Chipped tooth

The enamel is the protective outer covering of the teeth. While the enamel is the hardest part of the body, it has its limits, as excessive wear and tear or a forceful blow can crack the enamel, causing a chipped tooth. This results in an uneven tooth surface that can be sharp, disfiguring and tender.

Causes of chipped teeth

Chipped teeth can occur for several reasons. The common causes include:

• Grinding your teeth while sleeping
• Car accidents or falls
• Biting down on hard substances like hard candy or ice
• Playing contact sports without a mouthguard

Risk factors for chipped teeth

Weakened teeth are more likely to chip, and your teeth can become weak from:

• Teeth grinding that wears down the enamel
• Tooth decay and cavities that erode the enamel- large filling also weaken the teeth
• Eating lots of foods that produce acids, like fruit juices, spicy foods and coffee, can break down the enamel and expose the teeth' surface
• Heartburn or acid reflux can cause stomach acid can come up into the mouth, causing damage to the tooth enamel
• Excessive alcohol use or eating disorders can cause frequent vomiting, which leaves enamel-eroding acid in the mouth
• Sugar produces bacteria in the mouth which can attack the enamel
• Tooth enamel wears down over time as you grow older, so if you are age 50 or above, your risk of having weak enamel increases

Which teeth are likely to chip?

A weakened tooth can chip at any time, but a study showed that the second lower molar is likely to chip, because it accommodates considerable pressure when chewing. Teeth with filling are more likely to chip, but intact teeth can also chip.

Symptoms of chipped teeth

You may not easily notice the chip if it is minor and isn't at the front of your mouth.   Symptoms may not occur, but when they do, they include:

• Pain from pressure on the tooth, whenever you bite down, may be intense if the chip exposes the nerves of the tooth or exposes them
• Tongue irritation from feeling the tooth's rough and uneven edge
• Gum irritation around the chipped tooth
• Feeling a jagged surface when running your tongue over your teeth

Diagnosing a chipped tooth

Your dentist may diagnose a chipped tooth through an inspection of your mouth. The dentist will consider your symptoms and ask about the events that may have caused the chip.

Treatment options for chipped teeth

The treatment for a chipped tooth depends on its severity, symptoms and location. Except the chip is causing severe pain and significantly interferes with sleeping and eating, it isn't a medical emergency

However, you still need to schedule an appointment with your dentist as soon as possible to prevent infection and further damage to your tooth. Treatment for a minor chip often involves smoothing and polishing the tooth, but the doctor may recommend the following for a more extensive chip.

• Tooth reattachment

If you are still with the tooth fragment that broke off, put it in a glass of milk to keep it moist, and the calcium in the milk will keep the tooth alive. If you do not have milk, tuck the tooth into your gum, but do not swallow it.

Go to your dentist immediately so they can cement the fragment onto your tooth.

• Bonding

The dentist will cement a porcelain or composite resin material to your tooth surface and shape it to your teeth' shape, then harden and dry it with UV lights. After drying the material, the dentist may further shape it to fit your teeth. Bonding can last for about ten years.

• Porcelain veneer

Before attaching the veneer, the dentist will remove a small part of the enamel, usually less than one millimetre, to create room for the veneer.

Your dentist will take your tooth impression and send it to the lab to make your veneer. You may get a temporary veneer until the lab-made veneer is available. Veneers are durable and can last about 30 years.

• Dental onlays

If the chip affects a part of your tooth, the dentist may recommend a dental onlay. This dental restoration is usually placed on the surface of the molar. However, the dentist may suggest getting a dental crown if the damage is extensive. The procedure may need anaesthesia.

In most cases, the dentist will take your tooth mould and send it to the lab to create your onlay. When the onlay is available, the dentist will cement it on the damaged tooth.

Advanced technology allows some dentists to make porcelain onlays in their offices and fit them on the same day.

Your dental onlay can last over ten years, depending on whether you eat foods that wear or tear the onlay and the affected tooth. For example, a tooth that gets a lot of pressure when chewing, like the molar, will wear faster.

Dental costs

The cost varies significantly depending on where you live, but other factors are the extent of the chip, the damaged tooth, and whether or not the pulp is affected.

Generally, the cost includes:

• Tooth planing and smoothing – about £80
• Tooth reattachment – payment for a dental exam is between £40 - £280, and the dentist's fee, which isn't much
• Bonding - £80 - £800, depending on the complexity
• Veneers or onlay - £400 - £1600, depending on the material used and the extent of tooth preparation needed before fixing the onlay or veneer

Care for chipped teeth at home

You will likely need to visit the dentist to repair a chipped tooth, but the following can help reduce injury to the tooth until you see your dentist.

• Place a temporary dental filling material, sugar-free gum, dental wax or teabag over the rough edge of the tooth to protect your gums and tongue
• Wear a protective mouth guard when playing sports or at night if you grind your teeth
• Take anti-inflammatory painkillers like ibuprofen (Motrin IB, Advil) if you are in pain
• Place an ice pack on the outside of your cheek if the chipped tooth is irritating that area
• Floss to remove small food particles between the teeth that may cause more pressure on the chipped tooth while chewing
• Avoid chewing with the chipped tooth

Complications of a chipped tooth

An infection may be present if the chip is extensive and affects the tooth root. The treatment often involves a root canal. The symptoms of an infection include:

• Fever
• Sensitivity to cold and hot
• Pain when eating
• Sour taste in the mouth or bad breath
• Swollen glands in the jaw or neck area

If you have a chipped tooth and require immediate dental care, visit McKennell Dental Practice or contact us at 02078348802 for an appointment with our dentist.