A chipped tooth is a minor fracture, typically involving the outermost protective layer, the enamel. Sometimes the fracture extends into the softer, underlying dentin layer. While enamel is the hardest substance in the human body, it is not indestructible. A fracture can expose the more sensitive internal structures, often felt suddenly by the tongue discovering a sharp edge.
Acute Incidents That Cause Chipping
A significant number of tooth chips result from a single, high-force event that overwhelms the tooth’s structural integrity. This most commonly involves external trauma, such as a fall, a sports-related impact, or an accidental blow to the face or jaw. The sudden force applied directly to the tooth can cause a piece of enamel to sheer off.
Chipping can also occur during normal activities like eating, usually when biting down unexpectedly on an extremely hard object. Common culprits include unpopped popcorn kernels, fragments of bone, hard candy, or chewing on ice. Using teeth as tools—such as tearing open packages or attempting to open bottles—applies unnatural stresses that can also lead to immediate chipping.
Chronic Conditions That Predispose Teeth to Fracture
Often, an acute incident is merely the final trigger for a chip in a tooth that was already weakened by chronic conditions. Bruxism, the habitual clenching or grinding of teeth, subjects the dental structure to constant, excessive pressure, frequently while a person is asleep. This sustained force creates micro-fractures within the enamel and dentin over time, making the tooth highly susceptible to breaking under minor stress.
Dental decay, or the formation of a cavity, directly compromises the tooth’s internal strength by dissolving mineralized tissue. As the decay progresses, it hollows out the tooth, leaving the remaining walls brittle and prone to fracture, even during routine chewing. Similarly, teeth that have received extensive dental work, particularly those with large, older fillings, have less remaining native tooth structure, increasing the likelihood that the remaining tooth wall will break away.
Enamel erosion is another long-term factor that thins the protective layer, making the tooth vulnerable to fracture. This erosion can be caused by a diet high in acidic foods and beverages, or by chronic medical conditions like gastroesophageal reflux disease (GERD). Stomach acid, with a pH as low as 1.5 to 2.0, can chemically strip the enamel, leaving the tooth soft and fragile. The natural aging process also causes teeth to become more brittle after years of cumulative wear, which often contributes to chips in adults over 50.
Immediate Steps After Discovering a Chip
The first step after noticing a chipped tooth is to contact a dental professional to schedule an evaluation. Even if the chip appears small or only cosmetic, a prompt assessment is necessary to prevent potential complications like infection or structural worsening. Until the dental appointment, gently rinse your mouth with warm water to clean the area and remove any debris.
If the chip was caused by trauma and is accompanied by swelling on the cheek or jaw, apply a cold compress to the outside of the face in 15-minute intervals. If you can locate the broken tooth fragment, retrieve it and preserve it by placing it in a container of milk or a saline solution. This keeps the fragment moist and increases the potential for the dentist to reattach it. For pain management, over-the-counter analgesics like ibuprofen or acetaminophen can be taken according to package directions.
If the chipped edge is sharp, creating irritation or cuts on the tongue or cheek, cover the area temporarily with a piece of softened sugarless chewing gum or orthodontic wax. Avoid chewing food on the side of the mouth with the damaged tooth to prevent further breakage or irritation.
Professional Treatment Options for Repair
The professional treatment selected for a chipped tooth depends on the location, extent, and depth of the fracture. For a very minor chip that only involves a rough edge of enamel, the dentist may perform a procedure called enamel shaping or contouring. This involves gently polishing and smoothing the tooth surface to restore a natural contour.
For chips of a moderate size, the most common solution is dental bonding, a procedure often completed in a single office visit. The dentist applies a tooth-colored composite resin to the prepared tooth surface, meticulously shaping and sculpting it to match the missing structure. This resin is then hardened using an ultraviolet light and polished to blend seamlessly with the surrounding tooth.
If the chip is larger or located on a highly visible front tooth, a porcelain veneer may be recommended for its superior aesthetics and durability. A veneer is a thin, custom-made shell bonded to the entire front surface of the tooth, restoring its original appearance. When the damage is extensive and compromises a significant portion of the tooth’s structure, a dental crown is the preferred restoration. A crown is a tooth-shaped cap that covers the entire remaining tooth structure, restoring its function and protecting it from further fracture.
In severe cases where the chip extends deep enough to expose the tooth’s inner pulp—the soft tissue containing nerves and blood vessels—the treatment becomes more complex. This exposure necessitates root canal therapy to remove the infected or damaged pulp, followed by the placement of a crown to protect the compromised tooth. The long-term success of any repair depends on addressing underlying chronic causes, such as fitting the patient with a custom nightguard if bruxism was a contributing factor.