Cracked or Chipped Tooth: What to Do Next

A chipped or cracked tooth can happen in a split second: biting an olive pit, catching an elbow during a pickup game, or crunching on ice. Sometimes the damage is obvious. Other times there is only a twinge when you bite or a sharp zing from cold water. This guide explains what to do right away, how to judge how quickly you need to be seen, the repairs dentists commonly use, and how to lower the chance of it happening again.

How this guide differs: this article covers what to do after a tooth cracks or chips and how a dentist decides on a repair. For details on one common repair, see our dental bonding guide.

Chipped vs cracked: why the difference matters

People use the two words interchangeably, but they describe different problems.

• A chip is a piece of the tooth that has broken off, often from a front tooth or the edge of a back tooth. Small chips may only affect the enamel and be mainly cosmetic. Larger chips can expose the more sensitive layer underneath.
• A crack is a fracture line running through the tooth. Cracks can be tiny and stay in the outer enamel, or run deeper toward the root. A crack can be hard to see, even for a dentist, and may show up only as pain when biting or when releasing a bite.

The depth of the damage matters more than how it looks. The ADA notes that the pulp, the soft tissue inside a tooth that contains nerves and blood vessels, can become infected because of a cracked or fractured tooth, or even an injury that leaves no visible crack (ADA MouthHealthy: Root Canals). That is why any broken or chipped tooth deserves a dental exam, even if it does not hurt.

What to do right away

The ADA’s first-aid advice for a cracked tooth is to rinse your mouth with warm water right away to clean the area, and to put cold compresses on your face to help keep swelling down (ADA MouthHealthy: Dental Emergencies). A few other practical steps:

1. Save any pieces. If a fragment broke off, put it in a clean container. Your dentist can tell you whether it is useful.
2. Check for bleeding and other injuries. Apply gentle pressure with clean gauze if the gum or lip is bleeding. If you hit your head or face hard, think about more than just the tooth.
3. Protect the area. Avoid chewing on that side.
4. Do not put aspirin on the tooth or gum. The ADA warns against putting aspirin on an aching tooth or gum tissue, and MedlinePlus notes it can irritate the tissue and cause mouth ulcers. If you take a pain reliever by mouth, follow the label and ask a pharmacist if you are unsure.
5. Call your dentist. The ADA notes that most dentists reserve time in their daily schedules for emergency patients, and recommends giving as much detail as possible about what happened.

How urgent is it?

Use this as a rough guide, and call your dentist if you are unsure:

• Go to an emergency room or call 911 for a facial injury with heavy bleeding that will not stop, a possible broken jaw, trouble breathing or swallowing, a head injury with confusion or loss of consciousness, or rapidly spreading swelling.
• See a dentist the same day if you can for a large break, a tooth that is loose or pushed out of position, a visible pink or red spot in the broken area (which can mean the inner tooth is exposed), severe pain, or swelling.
• Book a prompt appointment for a small chip with no pain, or a tooth that hurts only when you bite or drink something cold. These are not usually emergencies, but cracks can get worse with chewing, and bacteria can get in.

MedlinePlus explains that a tooth abscess can form when a tooth is broken, chipped or injured, because openings in the enamel allow bacteria to reach the pulp, and it recommends having any broken or chipped tooth examined right away (MedlinePlus: Tooth abscess). Our dental emergency checker and our guide to what counts as a dental emergency can help you decide.

If a whole permanent tooth has been knocked out, that is a different and more time-sensitive emergency. The ADA advises keeping the tooth moist, trying to place it back in the socket without touching the root if you can, or holding it between your cheek and gum or in milk, and getting to a dentist right away.

What the dentist will check

Expect the dentist to look closely at the tooth, ask what happened and when, and test how it responds to biting and temperature. X-rays are commonly used. Because some cracks do not show clearly on X-rays, the dentist may also use magnification, a special light or a dye to trace a crack line. They will also look for signs that the pulp has been affected.

Common repairs

The right repair depends on the size and location of the damage and whether the pulp is involved.

Smoothing or polishing

A very small chip in the enamel may just need the edge smoothed so it does not irritate your tongue.

Bonding or a filling

Many chips can be repaired with tooth-colored composite material shaped to match the rest of the tooth. MedlinePlus notes that composite resin is widely preferred today because it matches natural tooth color and is strong enough for back teeth (MedlinePlus: Dental cavities).

A crown

When a larger part of the tooth is broken, or a crack weakens the tooth, a crown can cover and protect what is left. MedlinePlus points out that large fillings and weakened teeth are at greater risk of fracture, which is one reason a crown is sometimes suggested for a heavily restored tooth. Our guide to dental crowns explains the types and what affects cost.

Root canal treatment

If the crack or break has reached the pulp, or the pulp has become inflamed or infected, the ADA explains that a root canal can repair and save the tooth instead of removing it. You may be referred to an endodontist, a specialist in the pulp and the tissues around the root. A crown usually follows. See our root canal guide.

Extraction

A crack that runs deep into the root, or splits the tooth, may mean the tooth cannot be saved. Your dentist will then talk with you about whether and how to replace it.

How to protect your teeth

The ADA’s prevention tips are simple and effective:

• Wear a mouthguard for sports and recreational activities.
• Avoid chewing ice, popcorn kernels and hard candy, all of which can crack a tooth.
• Use scissors, not your teeth, to open packages or cut things.

MedlinePlus lists grinding among the causes of toothache and notes that a dentist may recommend a special appliance to protect the teeth from wear (MedlinePlus: Toothaches). If you wake up with a sore jaw or your partner hears you grinding at night, mention it at your next visit.

Cost and finding a dentist

Repairs range from a quick polish to a crown or root canal, so cost varies widely. Our page on dental cost factors explains what drives the price. To find a general dentist or endodontist near you, use our dentist directory.

Frequently asked questions

Is a chipped tooth an emergency?

A small, painless chip usually is not an emergency, but it should be checked soon. A large break, severe pain, swelling, bleeding or a loose tooth calls for same-day care.

Can a cracked tooth heal on its own?

No. Teeth do not repair cracks the way bones heal. A dentist can stabilize or protect the tooth, and early treatment may keep a crack from spreading.

Why does my tooth hurt only when I bite?

Pain on biting, or when you release the bite, can be a sign of a crack. Tell your dentist exactly when the pain happens; it helps them find the problem.

Should I keep the broken piece?

Yes. Keep it in a clean container and bring it to your appointment. Your dentist will decide whether it can be used.

Sources

• ADA MouthHealthy – Dental Emergencies
• ADA MouthHealthy – Root Canals
• MedlinePlus – Toothaches
• MedlinePlus – Tooth abscess
• MedlinePlus – Dental cavities

By the Dentist Review Editorial Team.

This article is for general information only and is not medical advice. Talk to a licensed dentist about your own situation. See our disclaimer.

Featured image: “Mirror, dental (AM 1999.164.63-2)” by Auckland Museum, via Wikimedia Commons, licensed CC BY 4.0. Resized and compressed for the web.