Broken tooth

Carola Felchner is a freelance writer in the medical department and a certified training and nutrition advisor. She worked for various specialist magazines and online portals before becoming a freelance journalist in 2015. Before starting her internship, she studied translation and interpreting in Kempten and Munich.

More about the experts All content is checked by medical journalists.

A collision while exercising or a fall from a bicycle - a tooth has already broken off or knocked out. This mainly happens to children and adolescents, but occasionally also to adults. The upper incisors are most commonly affected by the accident. Find out what to do and when to go to the dentist if a tooth has broken or fallen out.

Brief overview

• What to do with a broken tooth Calm down the affected person, look for a piece of tooth, store it correctly and bring the affected person to the dentist as quickly as possible
• This is what the doctor does: Examination of the oral cavity, possibly an X-ray, then depending on the injury, reinsertion of the tooth, filling, veneer, bridge or artificial implant
• Risks: inflammation, suppuration, discoloration, increased sensitivity

Broken tooth: what to do

As long as it is not a loose milk tooth, some form of force is necessary for a tooth to break out completely or partially - for example a violent fall or a blow to the face. The person concerned is then usually frightened or disturbed, especially if it is a child. So the first thing you should do is reassure the person concerned. The other first aid measures if a tooth has fallen out or partially broken off are:

• (Part) recovery of teeth: Search the scene of the accident for teeth that have fallen out or broken tooth parts and collect them. Teeth that are exposed in the oral cavity must also be salvaged. Only touch a knocked-out tooth by the tooth crown and never by the sensitive tooth root! If a tooth is very loose in the jaw, you should remove it so that the person concerned does not accidentally swallow it.
• Store (part) of the tooth correctly: knocked out teeth must be kept moist and cool so that they do not dry out during transport to the dentist - otherwise they cannot be reinserted. Ideally, a so-called tooth rescue box * is used. A tooth can be kept moist and germ-free for 24 to 48 hours.It is not a good idea to "store" the knocked out / broken tooth in the oral cavity until you get to the dentist - because of the germs in the mouth and the risk of swallowing!
• Emergency solution UHT milk, saline solution or saliva: If necessary, you can store a failed or broken tooth in cold UHT milk. It can be "kept" for 1 to 2 hours in it. Other alternatives are isotonic saline ** (30 minutes) and saliva (15 to 30 minutes) collected in a jar.
• Off to the dentist: Take the affected person with the broken / failed tooth to the dentist as soon as possible!

* Available in pharmacies for approx. 20 euros

** Only use saline solution from the pharmacy

Do not try to clean the broken or failed tooth from adhering dirt particles, or to disinfect, reinsert or glue!

Broken tooth: treatment by the doctor

In principle, dentists can also repair severe damage to teeth. If only small corners have broken out of a tooth, this defect can be made almost invisible with a tooth-colored filling. If a larger piece of tooth has broken off, a crown or veneer may also be necessary. In children, the final crown is usually made after puberty. A plastic children's crown helps to bridge the gap until then.

If a whole tooth of the permanent set of teeth has fallen out (tooth loss), it can be reinserted (reimplanted) in the best case. But it should be done as quickly as possible: the longer a tooth lies dry, the worse the chances of it being re-transplanted.

Knocked out milk teeth are usually not reinserted. This is because there is a risk of damaging the permanent tooth underneath.

If the tooth root is badly damaged or the tooth nerve is affected, the affected person can usually not avoid a root canal treatment (root canal treatment). If teeth are completely missing, an artificial replacement is necessary - bridges, prostheses or implants. Another possibility can be to close the gap with braces.

If children have lost a permanent incisor, it is rarely possible to replace it with transplanted small molars or deciduous canines. The tooth crown is relatively easy to grind into the correct shape.

If you have successfully treated a broken or knocked out tooth, go to the dentist for a check-up within a year to make sure that everything is in order.

Broken tooth: risks

If a broken or fallen tooth does not receive professional treatment, this can have various consequences for the person concerned. This includes:

• Increased sensitivity: If a tooth has broken off, the remaining stub often reacts with pain to hot, cold, sweet or sour foods and drinks.
• Discoloration: If the damaged tooth or tooth stub turns brown or black, this indicates tooth decay or a dead tooth root.
• Inflammation: Usually caused by food residues that have stuck to the damaged tooth or in the gap between the teeth and in which bacteria can easily multiply.
• Pus formation: If the pulp becomes inflamed, it can lead to a painful inflammation (pulpitis). Pus can form in the gingival pockets.

Broken tooth: when to see a doctor?

If a tooth has fallen out or broken off, the patient and the tooth or the fragment must always see the dentist immediately. Because a broken tooth or a piece of tooth knocked out has only a limited shelf life. The sooner the patient and (part) of the tooth arrive at the dentist, the higher the chances that the original tooth can be saved.

A visit to the dentist is also advisable after every dental accident because laypeople cannot recognize some accompanying injuries, for example a broken tooth root in the jaw or injuries to the jawbone.

Broken tooth: examinations at the doctor

If someone has knocked out or broken off one or more teeth, the doctor will first ask the person concerned about how the accident happened and collect their medical history (anamnesis). This is followed by an examination: the dentist takes a close look at the entire oral cavity. If he suspects an injury that cannot be seen with the naked eye (e.g. broken tooth root), he can use imaging methods such as X-rays to confirm or refute the suspicion.

Broken tooth: prognosis

In general, it depends on the condition of the tooth or piece of tooth whether the dentist can save the affected pearly whites. It plays a role here whether the broken tooth (or part) gets into the hands of the dentist in good time and correctly (e.g. in a tooth rescue box). If the tooth nerve was not damaged in the accident, the probability is high that the broken tooth can be saved.

If a whole tooth is knocked out, the doctor can or must - depending on the extent of the injury - replace it artificially, for example with a bridge or an implant.

The earlier the person concerned is at the dentist, the better the chances that the treatment will be successful.

Broken tooth: prevention

Especially when romping around or in high-risk sports such as hockey, mountain biking, inline skating or skiing, there is a risk that a tooth will be lost - that is, it will either be knocked out or broken off. The following tips will help prevent such injuries:

• Talk to your child and make them aware of dangerous situations.
• Make sure that you and your children are as safe as possible. For example, eliminate tripping hazards (such as toys or cables lying around on the floor). If there are small children in the house, secure the stairs with a special grate.
• Practice with your children how to protect their face in the event of a fall.
• Make sure you wear the right protective equipment when doing sports. A plastic mouthguard (either from a sports shop or custom-made by the dentist) can reduce the risk of tooth injuries such as a broken tooth.

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