Introduction
It is not uncommon for patients to suddenly discover that a tooth has broken off. See matching: Canine tooth broken off. Nevertheless, a dentist must be consulted as soon as possible.
The dentist may be able to reattach the broken tooth (or piece of tooth) or replace it with a suitable filling material. It is recommended to keep the piece of the tooth in case of an abortion and to bring it to the treatment appointment. If the piece of broken tooth is swallowed or lost, the only remaining option is a new filling or a crown. Frequently the incisors are affected by falls. If the defect is not clearly visible, most of those affected feel the broken edges with their tongue: they perceive that the tooth no longer feels as it used to.
Causes
A tooth can break off for various reasons: By far the most common is in connection with an accident, in which very strong forces act on the tooth substance. Sports accidents top the list of possible causes. Many of those affected report that they slipped off their lips while drinking from a heavy glass bottle and the bottle then bounced against the tooth.
In addition, many patients in dental surgeries report that a spoon has bounced too hard on their teeth or that they have bitten a hard object (bone or candy). In addition, teeth that have already been filled with roots are particularly often affected. This is due to the fact that during root canal treatment both the nerve branches and the blood vessels have to be removed from the inside of the tooth.
Sooner or later this leads to a reduced supply of the tooth substance, which then becomes porous and unstable. The same risk applies to root-resected teeth. Furthermore, many broken teeth are teeth that have had to be provided with a lot of filling material due to an extensive carious defect (caries).
The dentin is one of the hardest and most resistant materials and can therefore withstand particularly high forces. However, if a carious defect requires a lot of dentin to be removed and replaced by an artificial material, the resistance of the affected tooth is automatically reduced and it tends to break off much more easily. Caries can often cause a piece of the tooth to break off.
This can happen in two ways. Firstly, the tooth can be very badly damaged by caries. In this case the outer tooth substance is attacked, perhaps the bacteria have already penetrated to the inside of the tooth.
As a result of this attack, the tooth is no longer as strong, since the substances that give stability are weakened or have disappeared. Now it can happen that a piece of the tooth breaks off during chewing. Another case is when a tooth, which was exposed to strong carious influences in its past, has been treated with fillings.
The caries has been removed and the areas have been filled with a special material. But even at these repair spots, the tooth can break off, because the spot was added afterwards and thus represents a weaker point in the tooth than when everything is made of a natural material, like enamel. If the caries was already so advanced that a root canal treatment was carried out, it is not uncommon for the tooth to be broken off, because such a tooth is more unstable and more susceptible to breakage due to the lack of the supplying vessels.
After a root canal treatment, a tooth becomes brittle, since all the supplying vessels (blood and nerve vessels) have been removed from the pulp. Because the tooth is no longer alive and supplied with nutrients, it can break more easily. The dental guideline advises to crown root canal treated teeth quickly after the completed root canal treatment to protect them from fractures.
Once fractured, the root canal can break off so deeply that it is no longer worth preserving and must be removed. This diagnostic decision is made by the dentist according to the location where the tooth is fractured. The boundary is the enamel-cement boundary, which marks the transition between the crown and the root of the tooth.
If the tooth is not fractured below this limit and the tooth can still be tolerated in its biological width, it can still be treated.After a root-filled tooth has been broken off, the treatment consists of restoring the broken-off part as quickly as possible so that other parts of the tooth do not break off. The tooth is built up with plastic or cement beforehand and the broken-off part is replaced by a filling material. Afterwards the tooth must be restored with a crown as quickly as possible.
Furthermore, a pin is often inserted into the root-filled tooth to protect the tooth from peeling forces. This pin can be a glass fibre pin or made of cast metal. The crown form is then prepared on the post, which is cemented into place, and finally the crown is attached to it. As a rule, the broken tooth does not cause any pain after the root canal treatment, as it is not vital and does not feel any irritation. Pain is more likely to be caused by the surrounding tissue, which may be irritated by the fracture.
