What to Do When a Piece of Your Tooth Is Missing?

So you were eating salad and something crunchy came out.. It happens a lot and could happen with hard or soft food! That’s correct.. it’s not necessarily the fault of the restaurants.. I know that’s not what you wanna hear but it could be the case. We have already wrote about solutions for a fractured front tooth as well what you can do about a chipped molar tooth. In this post we are going into more details about different possibilities that can cause a piece of your tooth to be missing.

1. The tooth has had a large filling before with a small portion or weak wall of the tooth remaining on its side, or had large crazelines (small thin fracture lines) from clenching/grinding activity that have been fatigued out, and as such a piece is actually ready to separate from the body of the tooth. In this type of a case, even a soft piece of bread, if chewed on at “the right time” could cause a piece to come off
2. Something hard has been actually bitten on, like an olive pit or bone which has caused a piece of the tooth or filling to separate from the body of the tooth.
3. An old silver filling or a white one that’s not quite bonded to the tooth, has a recurrent cavity for instance, ready to be dislodged; and again biting on sometimes hard or even soft, sometimes even flossing honestly could bring them out.
4. Trauma related issues like falling off a bike or ball hitting one’s face or a baby’s head impact!

There are definitely times that I have seen patients come in not knowing that a piece of a tooth is missing because it’s not symptomatic, or that a piece has come off without much trauma really. Depending on what the circumstances, there could be more than meets the eye that would need to be done.

Most often the issues related to trauma would cause nerve damage long term (sometimes even short term) even if not a large portion of the tooth is missing initially. Often times, when something hard is bitten on, in a sense trauma, it’s not only a piece of the tooth or filling that’s separated but also a small fracture line that’s developed on the body of the tooth, which could open up long term, causing pain/sensitivity/needing the nerve to be addressed as well. And when a piece of the tooth is broken following a large/wide filling, that too often times is followed by nerve damage and need for root canal treatment to denervate the tooth in a sense.

Why does the etiology matter? Because it could determine the solution or the steps of treatment involved. Sometimes a filling can resolve the issue while, often times it’d be more than that – inlay/onlay/crowns and even need for root canals. I have had patients of course where the tooth was almost split in half of course in which case, prognosis is poor or that the costs of saving it would be incredibly high; and instead extraction and replacements (implant or bridge or partials) are recommended.