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.
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.
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.
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.
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 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.
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.”
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.
The tooth repair photos in our gallery have been shared by the provider who performed the procedure, with the patient's consent.
Updated July 20, 2023