Broken or chipped tooth: what to do right now

What’s probably going on

A broken tooth can mean anything from a tiny chip you can feel with your tongue to a tooth knocked clean out. Roughly from least to most urgent:

• A small chip in the enamel. Often painless, just a rough or sharp edge. Annoying, but it can usually wait for a regular appointment.
• A bigger break or a broken-off corner. Common on back teeth with large old fillings. The tooth may be sensitive to cold, sweets or biting.
• A break that reaches the nerve. This often hurts a lot, especially when air or a drink hits it. It needs a dentist soon.
• A crack you can’t see. Sharp pain when you bite or let go, often hard to pin to one tooth. See cracked tooth.
• A tooth knocked out or pushed loose. An adult tooth knocked out is a true dental emergency. The steps below are time-sensitive.

How much it hurts isn’t a perfect guide to how bad it is. A painless break can still leave the tooth weak, so get it looked at even if it feels fine.

What to do right now

For a chipped or broken tooth that is still in your mouth:

1. Save the pieces. Rinse any broken bits and keep them in a small container of milk. A dentist can sometimes bond a large piece back on.
2. Rinse your mouth with warm water. This clears out grit and lets you see what happened.
3. Stop any bleeding. Press clean gauze on the spot for about 10 minutes.
4. Hold a cold pack on your cheek. It can ease pain and keep swelling down. A reusable face cold pack that wraps the jaw is easier to hold than a bag of peas.
5. Cover sharp edges. A small piece of dental (orthodontic) wax pressed over the edge protects your tongue and cheek.
6. Take an over-the-counter pain reliever as the label directs. Ask a pharmacist first if you take other medicines, are pregnant, or have stomach, kidney or bleeding problems.
7. Eat soft foods on the other side until a dentist has seen the tooth.

If a tooth is knocked out

Move quickly. The best chance of saving an adult tooth is getting it back in the socket within about 30 minutes, though teeth have been saved after an hour or more.

1. Pick it up by the top (the chewing part), not the root. The cells on the root are what let it reattach.
2. If it’s dirty, rinse it briefly with milk or water. No soap, no scrubbing, and don’t dry it or wrap it in tissue.
3. Try to put it back in the socket. Push it in gently with your fingers, or set it over the socket and close your mouth slowly. Bite gently on gauze to hold it.
4. If it won’t go back in, keep it wet. Put it in milk or an emergency tooth preservation kit, or hold it in your mouth next to your cheek. For a young child who might swallow it, use a little of their saliva in a container. Don’t store it in plain tap water.
5. Get to a dentist or endodontist right away, or an emergency room if you can’t reach one.

A knocked-out baby tooth is different. Don’t try to put it back. Most of the time no treatment is needed, but let your child’s dentist know.

What not to do

• Don’t use a temporary filling kit on a broken tooth. Kits such as Dentemp are made for lost fillings and loose caps, and the maker says a broken tooth needs a dentist.
• Don’t file or sand a sharp edge yourself. Cover it with wax and let a dentist smooth it.
• Don’t put aspirin on the gum or tooth. It burns the tissue.
• Don’t wait weeks because it stopped hurting. A broken tooth can keep cracking or let bacteria reach the nerve.

How a dentist fixes it, and what it costs

The repair depends on how much tooth is gone and whether the nerve is involved. A dentist will usually take an X-ray to check.

• Small chip: the dentist smooths it, or fills it with tooth-colored bonding. Often done in one short visit.
• Larger break on a back tooth: a filling, or a crown if a lot of the tooth is missing.
• Visible break on a front tooth: bonding, a veneer, or a crown.
• Break that exposes the nerve: a root canal, then usually a crown. See root canal cost and crown cost.
• Tooth broken too badly to repair: sometimes it has to come out. See tooth extraction cost.

The price swings from a quick smoothing to a root canal and crown, so ask for a written estimate before work starts. For a rough idea, try the dental cost estimator. If you don’t have insurance, a dental savings plan (a discount membership, not insurance) can lower the price at participating dentists.

How to keep it from coming back

Most broken teeth come from a hard bite, a hit to the mouth, or a tooth already weakened by a big filling or decay.

• Don’t chew ice, hard candy, popcorn kernels or pen caps.
• Don’t open packages or bottles with your teeth.
• Wear a mouthguard for contact sports, and make sure kids do too.
• If you grind or clench, ask about a night guard. See grinding and custom vs. over-the-counter night guards.
• Keep up checkups, so a tooth with a large old filling can get a crown before it breaks.

It also helps to have wax, gauze and a lidded container ready before you need them. See build a home dental emergency kit.