Depending on the severity of fracture a broken tooth can be treated by,
- Composite filling,
- Temporary filling followed by permanent filling,
- Ceramic veneer/crown,
- Root canal treatment followed by crown,
- Extraction followed by replacement with a denture or an implant.
Tooth fractures can range from minor (chipping of the outer tooth) to severe (vertical, diagonal, or horizontal) fractures of the tooth and/or root. Enamel and dentin are the two outer protective layers of the tooth. The enamel is the outermost white hard surface. The dentin is a yellow layer lying just beneath the enamel. Enamel and dentin both serve to protect the inner vital part of the tooth tissue called the pulp.
Different tests are performed to determine if a tooth is fractured. In some instances, dental X-rays can help to diagnose, locate, and measure the extent of tooth fractures. A serious fracture is one that exposes both the dentin and the pulp tissue and should be treated promptly. Serious fractures may make the tooth displaced and loose, and cause the gums to bleed. To prevent the loose tooth from falling out completely, we can splint the loose tooth by bonding it to the adjacent teeth to help stabilize it while the underlying bone and gums heal. Because of the high risk of pulp infection after the exposure of the pulp to the oral environment, a root canal procedure may need to be performed during the first visit. Alternatively, we may elect to only apply a sedative dressing on the splinted tooth to help calm the tooth pain. The tooth will then be re-evaluated in two to four weeks to determine if a root canal procedure is necessary. If the tooth appears to have recovered and is stable in the mouth, the splint is removed at that time and a filling or crown is placed to restore the fractured tooth. The tooth may still require periodic monitoring over time (months to a year) to determine if any further treatment will be needed.
The most serious injuries involve vertical, diagonal, or horizontal fractures of the tooth roots. In most instances, a fracture of the tooth root leaves the injured tooth very loose and unable to be restored, thus necessitating tooth extraction. The extracted tooth is often replaced. There are some specific instances where teeth with horizontal fractures near the tip of the root may not need extraction. Root canal treatment for the injured tooth may be required in the future if symptoms of pulp death and tooth infection appear. Periodic dental X-rays of the fractured tooth are performed to monitor it closely.