Front teeth can take a beating. A knock in the face with a baseball, a hockey stick, an elbow, etc. can result in trauma from as small as a chip to a large crack on the tooth that could even involve the nerve.


Treatment could be nothing or a filling of appropriate size.   Or it could be as extensive as a root canal or extraction on the extreme end.

Adults are less prone to sports accidents, but they can have some damage done to their teeth with just routine chewing.   This is more prevalent in older patients as teeth continue to wear down over time. Most of the time the solution is to place a composite filling to restore the tooth to its form before the chip. Sometimes you can just leave it alone or smooth it down a bit. For major tooth structure loss, a crown may be indicated. However, if there is not enough tooth left to hold a crown, then an extraction is frequently indicated, followed by a crown for the implant.

Sleeping with a bite guard may help save tooth structure when a patient grinds during his sleep. Grinding can wear some of the tooth down along with causing some chipping. With a bite guard the grinding force is absorbed by the plastic thereby preserving some of the tooth structure.

I prefer doing fillings over crowns whenever possible. I have had patients who had crowns fall off, calling to recement the crown only to find that the tooth structure broke off inside the crown and there’s nothing left to cement the crown to. So, I prefer a conservative approach on recommending crowns.

When a filling is placed where the tooth was chipped, the chewing force may be stronger than the bond strength of our materials. This means that the filling may need to be replaced frequently–every 6 months to 2 years depending how strong the grind and grinding habit are. I still think this is superior to something major like a crown. If there is any good news with this, it is rare that I have to give any local anesthetic. Patients seems to tolerate this procedure quite well with no discomfort.