Chipped, Cracked and Broken Tooth Repair in Reston, Virginia
What to Do Right Now
Rinse your mouth gently with warm water.
If a piece broke off, keep it. Put it in a little milk or saline, and bring it in. Sometimes it can be bonded back on.
If the area is bleeding, press a clean piece of gauze against it for ten minutes or so.
For swelling, hold a cold compress against your cheek from the outside.
Chew on the other side and leave the tooth alone until we have looked at it.
If a sharp edge is catching your tongue or cheek, dental wax from a drugstore will cover it until your appointment.
Call us and describe what happened. We will tell you whether this needs seeing today or whether it can wait for a regular slot.
When It Needs Seeing Today
Come in the same day if the tooth is painful rather than merely rough, if the broken surface is bleeding from within the tooth itself, or if you can see a pink or reddish spot at the center of the break. That usually means the nerve is exposed, and treating it early makes a real difference to whether the tooth can be kept alive.
Same day also applies if the tooth is loose, if the gum around it is swelling, or if the break followed a blow to the face.
Otherwise there is no emergency. Book a normal appointment and avoid chewing on that side until then.
How a Damaged Tooth Is Repaired
Small chips and cracks
Teeth with minor damage to the crown are built back up with composite filling materials. These are strong, they last well, and they are not distinguishable from the natural teeth around them. The material goes on in layers, each cured under a polymerization light, and once enough of it is in place the tooth is shaped, smoothed and polished back to form. This is done in one visit and no healthy tooth structure has to be cut away to make room, which is the main reason we reach for it first. Composite closes gaps and cracks, and rebuilds worn surfaces just as well as chipped ones.Larger damage on back teeth
When a molar has lost a substantial amount of structure, an inlay or onlay is the better answer. These are made individually for the tooth in a laboratory, usually from ceramic, shaped to the defect so they rebuild the crown of the tooth precisely. Ceramic behaves and looks much like natural tooth tissue. Inlays are strong, they do not disturb the bite, and once they are in place they are invisible.When roughly half the tooth is gone
A tooth broken to this extent is rebuilt around a post, either fiber or metal, seated in the root canal. What matters most here is the state of the root. It needs to be sound, with the canals properly filled. A repair built this way lasts a long time, and longer still if the tooth is then covered with a crown. Where almost all of the tooth tissue is gone, a cast post and core is used instead. This is a single custom-made unit cemented into the root, and a crown always goes over it afterward.Front teeth and appearance
Small chips to the biting edge, discoloration, a slightly awkward shape or a gap between the front teeth can each be corrected with composite in one appointment, or with veneers where the change needed is larger or the whole smile line is involved. Veneers are very thin and strong, they resist staining from food and drink, and in some cases they need almost no reduction of the tooth beneath. Which of these fits is a conversation to have once we have seen the tooth.Direct and Indirect Repair
Repairs divide into two kinds, and it is worth knowing which one you are being offered.
Direct work happens entirely in your mouth in one appointment, using composite. Its great advantage is speed, since most cases take between thirty and sixty minutes from start to finish. The trade-off is that composite gradually absorbs color from food and drink, and after a year and a half or two it starts to look less bright than it did.
Indirect work means the restoration is made in a dental laboratory from impressions taken of your teeth, then fitted at a second visit. Inlays, crowns and veneers all fall into this group. Modern ceramic stands up to heavy chewing and looks natural doing it, and indirect work holds its appearance considerably longer. It costs more, and it takes an extra appointment.
How a Direct Repair Is Done
We prefer to do cosmetic repairs after a professional cleaning, since removing surface staining first lets us match the shade to your teeth as they actually are rather than as they look with a film of plaque on them. Using a shade guide, the dentist selects the materials closest to your own enamel.
Any decay is cleared out first, under local anesthetic if it is needed, and old fillings that have discolored are replaced at the same time.
Before the composite goes on, the tooth is isolated from moisture and saliva with a latex dam. This step deserves more attention than it usually gets. When a tooth is not properly isolated, the material does not seal against it cleanly, the restoration fails sooner, and decay can start underneath.
The dentist then builds up the composite in layers, using shades and degrees of translucency that vary through the thickness, which is how the result ends up looking like enamel rather than like filling material. The last stage is shaping the tooth, smoothing away anything that stands proud, and polishing.
A tooth that has already had root canal treatment can be restored this way too. A post placed in the canal strengthens the composite above it and adds years to the repair.
What Repair Costs
The figure depends on how much of the tooth is missing, whether the work is direct or indirect, and how many teeth are involved. A single chipped edge rebuilt in composite sits at one end of the range and a laboratory-made ceramic restoration at the other.
Repair of a damaged tooth is restorative rather than cosmetic work in most cases, which means dental plans generally contribute toward it. Where the work is purely for appearance, coverage is less likely, and we will tell you plainly which category yours falls into before anything starts.
After we have examined the tooth you receive a written treatment plan with an itemized estimate. Treatment is generally an eligible HSA and FSA expense, and financing is available.
