Chipped or Broken a Tooth? What to Do in the First Hour

Teeth break at inconvenient moments: a cricket ball, a fall, a piece of bone in the biryani, an old filling that finally gives way. What you do in the first hour genuinely changes what can be saved, so here is the short version by type of break.

A knocked-out permanent tooth: the one true emergency

This is the only dental injury where minutes matter. A permanent tooth that has come out whole can often be put back and survive, but the odds fall sharply after about an hour.

Pick it up by the crown, the chewing part. Do not touch the root.
Do not scrub it. If it is dirty, rinse briefly with milk or saline. Never use soap, disinfectant or tap water for long, and never scrape the root clean. The delicate cells on the root surface are what allow it to reattach.
Put it back in the socket if you can, right way round, and bite gently on a clean cloth to hold it.
If you cannot, put it in milk. Milk is the ideal storage medium and is in most kitchens. Saline works. Your own saliva, in a cup with the tooth held in your cheek, is a distant third. Never store it in water, which destroys the root cells quickly.
Get to a dentist immediately. Call ahead.

A knocked-out milk tooth in a child is the opposite: do not put it back, as that risks damaging the permanent tooth developing above it. Take the child to be checked, but the tooth itself is not going back in.

A large break, with pain

If a substantial piece has broken away and the tooth is painful or you can see pink or red in the middle, the nerve is likely exposed. This needs attention the same day. Rinse with warm water, use a cold compress on the outside of the cheek for swelling, and take an ordinary painkiller if you have no reason not to.

Save the fragment in milk and bring it. Larger pieces can sometimes be bonded back on and it is the best colour match you will ever get.

A small chip, with no pain

Less urgent, but do not leave it indefinitely. A sharp edge lacerates the tongue and cheek, and a rough edge collects plaque. It usually takes one short visit to smooth or bond.

The more important reason to have it checked is that a chip is often a symptom. Teeth do not usually break for no reason, and the underlying cause is commonly a large old filling, decay under it, or heavy grinding that is quietly fracturing several teeth at once.

A lost filling or crown

Keep the crown if it came off whole. It can very often be recemented. Clean the tooth gently, avoid chewing on that side, and see us within a few days.

What not to do

Never use superglue. We see this. It is toxic to the pulp, it makes the tooth impossible to repair properly, and removing it costs you more tooth than the break did.
Do not ignore a painless break. A tooth that snapped but does not hurt may have a nerve that has already died. Silence is not the same as health.
Do not put aspirin on the gum. It burns the tissue. Painkillers work through the stomach.
Do not delay a knocked-out tooth to find a “better” appointment time.

How breaks get repaired

The repair depends on how deep the break goes rather than how big it looks:

Enamel only: smoothing, or composite bonding in a single visit.
Into dentine: a filling or an onlay, depending on how much tooth is left.
Into the nerve: root canal treatment followed by a crown, because a treated tooth needs the protection.
Broken below the gum: sometimes savable with additional work, sometimes not. Where the tooth cannot be kept, an implant is usually the best replacement.

Most broken teeth are more repairable than they feel with your tongue. The ones that end badly are usually the ones left for months.

We keep same-day slots for emergencies at the clinic in Wanowrie (Wanwadi), open all seven days. See what we treat as a dental emergency, or save the number now: 093731 43403.