Rinse with warm water, press gauze on any bleeding, put a cold compress on the outside of your face, save the broken piece in milk, and phone a dentist today rather than tomorrow.
Work through the numbered list below in order, then read the section matching what your tooth actually looks like — a chipped corner and a tooth snapped off at the gumline are not the same emergency. If the tooth has been knocked completely out, skip ahead; that one is timed in minutes.
Bleeding you cannot stop, a tooth out of its socket, or escalating pain is an emergency dental appointment, not a routine booking. Call as early in the day as you can.
The First Ten Minutes
- Rinse your mouth gently with warm water. This clears blood and debris so you can see what you are dealing with. Do not scrub the area.
- Find the fragment if you can. Put it in a small container of milk, or in your own saliva. Do not let it dry out — a dentist can sometimes bond a clean fragment straight back on, and it beats any filling material for colour match.
- Control bleeding. Fold clean gauze or a damp tea bag over the site and bite with firm, continuous pressure for ten minutes by the clock. Do not keep lifting it to look.
- Cold compress outside your face over the area, twenty minutes on, twenty off.
- Take over-the-counter pain relief as directed on the package, assuming it is something you normally take safely.
- Cover a sharp edge with sugar-free chewing gum or orthodontic wax so it does not shred your tongue on the drive in.
- Phone a dentist. Say what happened, what you can see, and whether it hurts to bite.
Do not put aspirin or any tablet against the gum. Aspirin is acidic and burns a chemical ulcer into the soft tissue, so you end up with two problems. Pain relief works through your bloodstream, not by contact.
How Bad Is It? Reading Your Own Broken Tooth
Look in a mirror with good light. What you are trying to work out is how deep the break goes.
- Chipped enamel only. Small corner missing, no sensitivity, rough but not sharp. Not urgent. Book normally.
- Fracture into dentine. A larger piece gone, the exposed surface yellower than surrounding enamel, cold air makes it twinge. Needs seeing within days — dentine is porous and decays quickly once uncovered.
- Fracture exposing the pulp. A pink or red spot in the middle of the broken surface, or bleeding from the tooth itself rather than the gum. Urgent, same day where possible. The nerve is open to the mouth.
- Cracked tooth, nothing visibly missing. Sharp pain on releasing a bite, or on cold. Cracks are hard to diagnose and worsen if you keep chewing on them.
- Broken at or below the gumline. Often painless if the nerve died first. Whether it can be saved depends on how far below the bone the fracture runs.
- Knocked out entirely. See the next section now.
Any of these can happen without pain, and people take that as permission to wait. A painless exposed dentine surface is still an open wound. Bacteria do not need you to feel anything.
Knocked-Out Permanent Tooth: Do This Now
Time is the single variable that decides whether the tooth survives. The ligament cells on the root surface start dying within about fifteen minutes of drying out.
- Pick the tooth up by the crown — the white chewing part. Never touch the root.
- If it is dirty, rinse it for a few seconds in milk, saline or the patient’s own saliva. Brief cold running water beats nothing. Do not scrub it, use soap, or wipe it with a cloth — you are washing off grit, not cleaning the root.
- If you can, put it straight back in the socket the right way round and bite gently on a cloth to hold it. A tooth back in its socket has the best chance there is.
- Otherwise store it in cold milk, or the patient’s own saliva held in the cheek if they are old enough not to swallow it. Never tap water; it destroys the root cells faster than dry storage.
- Get to a dentist immediately. Not this afternoon. Now.
A knocked-out baby tooth should not be put back. Reimplanting a primary tooth risks damaging the permanent tooth developing above it. Control bleeding, keep the child comfortable, have them seen — but leave the tooth out. Unsure whether it is a baby tooth? Take it with you and let a dentist decide. Children’s injuries are best handled by someone used to treating children.
When It Is a Hospital, Not a Dentist
Go to an emergency department instead of a dental office if any of these apply:
- Facial swelling with difficulty breathing or swallowing, or swelling closing an eye or crossing the floor of the mouth. A spreading infection is time-critical.
- Significant facial trauma — a blow hard enough to break a tooth can break other things.
- Suspected jaw fracture: teeth no longer meeting correctly, inability to open or close, numbness in the lip or chin.
- Bleeding you cannot stop after twenty minutes of firm pressure.
- Loss of consciousness, confusion, repeated vomiting or severe headache after the injury.
A dental office cannot manage an airway or image a skull. Nobody will think you overreacted.
What to Eat While You Wait
Chew entirely on the other side. Soft food, nothing that needs tearing, nothing very hot or very cold — exposed dentine transmits both straight to the nerve. No nuts, crusty bread, ice or boiled sweets. Keep brushing the broken tooth gently with a soft brush; plaque left on an exposed surface makes everything worse faster.
Break Type Against Likely Treatment
| What you have | Usual treatment | |
|---|---|---|
| Minor enamel chip | Rough edge, no sensitivity | Smoothing, or composite bonding |
| Moderate chip into dentine | Yellower exposed surface, sensitive | A filling or bonding |
| Large piece of a back tooth lost | Cusp broken off, structure gone | A crown, sometimes an onlay |
| Pulp exposed or nerve dying | Pink spot visible, throbbing, or bleeding from the tooth | Root canal treatment plus a crown |
| Vertical root fracture, or broken deep below bone | Often mobile, may be painless | Extraction then an implant, bridge or partial |
Nobody can put you in a row of that table over the phone. It needs looking at, usually with an X-ray. The table is for knowing the range of what might be coming so a quote does not blindside you. Ontario-wide ranges for the bigger items are in our post on root canal costs, and our fees and payment page explains how written estimates work. If money is why you are hesitating, check CDCP coverage before deciding to live with it.
What Not to Do
Superglue. Not sterile, not designed for oral tissue, and it seals bacteria against exposed dentine. It also makes the eventual repair harder and dearer, because someone has to grind it off first.
DIY repair kits and pharmacy filling putty. Useful for one thing: re-seating an intact crown that has fallen off, for a night or two, until you can be seen. Everything else they promise, they do badly.
Filing the edge yourself. Nail files remove enamel you do not get back.
Ignoring a break that does not hurt. This is the big one. A dead nerve, damaged nerve, or a fracture that has not yet reached the pulp all produce a comfortable tooth. Meanwhile exposed dentine decays far faster than enamel, and a tooth that needed forty minutes of bonding in March needs a root canal and a crown by autumn. Roughly a tenfold cost difference. Painless is not the same as fine.
Stopping the Next One
If you broke a tooth on food that should not have broken it, something else is going on. Night grinding is the usual suspect — it flattens cusps, cracks enamel and destroys restorations, and most people who do it have no idea. A night guard is cheap compared with what it protects. Old, large amalgam fillings are the other common cause: a tooth with more filling than tooth left is held together by not much, and cusps fracture off them routinely.
Frequently Asked Questions
Can a broken tooth be saved?
Usually, yes, if there is enough structure above the bone and the root is intact. Fractures running vertically down the root are the main thing that cannot be repaired.
How long can I leave a broken tooth?
An enamel chip can wait weeks. Exposed dentine, days. Exposed pulp, a loose tooth or one broken at the gumline should be seen the same day.
Does a broken tooth always need a crown?
No. Small and moderate breaks are handled with bonding or a filling. Crowns are for teeth that have lost enough structure that a filling would not survive chewing. If you are told everything needs a crown, ask what happens if you do less — sometimes the honest answer is nothing much.
Will it hurt to fix?
Treatment is done under local anaesthetic. See how long dental freezing lasts for what to expect afterwards.
Get Seen Today
Bring the fragment if you have it, in milk. Tell us what happened, when, and whether anything else was injured. Contact the office or book online — and if it is out of the socket, phone rather than typing. Other things worth knowing before they happen are on the blog.
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