Chipped Tooth: Symptoms, Treatment, Causes

A chipped tooth happens when a portion of enamel breaks off. Larger chips occasionally cause pain and cosmetic concerns, although they are usually not severe. Seek treatment from a dentist immediately to prevent additional harm and properly address the condition.

A minor chip on a tooth, especially one not visible when the mouth is open, tends to go unnoticed. However, symptoms of a chipped tooth include feeling a jagged or rough surface when the tongue runs over the teeth, irritation of the gum around the chipped tooth, and irritation of the tongue from catching on the uneven edge. Pain or discomfort from pressure on the tooth when biting or chewing is particularly intense if the chip exposes the nerves within the tooth.

Chipped teeth result from various causes, including biting on hard substances like ice, hard candy, or bones, falls, car accidents, and playing contact sports without protective gear. Teeth grinding is another common cause. Certain factors increase the risk of chipping, such as tooth decay, cavities, large fillings, and enamel wear from acid-producing foods, acid reflux, or frequent vomiting due to eating disorders or excessive alcohol use. Natural ageing weakens enamel, making adults over 50 more prone to chipped teeth. A study published in the Journal of Endodontics found that nearly two-thirds of individuals with cracked teeth were over 50 years old.

The intensity, symptoms, and location of tooth damage dictate treatment. Smoothing and polishing are enough if the chip is minor and does not cause discomfort or inconvenience. Treatments are available for severe instances. Tooth reattachment involves glueing the shattered fragment back onto the tooth while keeping it moist in milk or saliva until dental care is available. Bonding uses composite resin or porcelain to contour and restore teeth. Custom-made porcelain veneers attach permanently to the tooth, needing little enamel removal. A laboratory or on-site custom fit is needed for dental onlays, which are put to the molars to repair partial tooth damage or crowns for more significant damage. These restorations last depending on dental function and oral hygiene.

Chipped teeth occur due to sudden trauma, injury, biting hard objects, or weakened teeth from large fillings or failed dental crowns. Teeth grinding (bruxism) is a chronic issue where people clench or grind their teeth due to stress, anxiety, sleep problems, or as a side effect of certain medications. The two dental issues require dental professionals to correct or treat them so as not to cause severe damage.

Research on broken teeth includes several important works. Gibbs initially identified Cracked Tooth Syndrome (CTS) as "cuspal fracture odontalgia" in 1954, and Cameron later renamed it "cracked tooth syndrome" in 1964. CTS is characterised by fractures originating from the crown and extending through the tooth. These fractures are classified as complete or incomplete, resulting in substantial discomfort. Herzl Chai, James J.-W. Lee, and Brian R In "On the Chipping and Splitting of Teeth." Lawn examined tooth fracture dynamics, particularly emphasising hard indenters' impact on human molars. Their findings revealed scallop-shaped chips that were influenced by the tooth's structure. The study gave insights into dental attrition in humans and other species. Ian Towle and colleagues' investigation of the teeth of Homo naledi revealed a high prevalence of chipped enamel, which implies that the diet of such a species was composed of hard, gritty objects such as underground tubers. The unique dietary adaptations of H. naledi compared to other hominins are underscored by such a distinctive dental wear pattern.

What are the Types of Chipped Teeth?

The different types of chipped teeth are listed below.

Cracked cusp: A cracked cusp is a dental condition where a part of a tooth's chewing surface (cusp) breaks or fractures. It occurs in molars and premolars, which bear the brunt of chewing forces. Cracked cusps are caused by biting down on hard objects, grinding teeth (bruxism), or trauma to the mouth. Sweets and acidic foods trigger discomfort, sensitivity to temperature changes, and sharp pain when biting or chewing. A cracked cusp leads to seriously damaging dental issues, such as infection or further tooth damage if untreated. Treatment involves dental procedures like bonding, crowns, or, in severe cases, root canal therapy to preserve the tooth's structure and function.

Split tooth: A split tooth is a serious dental condition where a crack runs from its surface to its roots, effectively splitting the tooth into two or more distinct segments. The condition arises from untreated dental cracks, significant trauma, or severe decay. Indications of a split tooth consist of intense pain when chewing, sensitivity to temperature changes, and discomfort when consuming sweet or acidic foods. A split tooth necessitates more extensive treatment, unlike a cracked tooth, which is reparable. Treatment methods include extracting the affected tooth and replacing it with a dental implant or bridge to restore structural integrity and aesthetics, contingent on the depth and position of the split. Early diagnosis and intervention are crucial to avert complications such as infection or damage to adjacent teeth.

Craze lines: Craze lines are minute, superficial fractures that develop on the enamel of teeth. There is no penetration of the deeper structures of the tooth by craze lines, unlike more severe dental fractures. These lines are frequently the result of normal wear and tear, habits such as teeth grinding (bruxism), or sudden temperature fluctuations from ingesting hot and cold foods and beverages. Craze lines are commonly harmless and do not substantially threaten dental wellness. They are sometimes more noticeable on the front teeth, causing cosmetic concerns. Treatment is not required unless the condition contributes to aesthetic considerations. Options such as dental veneers or teeth whitening must be considered to enhance the aspect of the teeth in such cases.

Cracked tooth: A cracked tooth shatters from the chewing surface to the root. Cracked teeth are held together, unlike split teeth. Cracks compromise enamel, dentin, and even pulp, varying depth, and position. Cracked teeth cause pain when chewing or biting, sensitivity to hot and cold temperatures, discomfort when eating sweet or acidic foods, and swelling around the tooth. The discomfort varies, making it hard to pinpoint the damaged tooth. Biting on hard foods or objects, mouth injuries, excessive tooth grinding (bruxism), and big fillings that weaken the tooth structure cause a cracked tooth. Crack severity and location influence rehabilitation. Minor cracks only need bonding or filling to repair the tooth. Crowns preserve teeth with larger cracks. Root canal therapy is necessary if the break penetrates the pulp. An extraction and dental implant or bridge are essential if the tooth is seriously decayed and unrepairable. Prevention of infection and tooth loss necessitates early detection and treatment. Get regular dental checkups to detect cracks early and maintain oral health.

What are the Symptoms of Chipped Tooth?

The symptoms of a chipped tooth are listed below.

Biting pain: Pain or discomfort from pressure on the tooth when biting becomes intense if the chip is near or touching the tooth's nerves. Misalignment results in pain and distress during the chewing or biting process. The improper alignment of the teeth results in additional tension in the jaw, resulting in headaches or other unpleasant symptoms.

Gum irritation: Irritation or discomfort in the gum area around the chipped tooth. Having crooked teeth for a long time causes jaw pain, irritated gums, and cheek injuries when chewing. Failure to address these symptoms leads to severe jaw discomfort, disc slippage, and gum problems, leading to tooth loss.

Tongue irritation: Irritation or soreness from rubbing the tongue on the tooth’s irregular and rough surface. Crooked teeth cause tongue soreness when their sharp edges or uneven surfaces scrape against the tongue. A constant rubbing causes discomfort, wounds, and irritation.

Jagged surface: A rough or uneven edge is felt when running the tongue over the teeth. Jagged teeth have irregular, sharp or serrated edges. Injury, chipping, or grinding (bruxism) induce such disorder, or it arises naturally due to genetics. Jagged teeth make oral hygiene difficult, increasing the risk of tooth decay and gum disease. Uneven surfaces irritate the mouth, cheeks, and gums, causing sores.

What are the Causes of Chipped Tooth?

The causes of a chipped tooth are listed below.

Injuries: Impacts on the face or jaw, such as falls, accidents, and sports injuries, cause parts of the enamel to break off. Injuries such as falls, accidents, and sports impacts exert significant force on the teeth, leading to chipped enamel. The pressure causes parts of the tooth's hard outer layer to break off if the tooth is weakened or vulnerable when a sudden blow or trauma occurs. These incidents often result in jagged edges, gum irritation, and potential exposure of the tooth's inner layers, necessitating prompt dental attention to prevent further damage or complications.

Biting or chewing hard items: A tooth chipped when biting down on firm foods, such as an apple or hard candy, or chewing on ice. Nailing gnawing chip nails. Biting or chewing on hard objects, such as ice, firm candies, or nuts, results in a chipped tooth by exerting excessive force on the enamel. Even strong enamel cracks under intense pressure or impact if the tooth is already compromised by decay or previous dental work. Jagged edges, sensitivity, and the potential exposure of the tooth's inner layers result from such action, producing cracks or chips. A failure to address such an issue promptly results in pain and further dental problems.

Teeth grinding: Teeth grinding exerts significant stress on the teeth, leading to cracks or chips. Bruxism, or the persistent clenching and grinding of teeth, frequently occurs unconsciously during slumber. The enamel is progressively worn down, and the teeth become more susceptible to damage due to the intense stress the repetitive force places on them. The continuous pressure results in cracks or chips, leading to jagged edges, increased sensitivity, and potential discomfort over time. Dental intervention is necessary to prevent further complications from tooth grinding, leading to significant dental issues, such as cracked or fractured teeth, if left untreated.

Tearing parcels with teeth: Many people have used teeth to open stubborn packaging quickly. However, using teeth as makeshift scissors leads to chips and breaks. The enamel is subjected to undue stress when teeth open shipments or packaging, which results in chips or breaks. The force needed to tear through tough materials exceeds the natural strength of the teeth if the teeth are already weakened. Dental treatment is necessary to repair damage caused by such practice, including exposure of the interior tooth layers, increased sensitivity, and jagged edges.

What are the Treatments of Chipped Tooth?

The treatments for chipped teeth are listed below.

Dental Cap or Crown: The dentist grinds part of the existing tooth and caps it with a crown, or tooth-shaped cap, to reinforce and improve its look if a big chunk falls off or with extensive decay. Permanent crowns are either metal porcelain bonded to metal, resin, or ceramic, each with specific advantages. Porcelain and resin crowns match the tooth, but all-metal crowns are stronger. The dentist or endodontist does root canal therapy, inserts a pin or post in the canal, and builds a sufficient foundation to support a crown if the top of the tooth is damaged, but the root is intact. The dentist cements the crown over the pin or post-retained repair. A crown takes two dentist appointments. X-rays are obtained at the first visit to evaluate tooth roots and bone. The dentist numbs the tooth and gum and scrapes off adequate teeth to place a crown if no other abnormalities are found. The dentist utilises filler material to rebuild the tooth and stabilise the crown if a break or chip has removed a considerable piece. The crown-receiving tooth and the opposite tooth (it touches while biting down) are imprinted with putty. Crowns are produced from impressions in a lab. The dentist puts an acrylic or thin metal temporary crown.

Dental Filling or Bonding: A dentist uses a filling to restore the damage if only a tiny portion of the tooth enamel is chipped. A bonding procedure involving a tooth-coloured composite resin is likely to be employed to repair a front tooth or a visible area when beaming. Bonding is a straightforward procedure that commonly does not necessitate tooth anaesthesia. The dentist roughens the tooth's surface with a liquid or substance to facilitate the adhesion of the bonding material. A tooth-coloured resin is applied to the tooth, followed by an adhesive material. An ultraviolet light is employed to solidify the dental bonding material after it has been shaped to resemble a natural tooth.

Root Canal Therapy: Bacteria from the mouth penetrate and infect the pulp if a tooth chip or break is large enough to expose the pulp, which is the tooth's interior containing nerves and blood vessels. Pulp injury or disease symptoms include tooth pain, discolouration, and sensitivity to heat. The tooth requires extraction if the pulp tissue expires and is not removed, as it becomes infected. Root canal therapy entails the removal of the dead pulp, the subsequent cleansing of the root canal, and the subsequent sealing of the canal. General dentists and endodontists are capable of administering root canal therapy. Most root canal procedures are not significantly more agonising than filling a cavity. A crown is required to cover the residual tooth to safeguard the now-weakened tooth.

Dental Veneers: A dental veneer enhances the appearance of a front tooth damaged or chipped, resulting in a more complete and healthy appearance. Porcelain or resin composite veneers are thin, tooth-coloured materials that cover the entire front of the tooth. It is similar to how an artificial nail covers a fingernail, with a thicker section that replaces the damaged portion of the tooth. The dentist removes approximately 0.3 to 1.2 millimetres of enamel from the tooth's surface to prepare it. The veneer is constructed at a dental laboratory after an impression of the tooth is taken. A return visit to the dentist is required for the installation of the veneer, which is completed within a week or two. The dentist initially uses a liquid to exfoliate the tooth's surface to roughen it. The veneer is subsequently affixed to the prepared tooth using a specialised cement. The dentist employs a specialised light to activate the compounds in the cement after the veneer is accurately positioned, accelerating its hardening process.

Can Chipped Tooth Be Treated At Home?

Yes, a chipped tooth can be treated at home, but only for temporary relief. Home remedies offer transient relief and protection for a chipped tooth; however, professional dental treatment is essential for proper repair and long-term health. The American Dental Association (ADA) recommends that if a tooth is chipped or broken, the affected area must be cleaned promptly with warm water, and pressure must be applied to prevent bleeding. Swelling is mitigated by using a cold compress. It must be wrapped in wet gauze and transported to the dentist if the fractured tooth is discovered.

Flushing the mouth with tepid water and applying cold compresses to the affected area alleviate pain and reduce swelling. Over-the-counter pain relievers and anti-inflammatories are permissible, provided they are administered in the prescribed dosage. Clove oil containing the numbing agent eugenol must be applied to the affected area for further pain relief. Dental wax is applied over a small fracture with a jagged edge to prevent it from cutting the tongue or damaging the mouth until a dental visit, thereby safeguarding the mouth. It is not advisable for larger chips or missing tooth sections, as it results in additional injury. Temporary dental wax packages are frequently available at drugstores for such a purpose. Refrain from gnawing on the side of the tooth that has been damaged, and floss around the tooth to alleviate pressure and irritation.

Urgent dental care is necessary for severe injuries, such as significant cracks that extend to the root or into the pulp chamber. These injuries are not always visible or symptomatic, and if left untreated, they lead to more severe complications. Extensive damage requires professional care to prevent further injury, discomfort, infection, or costly treatments such as root canals, although some minor cracks, such as craze lines, do not require immediate treatment. The American Dental Association (ADA) advises that in emergencies, such as a knocked-out tooth, the tooth must be located, if feasible, put back into the socket, and immediate dental care must be sought. Consult a dentist to ensure the appropriate diagnosis and treatment are administered, although temporary measures must be implemented at home to address a chipped tooth.

What are the Researches about Chipped Tooth?

The research about chipped tooth aims to discover the many causes of it and it’s origin. One research about chipped tooth is Cracked Tooth Syndrome (CTS). CTS is a fracture plane of unknown depth that originates from the crown, passes through the tooth structure, extends below the gum line, and interacts with the pulp space or periodontal ligament is called cracked tooth syndrome (CTS). Gibbs first identified CTS in 1954 as "cuspal fracture odontalgia," a condition characterised by incomplete fractures of posterior teeth. CTS causes excruciating symptoms even though the pulp and periodontium appear healthy. Cameron introduced the term "cracked tooth syndrome" in 1964. Maxwell and Braly promoted the term "incomplete tooth fracture" in the late 1970s, which Luebke subsequently classified as complete or incomplete. Split-root syndrome, hairline fracture, enamel infraction, and frenzy lines are additional related terms.

Another study on the chipping and splitting of teeth was conducted by Herzl Chai, James J.-W. Lee, and Brian R. Lawn. They investigate the mechanics of tooth fractures in the study "On the chipping and splitting of teeth," emphasising chipping and splitting in human molars. The use of hard indenters in chipping tests demonstrated the presence of scallop-shaped chips that were influenced by enamel anisotropy and tooth curvature. The research underscores that the critical loads for chipping are contingent upon the distance of the occlusal contact from the tooth edge, with higher loads potentially injuring dentin fractures. These discoveries offer a glimpse into the evolutionary history of dental attrition in humans and other species, emphasising the significance of comprehending tooth fracture mechanics in biological science and dentistry. The research entailed extensive in-situ fracture experiments on extracted human molars, with the support of grants from the National Science Foundation and the Israeli Science Foundation and the participation of various researchers and institutions.

Researchers have studied the Homo naledi’s teeth regarding chipped teeth. A high incidence of chipped enamel is indicative of a diet that includes hard and gritty objects, as evidenced by the teeth of Homo naledi. The consumption of underground plants, such as tubers, that are covered in dirt is suggested by dental injury. Ian Towle and colleagues conducted a study that revealed that 44% of H. naledi's teeth from the Dinaledi Chamber had fractures, with molars and premolars being the most affected. The chipping pattern suggests that the individual regularly chews on tough, abrasive meals compared to other hominins from the same region. The results, published in the American Journal of Physical Anthropology, underscore the distinctive dietary adaptations of H. naledi compared to ancient and modern human relatives.?

What are the Differences between Chipped Tooth and Grinding Tooth?

A chipped tooth and grinding tooth (bruxism) are two distinct dental conditions with different causes, symptoms, and treatments, although they exhibit some similarities. Acute incidents, such as trauma, injury, biting down on hard objects, or weakened teeth due to large fillings or unsuccessful dental crowns, are the most common causes of chipped teeth. Teeth grinding is a chronic condition in which individuals involuntarily clench, grind, or gnash their teeth. The behaviour is frequently induced by tension, anxiety, sleep disorders, or as a side effect of specific medications.

Localised pain, sensitivity to heat and cold, swelling, and bleeding of the gums are among the symptoms of a chipped tooth. The tooth sometimes exhibits visible fractures or sharp edges. Teeth grinding or Bruxism is distinguished by the presence of temperature-sensitive teeth, stiffness of the face and temples, earaches, jaw pain, and evidence of wear on the tooth enamel. Bruxism result in raised tissue inside the cheekbones, tooth indentations on the tongue, and cracked tooth enamel due to biting.

A cracked tooth is commonly treated with dental restorations, including veneers, crowns, fillings, or bonding, to restore its appearance and functionality. Seek immediate consultation with a dentist to prevent additional harm or infection. Managing bruxism involves using custom mouthguards to safeguard the teeth at night, stress management techniques, cognitive behavioural therapy, relaxation methods, and treating underlying sleep disorders. Dentists suggest patients reduce their teeth clenching and recommend regular exercise and good sleep hygiene.

Irritation and harm to dental health result from both conditions if left untreated. They share the commonality of necessitating professional dental intervention for effective management and treatment. Understanding the unique causes and suitable treatments for each condition to preserve the mouth's overall health. Bruxism is more closely linked to psychological and physiological factors. It necessitates a comprehensive approach encompassing dental and behavioural therapies. Fractured teeth are frequently the consequence of direct physical impacts.

Dentist Dr. Dt. Erdem CETIN

He started his professional career in a private practice in Antalya in 2005 and served there until 2012. Between 2012 and 2016, he continued his work as a partner at the institution named KlinikAntalya. In 2016, he founded Myra Dental Centre Turkey and continues his professional activities there. Additionally, he has strengthened his expertise in the field with his membership in the International Congress of Oral Implantology (ICOI).

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