What is a chipped tooth?
A chipped tooth occurs following the loss of any part of the dental crown (i.e. tooth enamel above the gumline). In minor cases, minimal treatment from the dentist could involve filling the chip or smoothing the surrounding enamel. In more serious cases, restorative treatments may include a dental onlay (partial crown) or full crown.
What are the causes of chipped teeth?
Chipped teeth may result from a number of causes. Obvious causes include impact injuries such as falling onto a hard surface or taking a blow to the mouth from a solid object. Less obvious causes include biting hard, untreated cavities (that weaken and fracture the tooth), night time grinding, large fillings, and a failure to replace older and no-longer-supportive fillings.
Why do chipped teeth hurt?
Chipped teeth can cause pain both at rest (i.e. when the mouth is closed and the teeth are apart) and when the teeth are in use (i.e. touching and compression from biting and chewing). In particular, patients may notice heightened sensitivity or pain when the teeth come into contact with hot or cold food and drink. This is because chipped teeth can expose underlying dentine.
Dentine is the substance that sits directly beneath the hard enamel tooth coating. Dentine is comprised of many microscopic structures called tubules, through which the tooth’s sensitive nerve endings may be stimulated if exposed to contact from objects (including the tongue), pressure from biting and chewing, or temperature changes from hot or cold food and drink.
Types of chipped teeth
Chipped teeth typically fall into two categories of either a cracked tooth or a chipped (broken) tooth.
Cracked tooth
A cracked tooth occurs where a fracture extends across part or all of the tooth, creating entirely or largely separated portions of the same tooth. A cracked/fractured tooth is typically more painful upon releasing the pressure from a bite. Unlike bone, tooth enamel does not heal itself. Therefore, a cracked/fractured tooth must be treated by a dentist.
Examples of cracked teeth include:
- Cracked tooth (from the surface penetrating into the tooth’s centre) – This is where the fracture extends from the crown (enamel) to the pulp (containing nerves) located in the centre of the centre of the tooth.
- Split tooth (where the tooth is split into two) – This is where the fracture splits the tooth into two portions (this typically affects the ‘double root’ rear teeth meaning the crown is split into two singularly rooted sections).
- Split root (affecting the root below the gumline) – Associated with nerve damage, split roots occur where the fracture begins or extends into the tooth root (tooth removal is a common remedy for split roots).
Chipped tooth (or broken tooth)
A chipped tooth is usually caused by accidents such as sporting injuries or trips and falls, but may also be linked to congenital conditions that may result in an underdeveloped tooth that is more likely to succumb to breaks or chips (i.e. the hard outer enamel – or crown – is too thin to withstand years of chewing pressure or even minor decay before developing a fault).
Examples of chipped teeth include:
- Craze lines in the surface of the enamel – Craze lines are minor cracks in the surface of the enamel and are not technically chipped teeth. However, if left untreated, craze lines can lead to chipped teeth.
- Chip in the enamel (or crown) of the tooth – A chip in the enamel may cause no pain. However, the chip should be treated by filling the depression (to prevent further development) or by smoothing the surrounding tooth.
- Chips caused by untreated cavities – The tooth experiences decay and begins to lose structure (disintegrate/crumble) due to an untreated cavity, which weakens the tooth from the inside out.
Should I fix a chipped tooth if it doesn’t hurt?
Yes. Chipped teeth create an uneven surface of unnatural pits and fissures that can be hard to keep clean throughout the day. The warm and wet environment inside the mouth creates the perfect breeding grounds for bacteria, leading to the potential for chipped teeth to harbour unhealthy bacteria.
Chipped teeth are linked to:
- Bad breath
- Tooth decay
- Periodontal disease (gum disease)
- Eventual tooth loss where symptoms are not treated
Depending on the level of damage and any subsequent decay, the dentist may choose to treat the tooth with a number of restorative procedures – with tooth removal presenting a last resort where the tooth cannot be saved. Therefore, seeking expert dental help as soon as possible following a chipped tooth can be essential in minimising the risk of tooth loss (see below: ‘Treatments for chipped teeth’).
Treatments for chipped teeth
In the immediate aftermath of chipping a tooth, patients experiencing pain are advised to invest in over the counter pain relief (always follow the accompanying dosage instructions) and to rinse the mouth with salt water to reduce the risk of infection. Jagged edges can be temporarily covered with sugarless chewing gum to protect the tongue and cheeks.
Treatments may include:
- Dental filling (also called ‘bonding’) applied to the surface of the tooth – Dental filling (or bonding) is a simple procedure typically used to treat relatively straightforward cases of chipped teeth. The tooth coloured composite resin is applied directly to the tooth without the need for anaesthetic, restoring the chipped tooth.
- Dental onlay (partial crown) or full crown – In more severe cases of chipped teeth (where a significant portion of the enamel has been lost to trauma or decay), a permanent partial or full crown may be used to restore the tooth. If most or all of the crown has been lost but the root remains, root canal treatment may be used to create a structure onto which a permanent crown is added.
- Dental veneer covering the surface of the tooth – A dental veneer may be used to restore a chipped tooth. This would typically involve removing a thin surface layer of the tooth enamel before etching the tooth to create special attachment points to help hold the veneer in place – cement is used to permanently attach the veneer to the tooth.
