Question 1

How does tooth repair work?

Accepted Answer

Teeth can’t heal themselves. Luckily, dentists have a variety of ways to repair teeth that have been damaged due to trauma, disease, or poor oral care habits.

The key to an effective repair is figuring out why the tooth broke before deciding how to fix it, says Dr. Steven Davidowitz, a dentist in New York City. “If teeth are weak from misalignment, clenching, and grinding or from acid, bonding, a veneer, or a crown is not the definitive answer.” He points out the need to set up preventive treatments, to avoid further damage. For instance, if your teeth are prone to chipping, you should have a full exam to be sure the chipping isn’t the consequence of a bigger problem, like your overall bite or a subconscious grinding habit.

Retired Chicago dentist Dr. Neal Nealis concurs: while most teeth problems can be fixed, “it’s more important to discuss with your dentist what you can do to prevent future damage. A dentist’s filling materials are never as good as the original tooth.”

Here’s how common dental problems can be repaired.

Question 2

Tooth decay repair

Accepted Answer

Tooth decay is a progressive disease caused when the outer layer (enamel) is compromised and the tooth is exposed to harmful bacteria. Tooth decay leads to cavities, permanently damaged areas that create holes as the decay works its way through your tooth structure.

Enamel has no living cells, so, unlike bone, it can’t grow back or heal itself. However, “weakened enamel can be ‘restored’ to some degree, by improving its mineral content through the use of oral hygiene products that contain fluoride,” says Dr. Davidowitz. “Although toothpaste and mouthwash can never ‘rebuild’ teeth, they can contribute to this remineralization process and help fortify the enamel to fight off further degradation.”

Remineralization may help stave off tooth decay, but once it reaches the dentin, the layer beneath the enamel, your dentist will need to repair the damage with a filling. During this procedure, the dentist will clean away the decay inside the cavity to prevent further damage, usually with a drill, before filling it in to replace the part of the tooth destroyed by decay.

If decay has caused the tooth to lose a lot of its structure, your dentist may need to do a dental crown. A cover or “cap” that’s put over what remains of a tooth, a crown makes the tooth stronger and improves the way it looks.

If decay reaches the pulp, the soft tissue inside the tooth, a root canal may be necessary. During a root canal, your dental provider (often a specialist called an endodontist) removes the inflamed or infected pulp, cleans and shapes the inside of the tooth, then fills and seals the space. Depending on the location of the tooth, you may need a crown or other restoration on the tooth so that it functions like any other tooth.

Question 3

Tooth enamel repair

Accepted Answer

While minor damage to enamel can be restored with remineralization treatments, more advanced damage requires more advanced treatments.

Small enamel defects can often be filled in with cosmetic dental bonding, during which a tooth-colored composite resin is tacked onto the tooth or used to fill in a crack. This material can blend in beautifully, says Dr. Davidowitz.

For larger defects, veneers can give a new face to teeth that’s smooth and realistic and blends in with neighboring teeth. A veneer is a thin layer of porcelain or plastic material made to fit over the front surface of a tooth.

Question 4

Cracked tooth repair

Accepted Answer

Your teeth can chip, crack, and split for a host of reasons—you may get hit in the mouth or chew on a piece of ice. People who grind their teeth are more prone to these problems, as are those with large fillings. When the crack goes through more than the enamel, the tooth requires treatment.

“Craze lines” are tiny, harmless cracks that affect only the enamel. If you don’t like how they look, bonding or veneers can hide them, says Dr. Ramesh Babu Mandava, a dentist in India, in a RealSelf Q&A.
Chipping, which occurs when a piece of tooth enamel is knocked off, may not need treatment if it’s minor; your dentist may just polish the surface to smooth a rough edge, a technique called cosmetic contouring. They may also use bonding material to fill in any gaps. If the repair is to one of your “smile” teeth, bonding is a common and inexpensive solution. A bigger chip may require a crown that covers the remainder of the damaged tooth.
A cracked tooth is also called a fractured tooth. In some cases, filling material can be used to repair the crack. When a tooth is broken or damaged to the extent that a filling won’t restore its natural function, a crown is used to restore the tooth. If the crack has extended into the pulp, the tooth can be treated with a root canal and a crown is placed on the tooth to protect it. If the crack extends below the gum line, it’s not treatable, and the tooth will need to be extracted (removed) and replaced with a dental implant.

RealSelf Tip: Teeth that have undergone root canal treatment are weaker than other teeth and may be more likely to crack. People with one cracked tooth are more likely to have others. If you suspect you have a cracked tooth—symptoms include erratic pain when you chew your food to sudden pain when your tooth is exposed to very hot or cold temperatures—see your dentist as soon as possible. The sooner your tooth is treated, the better the outcome.

A split tooth, when the tooth splits into two parts, is often the result of an untreated cracked tooth. A split tooth can’t be saved intact, but—depending on the position and extent of the crack—your dentist may be able to save a portion of the tooth.

Question 5

Repairing knocked-out teeth

Accepted Answer

A tooth that gets knocked out can be saved, if you act quickly. Teeth begin to die within 15 minutes of being knocked out—and while the surrounding nerves, root, blood vessels, and supporting tissue can’t be repaired, the bone may be able to reattach to the root of the tooth, if it’s put back into place properly. There’s about a 30-minute window for this to happen. Here’s what to do.

Pick up the “avulsed” (knocked out) tooth by the crown (the chewing surface), not the root.
Rinse it off with water (if dirty).
Immediately reposition it back in the socket, where it can be kept moist (put it in milk, if it can’t be replaced in your mouth).
Get to your dentist, an endodontist, or an emergency room ASAP.

RealSelf Tip: While dental bridges can be repaired and replaced, “over the past several years, dental implants have started to become the treatment of choice over dental bridges,” says Dr. Scott Young, a dentist in The Woodlands, Texas. “The only time I recommend a bridge over an implant is when the patient doesn’t have enough bone for an implant—and with the advancements in bone grafting and implant design, the lack of bone isn’t an issue very often anymore. Definitely look into dental implants before replacing a bridge.”

Question 6

What’s the cost of dental repair?

Accepted Answer

Your dental insurance should cover a significant portion of tooth repair, provided it’s not being done only for cosmetic reasons.

If cost is an issue, most dental providers offer payment plans or third-party financing. Another option is to inquire at dental schools. Most schools offer treatment at a significantly lower cost.

Question 7

Tooth repair before and after pictures

Accepted Answer

The tooth repair photos in our gallery have been shared by the provider who performed the procedure, with the patient's consent.

TOOTH REPAIR

Karyn Repinski

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Karyn Repinski

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