Why does a tooth chip or crack?
According to the American Association of Endodontists (AAE), chipped teeth account for the majority of dental injuries. The main causes of chips and cracks are:
- Biting on something hard: the AAE names ice, unpopped popcorn kernels and pens as risk factors for cracks.
- Grinding and clenching: the AAE recommends avoiding both to lower the risk of cracks.
- Large fillings: according to the AAE, a cusp of the chewing surface usually breaks off near a filling.
- Root-treated teeth: in the study by Ng and colleagues (2011), tooth and root fractures were among the common reasons why root-treated teeth were extracted; more in our guide how long does a root canal treated tooth last.
A chip or crack can affect the tissue of nerves and blood vessels inside the tooth (the pulp); the NHS counts chips, breaks and cracks among the causes of pulp infection.
How do you recognise a cracked tooth?
Large breaks are obvious; cracks are more deceptive. According to the AAE, typical signs are:
- erratic pain when chewing that comes and goes, often when biting pressure is released
- sensitivity to very hot or cold food and drink
- difficulty telling which tooth hurts, because the pain is not constant
The AAE explains that chewing moves the edges of the crack and irritates the pulp. Over time the pulp can be damaged to the point where the tooth hurts even without chewing; with extensive cracks, the infection can spread to the bone and gum.
Diagnosis is not always straightforward. The AAE’s 2022 continuing education article notes that a crack may be invisible clinically or on an X-ray, so dentists also use bite tests on individual cusps, transillumination, dye staining, magnification and measurement of the gum pockets.
What should you do at home until you can see a dentist?
The first step is a prompt appointment. The recommendations of the American Dental Association (ADA), the NHS and the AAE can be summarised like this:
- Rinse your mouth: the ADA recommends rinsing immediately with warm water after a tooth cracks.
- Save the fragment: NHS 111 Wales advises putting a large broken piece in milk or saliva and taking it with you. According to the AAE, the fragment can sometimes be reattached.
- Control bleeding and swelling: the ADA recommends a cold compress on the face to limit swelling.
- Do not chew on that side: NHS 111 Wales recommends soft foods and avoiding very hot and cold food and drink.
- Take painkillers correctly: NHS 111 Wales names paracetamol or ibuprofen, taken according to the packet; your pharmacist can advise which suits you.
- Do not put tablets on the gum: the ADA advises against placing aspirin on the aching tooth or gum.
Outside opening hours, contact your local emergency dental service.
What applies to a knocked-out or loosened tooth?
Here time matters. The AAE recommends reaching a dentist with a knocked-out permanent tooth ideally within 30 minutes. The advice of the NHS and the AAE:
- Hold the tooth only by the crown, never by the root.
- Do not clean it; if it is dirty, rinse it briefly in milk, saline or saliva, according to the NHS.
- If possible, push it gently back into the socket and hold it by biting on a clean cloth. If that is not possible, keep it in milk or saliva until you reach the dentist.
- Leave a loosened or displaced tooth alone and bite together only carefully.
Baby teeth are different: the NHS and the AAE advise against replanting a knocked-out baby tooth, because this can damage the permanent tooth developing underneath.
Loosened permanent teeth are repositioned and splinted at the dental practice; according to the AAE, root canal treatment is usually started several days after the injury. The AAE recommends check-ups for up to five years to watch for root resorption. These check-ups can take place at home.
When does the case belong in an emergency department?
A broken tooth is usually treated at a dental practice or by the emergency dental service. The NHS recommends the emergency department if toothache comes with swelling around the eye or neck, or if swelling makes it hard to breathe, swallow or speak. According to the ADA, if you suspect a broken jaw, apply a cold compress and go to a dentist or hospital emergency department immediately. With severe facial trauma, persistent bleeding or difficulty breathing, call your local emergency number.
How does treatment depend on the type of break?
The AAE classifies chips and cracks as follows; treatment follows this classification:
| Type | Description | Usual treatment |
|---|---|---|
| Craze line | fine line in the enamel only, causes no pain | no treatment needed |
| Small chip | piece missing from the edge of the tooth | reattach fragment, tooth-coloured filling or crown |
| Fractured cusp | part of the chewing surface missing | new filling or crown |
| Cracked tooth | crack from the chewing surface towards the root, parts still joined | root canal treatment and crown if the pulp is affected; extraction if the crack extends below the gum line |
| Split tooth | parts can be separated | cannot be saved whole; sometimes part of the tooth can be kept |
| Vertical root fracture | crack starts in the root | extraction or, where possible, surgical removal of the fractured root portion |
According to the AAE, a large break often needs a crown, and an exposed or damaged pulp needs root canal treatment. NHS 111 Wales describes the typical sequence: at the urgent appointment, the fragment is reattached or a temporary filling placed; later come the permanent filling, crown or root canal treatment, and a tooth that cannot be saved is removed. The criteria for keeping a tooth are explained in our guide root canal treatment or extraction.
Does a cracked tooth heal after treatment?
According to the AAE, a crack does not knit together like bone. Treatment aims to relieve pain and make it less likely that the crack progresses; some cracks progress anyway. A crown offers the most protection, according to the AAE, but does not guarantee success; most treated teeth, however, function comfortably for years.
The AAE’s 2022 article highlights:
- cracked teeth should be crowned as early as possible; this improves survival
- in one cited study, about 80 percent of cracked teeth with reversible pulp inflammation, no findings at the root tip and an immediate crown never needed root canal treatment
- root canal treatment of cracked teeth is more successful than previously assumed
- a gum pocket of 5 mm or more at the crack lowers the chance of survival
For prevention, the AAE advises not biting on hard objects, a night guard if you grind, and a mouthguard for contact sports.
What does this mean for treatment in Türkiye?
A chipped tooth is a case for a dental practice or emergency dental service near you, not for a flight: the initial care with the fragment, a temporary filling or a splint should happen at home. What can be planned is the final restoration, such as a crown, root canal treatment with a crown or, if the tooth cannot be saved, extraction and later replacement. For this, send us photos of the tooth and, if available, the X-ray from the emergency treatment on WhatsApp at +90 532 363 49 54; we communicate in English and German. Ask the dentist at home how long a temporary should last, so that your trip fits within that window.
At our clinic in Serdivan, the position and depth of the break are examined; if a crack or root fracture needs to be clarified, a cone-beam CT (CBCT) scanner is available. A crown is usually completed within one stay; the number of root canal sessions depends on the case. Before treatment starts, you receive a written treatment and cost plan; when you leave, a treatment summary and copies of your X-rays for your dentist at home. Details of the treatments are on our pages root canal treatment, zirconia crowns and tooth extraction; injuries in children are covered in our guide dental injuries in children.