenges of Dentistry (Part 7)

In our office we see a lot of cracked, chipped and broken teeth. These teeth can cause a variety of issues for the patient.  Some are just rough and irritating.  Others are sensitive, sometimes to temperature, sometimes to biting and chewing.  Other teeth hurt from the moment they break.  Often the pain is intense.

Teeth crack, chip or break for a variety of reasons. Accidents and trauma cause a lot of tooth damage.  These can only be avoided by being more careful and wearing a mouth guard during athletic events. Foods like popcorn kernels, ice, bones and hard candy cause a lot of tooth fractures.  Teeth are not indestructible.  Use care when biting on or chewing something that you maybe shouldn’t.  Using your teeth as a tool is never a good idea.

Teeth also break due to decay. If decay undermines a filling or part of the tooth, it will break.  If the decay is not addressed in a timely manner it will continue to progress.  This leads to a bigger restoration, a crown, or possibly a root canal and sometimes even extraction of the broken tooth. To avoid these more costly treatments, we recommend annual x-rays and having those older restorations monitored.

The biggest cause of cracked and broken teeth in our practice is large fillings. If a filling is placed that leaves unsupported or thin tooth structure, a broken tooth can occur.  More often it is an older silver filling that starts to act like a wedge inside your tooth causing cracks that lead to fractures.  Often we can see cracks as they develop.  We classify cracks from low to moderate to high risk.  A high risk crack is very likely to break.  These are the teeth we advise being proactive with and placing a restoration that covers or eliminates the crack.  In most cases this involves placing a crown over the tooth.

While any tooth can crack or break at any time, teeth with high risk cracks are the easiest to identify. With these teeth the question is usually not will this tooth break but when will it break.  The reason we don’t recommend waiting until the tooth breaks and then fix it is due to the potential of a broken tooth needing more extensive (and more expensive) work if we wait.  A tooth that breaks below the gum tissue is harder to restore.  A crack that involves the nerve of the tooth will probably need a root canal.  A tooth that cracks in half will need to be extracted.  It is a risky gamble to leave a high risk crack for any length of time.

The time to fix a chipped or broken tooth is as soon as you notice it. Any damaged tooth is more likely to break more.  The broken area may collect food and bacteria causing decay in the broken tooth as well as in teeth around it.  The longer you wait, the more expensive the fix.  Address any chipped, broken or cracked teeth as soon as possible.  This could save you from an lot of avoidable pain and expense.

Thanks for reading,

Dr. Bruce