Enamel is the hardest tissue in the body and it still chips and cracks — front teeth most visibly. What happens next depends on one thing: how deep the break goes.
What are the three levels of a broken tooth?
1. A small chip in the enamel. Restored with composite resin, usually in one appointment. This is the level most people hope they are at.
2. A fracture reaching the nerve. Root canal treatment followed by a crown. Where too little tooth structure remains to hold a crown, a post is placed into the root first to reinforce it.
3. A fracture extending into the root. Nothing restores this. The tooth is extracted and replaced with a bridge or an implant.
The gap between levels two and three is the whole question, and it cannot be judged by looking.
What this patient came in with
A front tooth broken off, with the pulp exposed — visible as red tissue at the fracture surface.
The pain was severe and the tooth extremely sensitive, which is what exposed pulp does.
Why is an X-ray taken before treatment?
A panoramic X-ray was taken first, for one specific purpose: to establish whether the fracture extended into the root.
That is the finding that would have changed the plan entirely — from saving the tooth to extracting it and placing an implant. Starting treatment before knowing means potentially doing root canal treatment on a tooth that cannot be kept.
It had not reached the root. The tooth could be saved with root canal treatment, a post, and a crown.
Which post material suits a front tooth?
The canal system was cleaned out and disinfected, then a post was placed into the root to reinforce what remained.
The three post materials
Ceramic — white and opaque, strong, and biocompatible. Difficult to remove if the tooth ever needs re-treating.
Metal — long-established and strong. Less aesthetic, and it can discolour the dentine around it, which matters on a front tooth.
Fibre — has some flex to it, which can be an advantage. Not as strong as ceramic or metal.
Which is appropriate depends on how much tooth remains, where it sits, and how much force it will take. It is a conversation to have before treatment rather than a default.
What kind of crown was fitted?
A zirconia crown was made — strong enough for the job and matched to the neighbouring teeth, so it does not read as a repair.
Treatment ran from 11 February 2022 to 24 March 2022.
How do I look after a treated front tooth?
Root canal treatment is not a full stop. A treated tooth can develop problems again, and then the options are retreatment or, if that fails, extraction with a bridge or an implant.
General advice is a check-up every six to twelve months. For a tooth that has been through this, every three to four months initially is more appropriate. A site that has already had a problem is more likely to have another, and to have it progress faster.
Practically: avoid hard foods on that tooth, and be careful about impacts. The fracture that started this had a cause, and the repaired tooth is not stronger than the original was.
Frequently asked questions
I chipped my front tooth. Will I need a crown?
Only if the break reaches the nerve. A small enamel chip is usually restored with composite resin in a single appointment. An X-ray is what distinguishes the two, and it also rules out the third possibility — a fracture into the root, which cannot be restored.
What is a dental post?
A post is placed into the root canal to reinforce a tooth that has lost too much structure to hold a crown on its own. It comes in ceramic, metal or fibre, each with different strength, appearance and removability.
Can a tooth broken at the root be saved?
No. A fracture extending into the root cannot be restored, and the tooth is extracted and replaced with a bridge or an implant. This is why the X-ray is taken before treatment starts rather than after.
Will the crown match my other front teeth?
That is the intention, and zirconia is generally chosen for front teeth partly for that reason. The shade is matched against the adjacent teeth rather than picked from a chart.
My tooth broke while I am travelling. What should I do?
Get it looked at promptly rather than waiting until you are home, particularly if the pulp is exposed — that is both painful and an open route for infection. A first assessment and X-ray establish which of the three levels you are at, and often the tooth can be stabilised even if the full treatment takes longer than your trip.
Read more: crowns and veneers · root canal treatment · emergency dental care