A tooth that has broken off at the gum line can often be saved, but it depends on how much sound tooth is left below the gum and whether the root itself is cracked. If enough healthy root remains, a dentist can usually rebuild it with a root canal, a post and a crown. If the break runs deep below the bone, or the root is split, removing it and replacing it is usually the more reliable choice.
This guide covers what to do in the first few hours, what a dentist checks to decide, and the realistic options from there.
What to do in the first few hours
A tooth that snaps at the gum line often does not hurt much at first, especially if it has had a root canal before or the nerve had already died. Others are very sore because the nerve is now exposed. Either way, the steps are the same.
- Rinse gently with warm water to clear any fragments.
- If there is bleeding from the gum, press a clean, damp gauze or tea bag on the area for 10 to 15 minutes.
- Keep any piece of tooth or crown that came away and bring it with you. It is rarely reattached, but it helps the dentist see how the tooth broke.
- Take your usual pain relief if needed, following the packet directions. Our guide to ibuprofen and paracetamol for tooth pain explains how each one works.
- Chew on the other side and avoid very hot, cold or sugary food and drink.
- Call a dentist the same day or the next working day. An emergency dental appointment is the right booking for a broken tooth, even if it does not hurt.
A broken tooth with no pain is still worth seeing quickly. The exposed root surface can decay fast, the gum can start to grow over the edge, and the longer it is left, the fewer options there tend to be.
When to go to hospital instead
Go to a hospital emergency department, not a dental clinic, if there is facial swelling spreading towards the eye or down the neck, trouble swallowing or breathing, a fever with a swollen face, or if the tooth broke in a fall or accident with a head injury, loss of consciousness or a jaw that will not close properly. Our article on when to go to hospital for a dental problem covers these signs in more detail.
Why teeth break at the gum line
Healthy teeth rarely snap cleanly at the gum. Most teeth that break this way were already weakened. Common reasons include:
- A large old filling or decay that had hollowed out the tooth from the inside.
- A root canal treated tooth that never had a crown placed over it, so it became brittle over time.
- Decay that started at the gum line, often under the edge of an old crown.
- A crack that had been spreading for months before the final break.
- Heavy grinding or clenching, especially on back teeth.
Knowing the cause matters, because the same weakness can affect the neighbouring teeth.
What a dentist checks to decide if it can be saved
The decision comes down to a few measurable things. Most can be worked out at the first visit with an examination and an X-ray, sometimes a 3D scan.
How much tooth sits above the bone
A new crown needs something to grip. Dentists look for a band of sound tooth, ideally about 1.5 to 2 millimetres high, that the crown can wrap around. This band is called a ferrule. Without it, a crown and post are much more likely to come loose or crack the root later. If the break sits at or below the bone, there may be no ferrule at all without extra work first.
Whether the root is cracked
A clean horizontal break can often be restored. A crack that runs vertically down the root usually cannot, because it lets bacteria leak along the crack and the tooth tends to fail even after treatment.
How long the root is
To support a post and crown, the root inside the bone needs to be longer than the crown that sits on top. A short root holding a long crown acts like a lever and tends to loosen.
The health of the nerve, gum and bone
An exposed or infected nerve needs root canal treatment before any rebuild. Gum disease or bone loss around the tooth also lowers the chance of long-term success.
Where the tooth is in the mouth
A front tooth carries lighter forces and matters most for appearance. A back molar takes heavy chewing load, so a weak rebuild is more likely to fail there.
The options, from saving the tooth to replacing it
Once the checks are done, the choice usually falls into one of four paths.
Root canal, post and crown
If there is enough tooth above the bone, the usual route is root canal treatment, then a post and core to rebuild the missing part, then a crown. This keeps your own root, which is often the best outcome when the numbers support it.
Crown lengthening first
When the break sits just under the gum, a small gum and bone procedure can expose more sound tooth so that a ferrule becomes possible. Our guide to crown lengthening explains what this involves. It works best on back teeth. On a front tooth it can leave the gum higher than the teeth next to it, which may show when you smile.
Orthodontic extrusion
For a front tooth, a light brace can slowly pull the root a few millimetres out of the bone over several weeks, bringing sound tooth above the gum without changing the gum line around the neighbours. It adds time, but it can keep a natural root in a very visible spot.
Removing the tooth and replacing it
If the root is cracked, too short, or the break runs too deep, saving the tooth is often a poor investment. Removing it and replacing it with an implant, a bridge or a denture is usually more predictable. Our article on root canal compared with extraction sets out how dentists weigh this up, and the implant, bridge or denture comparison explains the replacement options side by side.
If an implant is a likely path, the implant consultation page explains what the first appointment covers. Sometimes an implant can be placed on the day the tooth is removed, and sometimes the area needs a few months to heal first.
How long each option takes
| Option | Typical number of visits | Typical time to finished tooth |
|---|---|---|
| Root canal, post and crown | 3 to 4 | 3 to 6 weeks |
| Crown lengthening, then post and crown | 4 to 5 | 8 to 12 weeks, allowing the gum to settle |
| Orthodontic extrusion, then post and crown | 6 or more | 3 to 4 months |
| Extraction and implant | 3 to 5 | 3 to 6 months, sometimes longer if bone grafting is needed |
| Extraction and bridge | 3 | 4 to 8 weeks after healing |
A temporary tooth can usually be placed in the meantime for a front tooth, so you are not left with a gap.
What it typically costs
Costs vary with the tooth and the complexity. As a general guide in Sydney, root canal treatment commonly ranges from about $1,000 for a front tooth to $3,000 for a molar, a crown from about $1,500 to $2,500, and a single dental implant with its crown from about $4,000 to $7,000. Crown lengthening and a post and core add to the cost of saving a tooth. Saving a badly broken tooth is not always cheaper than replacing it once every step is counted, which is why a written plan with each option priced is worth asking for. Our dental implant cost guide breaks down the replacement side, and the payment plans page explains how treatment can be spread out.
For current offers on emergency and new patient visits, see the current deals page. Lumi Dental also provides a written quote for each option before any treatment starts.
Questions we are often asked
My tooth broke at the gum line but does not hurt. Can I wait?
It is best not to wait long. A painless break usually means the nerve has already died or been treated, but the root is still exposed to decay and the gum can grow over the edge. Seeing a dentist within a few days keeps more options open.
Can a tooth broken below the gum line be saved?
Sometimes. If the break is only just below the gum, crown lengthening or orthodontic extrusion can bring enough sound tooth back into reach. A review of the ferrule effect by Juloski and colleagues in the Journal of Endodontics (2012) found that a band of sound tooth of around 1.5 to 2 millimetres improves how well root filled teeth with posts and crowns resist breaking. If that cannot be achieved, extraction is often the more predictable choice.
Can the broken piece be glued back on?
Rarely, for a break at the gum line. Reattaching a fragment can work for a small chip on a front tooth, but a piece that includes most of the crown usually needs a full rebuild.
Is it worth saving a tooth that broke after a root canal?
It can be, if the root is not cracked and there is enough tooth for a crown to grip. Teeth that had a root canal without a crown are more prone to breaking, so a crown is usually part of the plan this time.
Who will I see at the emergency appointment?
At Lumi Dental, a broken tooth is seen by a dentist, who will examine it, take an X-ray and talk through the options. Some follow-up care, such as cleaning and maintenance, may be with an oral health therapist.
