What should I do if I have a chipped tooth?

Management of a Chipped Tooth

For a chipped tooth, immediate referral to a dentist within a few days is recommended for proper assessment and restoration with tooth-colored dental material. 1, 2

Assessment of Chipped Tooth Severity

The management depends on the extent of the damage:

Uncomplicated Fractures (No Pulp Exposure)

• Enamel-only fracture:

  • Minimal sensitivity
  • Can be smoothed with a dental handpiece and polishing bur
  • No immediate referral needed if fracture site is smooth to touch 1
  • Should be monitored for signs of pulpal necrosis

• Enamel and dentin fracture:

  • May cause tooth sensitivity
  • Requires referral to a dentist within a few days
  • More sensitivity indicates more urgent need for dental care 1
  • Covering exposed dentin reduces discomfort and risk of bacterial contamination

Complicated Fractures (With Pulp Exposure)

• Requires immediate dental referral
• Pulp therapy needed to preserve pulp vitality
• For primary teeth: pulpotomy or pulpectomy is indicated
• For permanent teeth: treatment depends on root maturity 1, 2

Immediate Self-Care Measures

While awaiting dental care:

• Rinse mouth gently with warm water
• If bleeding occurs, apply pressure with clean gauze
• Take over-the-counter pain relievers if needed
• Avoid extremely hot, cold, or sweet foods that may cause sensitivity
• Cover any sharp edges with dental wax (available at pharmacies) to prevent soft tissue injury 3

When to Seek Emergency Care

Immediate dental care is needed if:

• The fracture exposes the pulp (pink or bleeding tissue visible)
• The tooth is severely mobile or displaced
• There is severe pain or swelling 1
• The injury is accompanied by other facial trauma

Long-Term Considerations

• Untreated chipped teeth can lead to:
  • Increased sensitivity
  • Risk of pulpal necrosis
  • Potential for bacterial infection
  • Further tooth structure loss 4, 5

Special Considerations for Children

• Child abuse should be considered as a possible etiology in children younger than 5 years with severe tooth injuries 1, 2
• Primary (baby) teeth are managed differently than permanent teeth
• For primary teeth with minor fractures, if the child's behavior precludes restorative care, the tooth can be monitored if the fracture site is smooth 1

Prevention of Future Dental Injuries

• Use mouthguards during sports activities
• Address habits that may damage teeth (e.g., ice chewing, using teeth as tools)
• Regular dental check-ups to identify and address weakened teeth

Remember that even minor chips should be evaluated by a dentist, as they can potentially lead to more serious dental issues if left untreated 5. The timeliness of treatment is important for preserving tooth structure and preventing complications.