Chipped, Cracked or Broken Tooth: Next Steps

If you have a broken tooth, rinse your mouth with warm water, save any pieces, cover sharp edges and call a dentist the same day. A dentist needs to see how deep the break goes, because a photo or description cannot show that. A broken tooth after a hard blow to the face, with a possible jaw injury or heavy bleeding, needs 911 first.

Key Takeaways

• For a broken tooth, rinse gently, keep any fragments in a clean container, avoid chewing on that side and call a dentist.
• Pain, a sharp edge, a loose piece, pink or red tissue showing, or swelling make a broken tooth more urgent.
• Call 911 or go to the emergency department for difficulty breathing, bleeding that will not stop, a suspected broken jaw or signs of a head injury.
• Dental wax, sugar-free gum or drugstore temporary material can shield a sharp edge for a short time, but they do not repair the tooth.
• Treatment depends on how much tooth is left and whether the nerve is involved, and ranges from smoothing or bonding to a crown, root canal or extraction.

What to do right away with a broken tooth

A broken tooth is a tooth that has lost part of its structure from an injury, biting something hard, or a weakness such as decay or a large old filling. Part of the tooth remains in the mouth. If the whole tooth has come out, that is a knocked-out tooth, and you should follow our guide to what to do with a knocked-out tooth instead.

Take these steps in the first few minutes:

1. Check for other injuries. Look for heavy bleeding, a jaw that will not close properly, or signs of a head injury. If any are present, call 911.
2. Rinse gently. Use warm water to clear blood and debris.
3. Stop bleeding. Press clean gauze or a clean cloth on the gum or lip for several minutes.
4. Save the pieces. Put any fragments in a clean container with a little milk or water, and bring them to the appointment. The dentist will decide whether they can be used.
5. Reduce swelling. Hold a cold pack wrapped in a cloth on the outside of the cheek or lip.
6. Call the dental office. Describe what happened, which tooth broke and what you feel.

The American Dental Association's MouthHealthy guidance for a cracked tooth is similar: rinse with warm water and use a cold compress to limit swelling.

Over-the-counter pain relievers such as ibuprofen or acetaminophen may help if they are safe for you and taken as the label directs. A pharmacist can check them against your other medications.

Chipped, cracked or broken? How tooth damage differs

People use "chipped," "cracked" and "broken" loosely, but the difference matters for urgency and treatment. The American Association of Endodontists groups tooth cracks into several types, and the table below puts them next to chips and larger breaks.

Type of damage	What it is	Typical signs	Usual urgency
Craze lines	Tiny surface lines in the enamel only	None; cosmetic	Mention at your next checkup
Small chip	A small piece of enamel missing	Rough edge, little or no pain	Book soon; sooner if sharp
Fractured cusp	A corner of a back tooth breaks off, often near a filling	Sharp edge, sometimes mild sensitivity	Within a few days, or same day if painful
Cracked tooth	A crack running from the chewing surface toward the root	Sharp pain when biting or releasing, sensitivity to cold	Call the same day; cracks can spread
Large break or exposed pulp	Much of the tooth is gone, or a pink or red dot shows	Significant pain, sensitivity to air	Call the same day
Split tooth	A cracked tooth that has separated into parts	Pain, pieces that move	Call the same day
Vertical root fracture	A crack starting in the root	Often few signs until the gum or bone becomes infected	Call when you notice swelling or pain

According to the American Association of Endodontists, a cracked tooth caught early can sometimes be saved, while a crack that extends below the gum line usually cannot. Unlike a broken bone, a cracked tooth does not heal itself, which is why early assessment matters.

For cosmetic and repair options for small chips and cracks, such as bonding and veneers, see our guide to chipped and cracked teeth.

Is a broken tooth an emergency?

A broken tooth is usually urgent, and sometimes an emergency. It depends on symptoms.

Call the dental office today if you have:

• moderate or severe broken tooth pain, or pain that wakes you at night;
• a sharp edge cutting your tongue or cheek;
• a piece of tooth that is loose or moves when you bite;
• a tooth that has shifted or feels loose after an injury;
• a pink, red or dark spot in the centre of the break, which can mean the pulp is exposed;
• strong, lasting sensitivity to air, cold or sweets;
• swelling of the gum or face near the tooth, a bad taste or fever;
• a tooth broken at the gum line.

Book soon, within a few days, if the chip is small, there is no pain and no sharp edge, and your bite feels normal. Move the visit up if anything changes.

Even when a broken tooth does not hurt, have it checked. Cracks can grow without warning, and exposed dentin can become sensitive or decayed over time.

When to call 911 instead of the dental office

A dental office can manage most broken teeth. A hospital is the right first stop when the injury goes beyond the teeth.

Call 911 or go to the Emergency Department at the Colchester East Hants Health Centre for:

• difficulty breathing or swallowing;
• bleeding from the mouth or face that does not stop with firm pressure;
• a suspected broken jaw: the teeth no longer meet normally, the jaw is very painful to move, or the face looks misshapen;
• deep or gaping cuts to the lips, cheeks or tongue;
• loss of consciousness, confusion, repeated vomiting or a severe headache after the injury;
• rapidly spreading facial swelling, especially with fever;
• a piece of tooth that may have been inhaled, with coughing or wheezing.

When there is a serious injury, medical care comes first. Keep any tooth pieces, and arrange a dental visit once you are stable, because the hospital may not repair the tooth itself.

How to protect a broken tooth until you are seen

Until your appointment:

• Chew on the other side and choose soft foods such as yogurt, eggs, soup and pasta.
• Avoid hard, sticky and very hot or cold foods, including ice, nuts, hard candy and toffee.
• Cover a sharp edge with dental wax or orthodontic wax from a drugstore. Landmark Dental Care's emergency guidance notes that sugar-free gum can also be used as a short-term cover. Some pharmacies sell temporary filling material; follow the package directions and use only a thin layer.
• Keep it clean by brushing gently and rinsing with warm water after meals.
• Do not use superglue, craft glue or epoxy on a tooth. These can damage the tooth and gum and make repair harder.
• Do not file the edge with a nail file or try to push a loose piece back into place.
• Do not press wax or temporary material into a deep crack or over an exposed pink spot. Call the office instead.

If temporary material falls out, call the office rather than trying household products. If pain, swelling or bleeding gets worse, call sooner, and check whether any of the hospital red flags now apply.

How a dentist assesses a broken tooth

The visit usually starts with questions: how the tooth broke, when, what hurts, and whether it has happened before. The dentist then checks the tooth, the neighbouring teeth, your gums and your bite.

Tests and imaging

The dentist may test how the tooth responds to cold or pressure and look for crack lines using light or magnification. Digital X-rays are often taken when there is a chance the root, bone or nerve is involved. Imaging is chosen based on what the exam finds, not on routine.

Some cracks are hard to see even with X-rays. If symptoms point to a crack that cannot be found, the dentist may recommend watching the tooth over a few visits.

Possible treatments, in general terms

Treatment depends on how much of the tooth is left, where the break is and whether the pulp is healthy. After an exam, a dentist may discuss:

• Smoothing and polishing a small chip.
• A filling or bonding with tooth-coloured composite material to rebuild a chipped area.
• A crown to cover and strengthen a tooth that has lost a lot of structure or has a crack.
• An inlay or onlay, a custom restoration for a back tooth with moderate damage.
• Root canal treatment if the pulp is exposed, infected or badly inflamed, usually followed by a crown.
• Extraction when the break or crack extends too far below the gum to restore, followed by a discussion of replacement options such as a bridge or implant crown.

No article can say which option fits your tooth, how long a repair will last, or how many visits it will take. Those depend on the tooth, your bite, habits like grinding, and your oral hygiene. Ask your dentist to explain why one option suits your tooth better than another.

Broken teeth in children, seniors and people with dental work

Children

Tell the dental team the child's age and whether the broken tooth is a baby tooth or a permanent tooth, because they are managed differently. Do not push a loose or displaced baby tooth back into place. A child who fell hard enough to break a tooth should also be watched for signs of a head injury. In Nova Scotia, the Children's Oral Health Program covers some basic care, including fillings and necessary extractions, for children aged 14 and younger with a valid health card.

Seniors and people with large fillings

Teeth with large, older fillings are more likely to crack or lose a cusp, often while eating something ordinary. The break may not hurt, especially in a tooth that had a root canal. Have it checked anyway, because the remaining walls of the tooth may be thin.

Teeth that already have a crown or root canal

A tooth with a crown can still break under the crown, and a tooth that has had a root canal can crack without pain. If a crowned tooth feels loose or a piece of porcelain chips off, call the office and bring any pieces. Our guide to a lost filling or crown covers restorations that come off completely.

Grinding and clenching

People who grind or clench their teeth at night are more likely to crack teeth. If a dentist suspects grinding, a night guard may be suggested to protect the repaired tooth and the others.

Getting a broken tooth seen in Truro

For a broken tooth without medical red flags, call Landmark Dental Care at 902-893-2919. The practice is at 125 Queen St in downtown Truro, in a Victorian Queen Anne–style home, and is open Monday to Friday, 8:30am to 5:00pm. Patients come from Truro, Bible Hill and across Colchester County and Central Nova Scotia. Restorative dentistry is a special area of interest for the practice. Read more about emergency dentistry here.

If the tooth breaks on a weekend and you have only a sharp edge or mild pain, cover the edge, take care with chewing and call when the office opens.

If there is a serious facial injury at any hour, call 911 or go to the Emergency Department at the Colchester East Hants Health Centre, 600 Abenaki Road, Truro, which is open 24 hours. For advice when you are unsure where to go, call 811 to speak with a registered nurse.

For questions about coverage, including the Canadian Dental Care Plan, call the office to confirm current participation and billing, and see our CDCP page.

FAQ

Is a broken tooth an emergency?

A broken tooth is an emergency when it is very painful, the pulp is showing, a piece is loose or the face is swelling, so call the dental office the same day. A small chip without pain can usually wait a few days, but it still needs to be checked.

Can a broken tooth be fixed?

Many broken teeth can be repaired with bonding, a filling, a crown or root canal treatment. A tooth that is cracked deep below the gum line may need to be removed, and only an exam can tell which applies.

Can I glue a broken tooth back together?

No. Household glues are not safe in the mouth and can damage the tooth and gum. Keep the piece in a clean container and bring it to your dentist, who will decide whether it can be reattached.

What should I do if my tooth broke at the gum line?

Rinse gently, press gauze on any bleeding and call the dental office the same day. A tooth broken at the gum line often needs more involved treatment, so early assessment gives the most options.

Why does my broken tooth not hurt?

A broken tooth may not hurt if the break is in enamel only, or if the nerve inside has already died or been treated with a root canal. Lack of pain does not mean the tooth is safe, because cracks can grow and infection can develop without warning.

Next step

If you have chipped, cracked or broken a tooth, call for emergency dentistry in Truro at 902-893-2919 for an assessment at Landmark Dental Care, 125 Queen St, Truro. You can also reach the team through our contact page. For difficulty breathing, uncontrolled bleeding, a suspected broken jaw or a head injury, call 911 or go to the Colchester East Hants Health Centre emergency department.

References

• American Association of Endodontists: Cracked Teeth
• ADA MouthHealthy: Dental Emergencies
• ADA MouthHealthy: Top Dental Symptoms
• Government of Nova Scotia: 811 Health Advice
• Nova Scotia Health: Colchester East Hants Health Centre
• Government of Nova Scotia: Children's Oral Health Program

This article provides general educational information and is not a diagnosis or a substitute for care from a dentist or other qualified health professional.