A chipped or fractured piece of a tooth can often be reattached, but this procedure must be performed exclusively by a dental professional using specialized materials and techniques. The core question of whether a tooth fragment can be “glued” back on is answered with a qualified yes, relying on a sophisticated dental process called adhesive reattachment. Never attempt this at home with household adhesives such as superglue. These products are toxic, contain chemicals that can cause severe irritation to the dental pulp or nerve, and will fail to create a durable, sterile seal. A professional procedure is necessary to ensure the structural integrity of the tooth and maintain the health of the remaining tooth structure.
Immediate Care and Preservation of the Fragment
If a tooth fracture occurs, locating and properly caring for the broken piece is the most immediate action you can take to improve the chances of successful reattachment. First, gently rinse your mouth with warm water to clear any debris. Control minor bleeding by applying light pressure with clean gauze. A cold compress applied to the outside of the cheek or lip can help reduce swelling and discomfort.
The fractured fragment should be retrieved and kept moist to prevent dehydration, which can cause shrinkage and discoloration. Preventing dehydration makes a successful bond easier. The ideal storage medium is a specialized dental transport solution. If unavailable, whole milk is a recommended alternative due to its specific pH and osmolarity.
Storing the fragment in a small container with the patient’s own saliva or a saline solution are acceptable temporary options. The fragment should never be stored in plain tap water, which can cause cells on the surface to swell. Once secured, contact a dentist immediately, as successful reattachment is time-sensitive. The quicker the fragment can be bonded, the better the long-term prognosis for survival and aesthetics.
The Dental Bonding Procedure
The professional reattachment process begins with a thorough clinical and radiographic assessment to determine the extent of the fracture and whether the dental pulp has been exposed. The dentist cleans the fractured surfaces of both the remaining tooth and the fragment, often using a solution like 0.2% chlorhexidine. This ensures a sterile bonding environment and removes any debris that could compromise the bond’s strength.
The next step involves conditioning the tooth’s surface, a process known as etching, typically using a low concentration of phosphoric acid for about 15 seconds. This etching creates microscopic porosities in the enamel and dentin, preparing the surface to chemically lock with the adhesive material. A liquid bonding agent, or resin adhesive, is then applied to both the remaining tooth and the fragment, penetrating the etched surfaces to form a hybrid layer.
The fragment is then carefully repositioned onto the remaining tooth structure. A flowable or dual-cure resin cement is often used to fill any minute gaps between the two pieces. Finally, a specialized curing light is directed onto the area, causing the resin cement to rapidly harden. This creates a strong, durable chemical bond that functionally and aesthetically restores the tooth, resulting in a seamless restoration.
Repair Options When Reattachment Fails
Reattachment is not always possible, such as when the fragment is lost, too small, or too severely fractured to be viable for bonding. In these situations, the dentist will turn to alternative restorative options, with the choice depending on the size and location of the missing tooth structure.
Composite Bonding and Veneers
For small chips and minor fractures, composite bonding is a conservative and effective solution. This technique involves applying a tooth-colored composite resin directly to the tooth, where it is sculpted and polished to rebuild the missing portion. If the fracture is larger, especially on a front tooth where aesthetics are paramount, a porcelain or composite veneer may be recommended. A veneer is a thin, custom-made shell that covers the entire front surface of the tooth, providing a highly durable and natural-looking restoration.
Dental Crowns
For severe fractures that involve a significant portion of the tooth or where the pulp has been compromised and requires a root canal, a dental crown is the typical course of action. A crown is a cap that covers the entire visible portion of the tooth. This provides maximum strength and protection to the weakened structure underneath. These alternatives ensure that function and appearance are restored even when the original fragment cannot be saved.