Molar broken off
Who doesn't know this problem? Sometimes it happens very quickly - take a bite and it breaks off, the molar. Immediately you get annoyed that you have even eaten it. But that's not bad at all and, above all, not a rare problem. It happens to almost everyone at some point in their life. Often the tooth can be saved and the broken piece can simply be glued on again or replaced. Sometimes, however, a major treatment is necessary.
Read more on the subject in general: Broken tooth - you should do that immediately.
There are many reasons for this known problem, but they often last for a long time. In technical terms, a break in the tooth is called a "tooth fracture". An external force ensures that a molar yields and breaks. Typically, caries or a root canal treatment of the molar tooth beforehand reduce the stability. Teeth that already have a large filling often end up in such a position because they are no longer so robust.
Biting on a hard piece of bread, a nut, a core or a piece of candy is enough for the little mishap. Molars can also break off in an accident. Sports accidents, such as colliding with a teammate or opponent, are very typical here. However, a simple fall is often enough. The teeth then clench hard and the molar region can grind.
The affected patient usually feels and hears the fracture as soon as it happens. A faint or loud crack, a piece of the broken tooth in the mouth, or a sharp edge at the fracture site are typical signs.
The dentist examines the oral cavity and the individual teeth. In addition, a cold and percussion test is carried out to see how severe the damage really is. An x-ray of the tooth completes the diagnosis. The doctor can then decide which treatment method is best.
When do I have to go to the dentist?
No matter how the tooth broke off, you should visit a dentist or dental clinic as soon as possible. You can go to the emergency dental service on weekends and public holidays.
With a broken tooth there is always an increased risk of tooth decay and inflammation. The degree of injury can often not be assessed even with the naked eye.
What to do if the nerve is exposed
If the tooth breaks off in such a way that the nerve and blood vessels are exposed, this usually needs root canal treatment. If the tooth has broken off in such a way that the nerve and vascular chamber (tooth pulp) was only opened selectively and there is no contamination with bacteria, there is the possibility of direct capping. A drug (calcium hydroxide) is applied to the pulp, which is supposed to cover the wound by forming dentin and thus a root canal treatment is not necessary.
Since in most cases a contamination of the tooth pulp with saliva cannot be avoided, root canal treatment is the treatment of choice.
For more information, see: Course of a root canal treatment
Typically, patients report pain associated with the broken tooth. However, there are a number of other typical symptoms that can occur. Most of the time, sharp corners are created at the broken edges where the tongue can get caught. People like to play around on these edges, which can lead to the tongue becoming easily inflamed and painful.
If the broken piece is missing between the teeth, it can happen that various bits of food, especially meat fibers, accumulate there. These are often difficult to remove and you also have to use interdental brushes or dental floss. Bite, percussion and temperature sensitivity, especially to cold, occur when a large piece of the molar has broken out. Depending on the type of causal injury, it is even possible that the tooth is mobile and wobbles. This can sometimes make it feel like the tooth is too long or too short. This happens when the tooth is pushed out or in from its socket.
If a molar tooth breaks, the tooth can suddenly cause pain. This is the case when the fracture site is close to the tooth cavity and the "living tissue" of the tooth, i.e. the dentin, is affected. Sometimes even the nerve itself is exposed. If this happens and there is severe pain, treatment must be given as soon as possible. Otherwise the disease can spread even more and inflammation can develop around the root. As this can lead to major complications, it is advisable to see a doctor immediately.
Read more too Toothache and what you can do about it.
What can I do about the pain?
If there is pain in the broken tooth, action should be taken quickly. Not only does the aesthetics suffer as a result, there could also be further complications on the untreated tooth, which could worsen the prognosis.
For temporary pain relief, pain relievers such as ibuprofen or paracetamol can be taken. You can also cool the area so that there is no swelling. If the area is bleeding excessively, it can help e.g. biting a handkerchief to stop the bleeding.
Pain caused by a broken tooth cannot be relieved permanently without dental treatment. Therefore, a dentist should be visited as soon as possible.
Read more on the subject at: Paracetamol for toothache and ibuprofen for toothache
Can a molar break off without pain?
If only a small piece of hard tooth substance breaks off from the molar and the fracture gap is far away from the tooth nerve (in the tooth enamel), this often causes no pain. In many cases in which a tooth breaks off, it is a tooth that has already been filled over a large area. This does not cause any pain, as usually only a piece of the filling material breaks off.
Even when the hard tooth structure of teeth that have been treated with root canals is broken off, there is often no pain, as the nerve of the tooth has already been removed and therefore no pain is passed on or the tooth is filled.
Treatment can vary depending on the degree of the fracture. If there is only a simple fracture and the enamel is affected, one filling is often enough to preserve the tooth. Sometimes it is even possible to glue the broken piece back on. To do this, however, the fragment must be picked up immediately after the accident and stored in a tooth rescue box or in alcohol. The dentist should then be visited within the next few hours.
However, if the nerve is exposed due to a major loss of tooth structure, a root canal treatment is necessary. The bacteria that have penetrated the canal, which are always in the mouth, can otherwise lead to tooth inflammation. An abscess with pus formation would then be the result. Crowning is advisable when a root canal treatment has been performed and when a very large piece of the tooth has broken off. The stability of the natural substance is so severely limited at this point that there is no other way of preservation.
Read more on this topic: Pull molar tooth
When does the tooth need to be extracted?
Only a dentist can determine whether the broken tooth needs to be extracted after a clinical and X-ray examination of the affected tooth.
A deeply fractured tooth down to the root area is often a reason for an extraction, as the root surface can become inflamed. Furthermore, a broken tooth must be extracted if there is deep caries that can no longer be treated with a filling.
If the broken tooth also shows a strong degree of loosening (movable under pressure from the tongue) and can no longer be held by a splint, this can also be a reason for extraction.
If the broken tooth has already been treated with a root canal and is severely inflamed, this can also lead to the tooth having to be extracted.
Read more on the topic: Pull molar tooth
When do i need a crown?
A crown is always necessary when the broken molar has lost too much of its stability.Only the setting around the tooth can then protect the tooth from extraction, a drawing. This is the case, for example, if a root canal treatment has to be carried out on the molar. Since the nutrient supply is then cut off, the tooth can become brittle and an artificial crown may be necessary.
A special case is here when the tooth crown has broken off completely and only the tooth root can be seen. A filling can no longer do anything and the crowning with an additional root post is absolutely necessary. Even if the molar is cracked fairly deep, i.e. below the gumline, a crown is required. The filling therapy is no longer possible here either. The problem is that the exposed fracture point cannot be kept 100% dry. However, this would be absolutely necessary for the restoration therapy, since the restoration material only then becomes firm. The cement with which the crown is attached to the tooth stump also hardens with the addition of liquid.
Read more on the topic: Dental crown
The cost of the treatment can vary depending on the type and size of the broken piece. If only a small corner has broken off, it can be filled with, for example made of plastic, be replaced. Since this is a pure Private service is, the costs for a molar start at approx. 20€ per affected area. If the tooth is so badly broken that a crown is needed, the cost depends on the type and material of the crown. The cheapest version that Metal crown, deducted from the health insurance benefit, starts at around € 175. However, if a root canal treatment is necessary, the cost of the treatment and the price increase significantly. The health insurance company will only cover the root canal treatment in special cases of a molar. The attending physician should be asked about this. If the costs are not covered, you have to pay privately, this can in the worst case up to € 600 per tooth costs. A restoration of the broken off part with a filling or crown is also necessary here. The However, costs can vary widely from dentist to dentist, a comparison of several doctors is worthwhile from time to time.
Read more about the here Root canal treatment costs, Cost of a denture and Cost of a denture.
Why does a molar break more often after a root canal treatment?
If a tooth has been treated with a root canal, it becomes brittle and porous afterwards, as all supplying vessels (blood and nerve vessels) have been removed and the tooth is no longer supplied with nutrients. This means that it can break faster.
The dental guideline advises that teeth that have been treated with a root canal should be restored with a crown quickly after a root canal treatment has been completed in order to protect them from a fracture. If a tooth that has been treated with root canals fractures and the fracture gap is very deep, it may no longer be worth preserving and must be extracted.
Read more on the topic: Crown after a root canal treatment
Broken molar due to tooth decay
Tooth decay is an infectious disease. This means that once you have tooth decay, you will get it again and again. If several teeth are affected by the disease in one set of teeth, this is called "caries-active teeth".
In most cases, various factors come together here: a saliva quality that is favorable for tooth decay, inadequate oral care if the food is poor and a high number of bacteria. This explains why tooth decay occurs precisely when it is found elsewhere in the mouth. With regard to a tooth that has broken off due to tooth decay, it can be said that tooth decay occurs again on rough broken edges, since food residues can easily settle here. The same applies if the broken piece creates a trough in which leftover food can collect. The term secondary caries means that caries comes back at a point under a filling or crown where there was caries before. The problem here is that the dentist has not drilled out the caries enough. Then it can become active again under the new filling. This can be made visible on an X-ray and a renewal of the filling is then absolutely necessary.
Read more here
- Inflammation under a crown
- Tooth decay treatment.
Broken molar during pregnancy
It is also possible that a molar may break off during pregnancy. This is usually not a problem. The Treatment is the same as for non-pregnant women also. If there is no pain and little or no tooth decay, the piece can often simply be filled with plastic without anesthesia be offered. If there is pain when drilling or a root canal treatment is necessary locally anesthetized become. The important thing is that the dentist has the correct anesthetic, too Local anesthetic called, chooses so that no side effects occur. The attending physician must therefore be informed of the pregnancy before the anesthetic is injected. The same applies to an X-ray. The X-rays can be very harmful to the unborn child.