A broken tooth is a partial or total fracture of the tooth structure (enamel, dentine and sometimes pulp). It is a common problem, especially in molars, as they bear the greatest forces during chewing.

A tooth fracture can occur suddenly or gradually and, in many cases, can cause pain and complications that require prompt intervention. Early diagnosis of such a lesion is important to prevent the lesion from spreading to the dental structures, thus avoiding the extraction of the tooth in question.

A tooth fracture usually occurs when its structure is weakened or subjected to excessive forces.  

The most common causes are:

Tooth decay - destroys the enamel and dentine, making the tooth fragile. A decayed and broken tooth is a common consequence of untreated tooth decay. In advanced cases, root canal treatment may be necessary to preserve the affected tooth in the arch.

Physical trauma - blows, falls, accidents or strong bites can lead to fracture lines on all teeth, especially molars.

Chewing hard foods (nuts, ice) or bad habits such as teeth grinding (bruxism) increase the risk of tooth fracture. 

A broken tooth may be easy to overlook at first, but the symptoms become apparent as the problem progresses.

The main symptoms are:

• Spontaneous pain or pain when chewing - a typical sign of a painful broken tooth
• Sensitivity to hot, cold or sweet foods
• Inflammation of the gum around the affected tooth 

If you are dealing with a broken tooth, you should know that treatment depends on the severity of the dental fracture and the condition of the dental pulp.  

"In the case of minor dental fractures, the simplest method of restoration is dental fillings or dental inlays or onlays. These are prosthetic pieces that do not require root canal treatment and are used to restore the shape, function and aesthetics of a broken tooth. However, in the case of an advanced dental fracture, when the fracture line reaches deep into the dental structures, root canal treatment is recommended. In this way, we can restore the broken molar with a dental crown, the major advantage being that the unaffected hard dental structures are preserved in the long term," explains Dr. Mihnea Grigore, dentist at DENT ESTET clinics.

In severe cases, when the fracture line also affects the root of the tooth, the only recommended treatment is tooth extraction, as it becomes impossible to preserve the tooth without sufficient bone support to sustain a prosthetic restoration such as a dental crown.

Rapid assessment and diagnosis by a dentist are essential to prevent infection and tooth loss. 

Prevention is the safest way to avoid unpleasant situations, such as a broken tooth or a painful toothache. Dental prophylaxis plays an essential role, which involves regular check-ups at the dentist, professional scaling and, when necessary, radiological investigations to detect weak or damaged teeth early on.

It is also important to avoid very hard foods, such as ice, hard candies or the very hard shells of some foods, which can lead to cracks or fractures in the teeth, especially in the case of teeth that have already been treated or are loose.

In addition, the use of a protective dental guard is recommended both in contact sports and for patients suffering from bruxism. This helps to protect the teeth against excessive forces and significantly reduces the risk of tooth fractures.

It is recommended that you consult your dentist if symptoms such as the following occur:

• persistent pain or increased sensitivity to hard, cold or sweet foods
• if fracture lines are visible to the naked eye, usually during brushing
• swelling or bleeding localised to the affected tooth
• if the cavities are in an advanced stage and cause slight "grinding" of the hard tooth structure 

Frequently asked questions about broken teeth

What should you do if you have a broken tooth?

Make an appointment with your dentist as soon as possible and avoid chewing on the affected side.

Can a broken tooth become painful?

Yes. A broken tooth can become painful, especially if the dental pulp is exposed.

Can a decayed tooth break?

Yes. Untreated cavities weaken the tooth and often lead to decayed and broken teeth.

How can tooth fractures be prevented?

Through regular check-ups, proper oral hygiene and avoiding risk factors.

Does a broken tooth need to be extracted?

Not always. Often, the tooth can be saved through direct or indirect restorations that also require root canal treatment.

1. A. Banerjee, T. F. Watson - Cracked Tooth Syndrome: Etiology, Diagnosis, Management, and Prevention, British Dental Journal, 2010
2. C. E. Cameron - The cracked tooth syndrome: Additional findings, Journal of the American Dental Association (JADA), 1976
3. Cracked Teeth. Online professional guide, American Association of Endodontists (AAE)
4. Seo, D. G., Yi, Y. A., Shin, S. J., et al. - Treatment of cracked teeth: A comprehensive narrative review, Restorative Dentistry & Endodontics, 2018