A chipped tooth can drive you to despair.

A small break in a front tooth is normally repaired with a filling. The problem is when you bite down on food it constantly gets knocked, loosening over time. Then one day while you’re presenting to a room full of colleagues, the filling’s broken…again.

Brilliant. You look like a pirate in front of your boss and you need yet another trip to the dentist.

However, you’ll be glad to know there are long term solutions to help you avoid situations like these.  This will mean you’ll spend less money on repairs, less time missing work and ultimately, less time worrying if this will happen again.

In this article, we’ll briefly look at the causes of chips, and see long term treatments which are recommended for your chipped tooth.

Causes of a chipped tooth

photo of a man biting a pen

There are many reasons teeth break, from abnormal habits or accidents to having an unlucky bite. Here are a few of the most common:

  • Biting down on hard food
  • Trauma e.g. playing a sport or falling over
  • Grinding your teeth
  • Strange bite putting added pressure on points
  • Missing teeth putting area under extra biting forces
  • Large amalgam fillings putting stress on the enamel

Before we do anything, we need to assess why your tooth is chipping

If we don’t address the cause of your chipped tooth first then it’s likely whatever fix we do will fail.

Let’s say your child has thrown a toy car in your face (great shot) and it’s broken your front tooth. In this instance, there would be no problem just going ahead and fixing it. You’d hope it won’t happen again and were just unlucky. That or your child is the next Phil Taylor.

But, if we find out you’ve been drinking fizzy drinks for years and this has eroded your enamel away causing your tooth to chip, there is an underlying issue. If you don’t stop those fizzy drinks, the problem is just going to move around your mouth. Piece after piece is going to break.

So, first thing’s first it’s important we get down to the root cause of the problem.

A chipped tooth in enamel or dentine

diagram showing layers of a tooth

Once we know why your tooth is breaking, we measure how big that missing piece it.

Why?

A tooth has several layers. The outside layer of your tooth is made of enamel, then dentine and the furthest inside is the pulp.

How we provide long term treatment for a chipped tooth into enamel is different to dentine, as it is different to the pulp.

Now we know why your tooth is chipping and the depth of the breakage. Without further ado, let’s look at the treatments options you have…

Smooth or leave it

If the chip doesn’t bother you and it’s not detrimental to your health there’s nothing wrong with leaving it.

A tiny enamel chip on a pointy cusp of a back tooth, for example, is unlikely to get any worse or cause you any bother.

If it’s a small chip it’s unlikely to cause any long term harm but it can catch your lip or tongue. If this was causing you discomfort, it can be smoothed down slightly, although you’ll find it will smooth naturally over time.

Normally, we’d only leave a chipped tooth if it’s no deeper than the enamel layer. If the chip extends into the dentine you’ll get sensitivity and probably want it addressed.

Composite bonding

Isn’t this the same as the filling the dentist keeps sticking on my tooth I hear you say?

Well not exactly, if the bonding is done properly.

Composite bonding is the addition of white filling material (composite) over the broken part of the tooth to build up the shape to its former glory.

When it’s done properly, cosmetic bonding follows a strict protocol to ensure the filling doesn’t break again.

Firstly, for the composite to stick to your chipped tooth, the dentist needs to ensure the tooth is completely dry. They will use a rubber dam (a blue sheet) over the tooth for this. Secondly, they’ll spray sand particles over the tooth to roughen the surface and improve the bond between the tooth and composite. They’ll then use specific timings during the stages of bonding to ensure precision accuracy and give the chipped tooth the best chance of longevity.

If your dentist is doing the job in 5 minutes, the chances are it’ll fail.

Composite bonding for chipped teeth won’t last forever though. We’d normally say between 5-7 years but this is dependent on how well you look after it.

The beauty of composite is it can be used for small fillings or extended as a composite veneer over the whole surface. It’s mixed to the shade of your tooth and can easily be added to if it chips off. It’s a quick and easy treatment, often done without drilling or injections.

However, it’s success is highly dependent on the skill of the dentist and how well you look after it. For example, you can’t bite directly into hard food. It can also stain around the edges over time.

Crowns

diagram showing a crown for chipped tooth

Dental crowns, or caps as they’re sometimes known, are a covering which stretches over everything you see of a tooth above the gum.

When they’re fitted you will no longer see your natural tooth, just the crown.

Crowns stop teeth chipping by banding around the tooth. Because the tooth is completely covered there’s no way it can chip off.

This is the most robust and long term solution to chipped teeth. If you put a crown on a tooth, that tooth will not chip.

Crowns can be matched up to the shade of your neighbouring teeth to make them invisible.

One negative associated with a crown is the amount of your natural tooth that needs to removed to fit it in. This can lead to the tooth dying off in the future, and a possible root canal treatment.

You’ll need two appointments to complete a crown fitting.

Onlays

These fit over the top of the biting surface of a back tooth. It’s like a half-crown as it wraps down the sides, stopping part way before it reaches your gum line.

Again, it holds the weakened tooth together and stops pieces breaking off the sides, just like a crown would.

They can be a useful stage between a composite filling and a crown, and because there’s less tooth removal to place them, there’s less chance of problems in the future.

Veneers

diagram of a veneer

These are shells of porcelain cemented over the showing surface of front teeth, similar to when an acrylic nail is placed on your finger. It will cover both the chipped part and the healthy part to fill in the gap and give your tooth an aesthetic natural appearance.

This is completed over two appointments.

The first appointment the tooth may need a little preparation and reduction so the veneers don’t look bulky. The dentist will then place temporary veneers while the permanent ones are made. The temporary veneers are removed on the second visit and replaced with the permanent veneers.

Veneers only work if your bite is good. If your bite is out and you’re putting too much pressure on one then it can flick off as easily a filling. Luckily, there may be ways to persuade your dentist you’d like veneers if you’re not suitable straight away.

Finally

Whatever you do.

Make sure you see your dentist if you have a chipped tooth.

Although you may not have any initial pain, it’s best to get it checked. Because it’s OK today, it may not be tomorrow. Even if you don’t wish for treatment, your dentist will be able to monitor the tooth between check-ups to ensure it won’t get worse.

A little bit of sensitivity with a chipped tooth can be normal if the underlying tooth layer (called dentine) is exposed.

But if you feel anything more than sensitivity, any swelling, or if your tooth darkens over time, this could be a sign of bigger problems.


AUTHOR

Dr Gareth Edwards Dentist AuthorDr Gareth Edwards BDS (Hons) MFDS RCPS (Glasg)  qualified as a dentist with honours. He has a keen interest in aesthetic dentistry, composite bonding, and is a certified Invisalign and Six Month Smiles provider, practicing in the Bournemouth and Poole area. For more information click here.

 

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