The Fractured Tooth

The Fractured Tooth

Top 7 reasons why teeth chip and break:

  1. Tooth Decay- slowly eats away and softens the remaining tooth structure making it more liable to break.
  2. Filling too large- tooth colored fillings are a great option for small to medium sized cavities. But large fillings will always be prone to further fracture.
  3. Over Loaded- if you have missing teeth, the tooth adjacent to the gap may be taking more than its share of chewing load.
  4. Bite Issues- Clenching, grinding or if your bite in general is not a balanced one, you may notice regular chipping and breaking down of several teeth.
  5. Trauma- accidental damage to teeth can occur with high impact causing fractures.
  6. Neglected Oral Hygiene- if a particular part of a tooth is not mechanically cleaned every day with a toothbrush and floss, food and plaque can remain for weeks in the neglected area causing acid build up and destruction of tooth structure.
  7. If you genetically have softer enamel, then your teeth may always be prone to decay or fracture. Extra vigilance is necessary. Toothmousse Plus or dentist prescribed high Fluoride toothpaste can help in remineralising your enamel. Along with xylitol based chewing gum to increase the alkalinity of your saliva.

Options for restoring fractured teeth:

  1. Amalgam filling if you are not averse to the mercury contained in them. Although strong, they tend to contract and expand with heat and chewing over time to cause crack lines in your tooth that can be catastrophic to further fracture.
  2. Tooth Colored filling if the fracture is small to medium sized this is a great option to seal your tooth. Although over time they may discolour, stain, chip and wear down.
  3. Tooth Colored Porcelain or Gold Onlay if over 1/3rds of the tooth is broken this is a great option to seal and protect your tooth. It is a conservative option retaining most of your good tooth structure for the onlay to sit against. It is stronger and more durable in material than fillings. More polished a finish to attract less plaque and does not stain or discolour over time. It is also less prone to wear and fracture than tooth colored fillings.
  4. Full Coverage Crown made of Porcelain, Gold or Zirconia if over 2/3rds of the tooth is broken. This can help cushion the tooth from further catastrophic fracture.
  5. If however your tooth has broken way beyond the gum margin, the prognosis gets worse for longevity with any form of restoration. Sometimes gum surgery is necessary to expose the tooth margin. Sometimes root canal therapy or extraction and implant or bridge may need to be considered.

SmartDentist® offers a variety of options for your broken tooth including tooth colored composite fillings, lab made crowns, and ONE appointment Digital Onlays and Crowns. For Digital Crowns we use state-of-art scanning technology and in-office milled porcelain or zirconia for your comfort and convenience.

Having used CEREC CAD/CAM scanning technology for close to 10 years, we find that treating a broken tooth in one appointment with a digital onlay or crown reduces post-operative discomfort as the tooth gets permanently sealed and protected at once without unnecessary delays with temporary crowns and repeat appointments. However, in some circumstances we may recommend lab made crowns or veneers depending on your unique situation. Choosing a more durable option also means better chewing for you with more comfort and less expense in the long term.

-Dr Ginal Bilimoria

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