One of the most common injuries in dentistry, especially for children, is breaking or chipping a tooth.
From falling injuries, to car and sports accidents, having a small piece of your teeth chipped off is quite a common occurrence that thankfully has a relatively safe treatment with a trusted prognosis.
Depending on the severity of the injury, a chipped tooth may be very painful and would require immediate medical attention to alleviate this pain and prevent further damage to the tooth.
Repair of a chipped tooth can be anywhere from simple polishing of the area, to a full root canal treatment. Read on as we highlight the nature and different types of chipped tooth injuries and what their treatment is.
What is a chipped tooth?
A chipped tooth is when a small piece of a tooth gets fractured or broken off and detached from the rest of the tooth structure.
The chip can be superficial, involving only the outer layer of a tooth (the enamel) or it can be larger, involving the inner layer (dentin).
Dentin is softer than enamel and it’s much closer to the nerve of the tooth. For this reason dentin is much more sensitive than enamel.
Injuries involving only the enamel layer are usually much safer and don’t cause any pain.
On the other hand, if the chipped tooth injury breaks off enough of the tooth surface so that it involves the dentin layer, then this is more painful.
A chipped tooth injury may also be so deep that it breaks off so much of the tooth that the nerve becomes exposed. This usually leads to bleeding, and depending on the time or size of the injury, may require a root canal treatment.
A “cracked tooth” usually refers to a deeper crack that may start in the crown of a tooth and runs longitudinally all the way near the gums (possibly even to the roots).
Chipped tooth, immediate treatment
When a tooth gets chipped, it’s important to go to a dentist immediately. However, there are a few protocols that can be followed that may be increase the success of its restoration and prevent any further complications.
Rinse your mouth
If a piece of tooth is broken away, it is advised to wash and rinse your mouth with warm water. This allows you the site of injury to be cleaned, and to wash away any debris.
Keep the piece of broken tooth
If the piece of tooth that is chipped off is big enough for you to handle and hold, it may not be a bad idea to try and retrieve the piece that broke off.
Depending on the nature and extent of the injury, the dentist may actually be able to cement the broken piece back to the tooth.
Stop the bleeding
If there is bleeding, then that means the chipped tooth is more serious, and that the pulp of the tooth has been exposed.
If this is the case, then using a clean piece of gauze to apply pressure to the area that is bleeding. Hold the gauze against the exposed tooth for at least 10 minutes to try to stop the bleeding.
This is also important to try and keep the area clean and prevent any foreign debris such as dirt form entering into the pulp or nerve chamber of the tooth.
Take pain killers
If the chipped tooth injury causes so much pain, consider taking over-the-counter medicine and pain reliever.
Chipped tooth treatment
Small chipped tooth injuries
If the chip in your tooth is quite minimal and small, then your dentist may only need to polish the site of injury.
This is to make sure there are no sharp edges of the tooth where you may injury or cut yourself, such as your tongue.
Small cracks that are not wide but run deep into the tooth, may not be painful or even visible, however, they do weaken the tooth. Such injuries are usually treated by a flowable resin filling material that can seep through the cracks and fill it up.
Medium sized chipped tooth injuries
Larger chipped tooth injuries, especially those that expose the dentin will require a filling.
The site of injury is smoothed, then an acid etchant and a primer are applied.
Finally, a filling material (usually a composite resin based material) is applied to the site of injury, and is built up to the shape of the broken tooth.
Such fillings usually last around 4-6 years.
Larger chipped tooth injuries
Larger chipped tooth injuries that cause bleeding and exposure of the blood and nerve chamber (pulp) of the tooth will require more urgent dental treatment.
Exposure of a tooth nerve and pulp leads to a high risk of bacterial contamination to the pulp. This means that if bacteria has entered the pulp since it has been exposed, it will cause an infection in the root canal that can only be treated by removing the nerve in the canal (root canal treatment).
If the pulp exposure is extremely small (consisting of a small red dot of blood not larger than 2mm) and has occurred less than 24 hours before, then your dentist may assess the situation and decide that no contamination of the pulp occurred. In this case, a small antibacterial medicament may be applied directly on the injury, and a filling on top of that.
Chipped tooth repair summary
Because it’s such a common injury, with the advancement in dentistry, repairing a chipped tooth has become quite a routine treatment, with many of the cases being resolved in the same day.
More severe cases may require a root canal treatment in order to avoid infection of the nerve and root canal, with the most important determining factors being the size of pulp exposure and the time period between injury and treatment.
Furthermore, initial protocol by those injured continues to prove to be extremely important in determining the prognosis of the injury, specifically keeping the site of injury clean of any bacteria or debris.
