Many parents wait to see whether a chipped front tooth starts to hurt before calling a dentist. With an adult tooth that is a risky wait. The visible chip shows only part of the injury, and the knock that broke the edge may also have bruised the nerve, loosened the tooth or cracked the root.
The aim is a dental check on the same day, or as soon as you can get one, with the broken piece if you can find it.
In the first hour
Comfort your child and look at the whole mouth, not just the tooth. Lips, gums and the inside of the cheeks are often cut by the same fall, and a split lip can hide a tooth fragment inside it. Rinse with cool water and hold a cold pack on any swelling.
Search the floor, the grass or the drink bottle for the missing piece. If you find it, rinse it without scrubbing and keep it wet in a small container of water, milk or saline. A dried-out fragment is less likely to bond back well. Note the time of the accident and whether the tooth looks pushed in, pushed out or out of line with its neighbours, because the dentist will ask.
If the whole tooth has come out, the situation is far more urgent and the steps are different. Follow our guide to first aid for a knocked-out tooth instead.
What the dentist is looking for
The examination covers more than the broken edge. Your dentist will usually:
- check how deep the break goes: enamel only, into the dentine beneath, or through to the pulp (the nerve and blood supply)
- feel whether the tooth is loose or displaced, and check the bite
- test how the tooth responds, while bearing in mind that a recently injured tooth can give misleading results for a while
- take an X-ray to look at the root and the bone around it, and to see how far root development has progressed
Repairs depend on how deep the chip goes
Enamel only
A small chip confined to the outer enamel may need nothing more than smoothing of the sharp edge, or a small amount of tooth-coloured filling for appearance.
Into the dentine
Dentine is softer and more porous than enamel, and an exposed area can be sensitive. These chips are usually rebuilt with composite resin, the same tooth-coloured material used in bonding. If the original fragment is intact it can often be bonded back on instead, which gives a natural colour and shape. Our article on what happens during a bonding appointment walks through the steps.
Through to the nerve
When the break exposes the pulp, the goal in a child is usually to keep as much of the living pulp as possible. In a young permanent tooth the root is still growing and its walls are thin, so a partial pulpotomy (removing only the damaged surface layer of pulp and sealing it) is often preferred over a full root canal. Keeping the pulp alive lets the root keep developing. Crowns are seldom used on children's front teeth after a chip, and are usually left until growth is complete if they are needed at all.
Young adult teeth need follow-up
A front tooth that has been knocked can lose its nerve weeks or months later, sometimes with no pain at all. The clues are a grey, yellow or pink change in colour, a pimple on the gum above the tooth, or new tenderness. Because of this, dental trauma guidelines from the International Association of Dental Traumatology (2020) recommend review appointments after a crown fracture, typically at around six to eight weeks and again at about one year, with more visits for more serious injuries.
Watch the tooth against its neighbour in good light and keep those review appointments, even if the repair looks perfect.
Preventing the next one
Front-tooth injuries peak in primary school and early high school, when adult incisors are newly through and still have immature roots, and children are busy with sport, scooters and play equipment. A mouthguard for contact and ball sports is the most practical protection. Custom-fitted guards fit better and are more comfortable, although evidence that they prevent more injuries than other types is limited, and they need refitting as new teeth erupt. Our guide to the second permanent molars explains why the bite keeps changing through these years. Children whose upper front teeth stick out are more prone to this kind of injury, which is one of the things a dentist considers when talking about orthodontic timing.
Common questions
The chip is tiny and my child says it does not hurt. Can we wait?
A short wait is not usually dangerous for a tiny enamel chip, but you cannot tell from looking whether the root or nerve was also hurt. A prompt check is the safer choice.
We could not find the broken piece. Does that matter?
No. The tooth can be rebuilt with composite resin that is matched to its colour. Do mention it if the piece may have been inhaled or is lodged in a cut lip.
Will the repair last?
Composite repairs on front teeth can last many years, but they may chip or stain and need touching up over time, especially as a child grows and the gum line changes.
Booking a check
If your child has chipped an adult tooth, call us and mention it is an injury so we can find the earliest available time. You can read more about routine and urgent care on our general dentistry page or see family offers on our current offers page.
This article is general information and not a substitute for an individual dental assessment.
