I’ve broken a tooth

I'm sure you're familiar with the scenario:

Imagine this: You’re eating a sandwich or a piece of toast and suddenly you find something in your mouth that’s hard like-a-tooth, that you’re pretty sure wasn’t in the sandwich. You search with your tongue around your mouth to find a gaping hole where a tooth used to be. You’ve had a filling come out.

Except 99% of the time it’s not that a filling that has come out but rather a piece of tooth that has broken off.

Some patients are more prone to tooth fracture than others. Patch and fill doesn’t work. Even after the fracture has been rebuilt the conditions that created the tooth fracture will still be present in the mouth.

The key to succcessful treatment is to prevent further fracture in that tooth and anticipate fracture in other teeth.

The good news is:  the first tooth fracture will not result in loss of the tooth – if the problem is dealt with at an early stage.

A stitch in time saves nine!

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Imagine if you could fix the broken tooth so that it feels stronger than ever

How does tooth fracture come about?

The simple answer is that it is down to repeated wear on the tooth. Like metal fatigue developing in an aircraft wing, a small crack starts and gets bigger until…..disaster.

When a filling is present in the middle of the tooth, the two cusps on either side are separated by the filling and free to move independently of each other (whereas in a sound tooth both cusps are joined together and move together).
When you bite on the cusp it bends out slightly. After a few decades of chewing a fracture line starts at the base of the cusp, where the degree of bending is greatest. Cutting across nerve endings the fracture then progresses to the outside of the tooth. Until the fracture lines gets to this point generally the teeth hold together. That’s why it’s usually not until we are in our 40’s or 50’s before this process becomes apparent. By the time the fracture line is visible on the outside of the tooth it has progressed 100% and is just waiting to fall off. Cue: sandwich.

After a chunk of my tooth breaking off what is the best outcome I could expect?

The tooth can still be saved if the problem is identified and dealt with early enough to give the tooth a good prognosis.

One cusp may already have broken away but, so that the remaining tooth can be saved, the original strength of the tooth has to be fully restored.

The solution here is either a full coverage crown or onlay.

It isn’t every tooth which can be saved with the strengthening restoration. Sometimes there is just too little tooth left for even such a great technology.

In those circumstances the solution with the greatest degree of health and certainty of outcome is what should be recommended.

If I have this problem in my teeth should I expect to lose them eventually?

You should not expect that you should lose your teeth simply because you have a few teeth with fracture lines undermining the cusps.

In fact it’s a really common thing and it’s very easily dealt with. The solutions we have are really excellent. As a practice we have been placing same day crowns since 2009 with a very high degree of success.
If you want to read more about cusps breaking off check out Dr Ian Harper’s dental journey.

Could this be a blessing in disguise?

Not usually. If you had to choose between having fractures in your teeth or having no fractures in your teeth, you would choose no fractures every time.

But it can alert you to the fact that you have a pattern of fracture, which can lead to further fractures in other teeth. If you can address the fractures in those other teeth before they become a crisis then you can prevent those teeth from being extracted.

You can read about how this same process happened in Dr Harper’s rehabilitation journey and how he dealt with it.

Call us now on 03 5303 9999

Tooth fracture is becoming an increasingly common problem as we age.
If the problem is addressed early enough then the solution is both straightforward and generally successful.
The correct solution is one which occurs early enough to prevent a problem from becoming a crisis. A stitch in tme saves nine!

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