Teeth!

May 16, 2008 6:54 AM

A fair-sized bit of one of my teeth just fell off. The tooth is a molar, third from the back on the bottom jaw. I'm not in pain, and this has never happened before; I have no fillings and my teeth are generally healthy. I can see an NHS dentist in two weeks' time at the earliest, but what (if anything) should I do about it in the meantime?

Is it OK to keep eating normal foods?

And what is the dentist likely to do? Remove the whole thing? File down the sharp bits? Fill it?

posted by matthewr to health (21 comments total)

Emergency dental kits are available from pharmacies - these will patch over the hole and prevent further damage until your dentist appointment.

What the dentist will do probably depends on whether the nerve is damaged - in which case you may need root canal work. Normally though it'll just be a case of fitting a filling or a crown.

Save the broken piece - it may be salvageable.
posted by le morte de bea arthur at 7:01 AM on May 16

This happened to me a couple of years ago. You are probably going to lose the tooth.

It is quite likely to get infected at which point the pain will become terrible and your dentist will insist on a round of antibiotics to subdue the infection before doing the extraction. During this time you will be in terrible pain. Even the relatively high grade painkillers did almost nothing for me, except make me foggy and extremely constipated.

In other words, if you can afford to see a non NHS dentist before two weeks from now GO! GO! GO!

But I could eat normal foods for the most part up until I could get the rotten lump of mind-numbing pain pulled from my mouth.
posted by MasonDixon at 7:02 AM on May 16

As for food, just avoid anything extremely chewy or hard (keep off the toffee). You might notice some sensitivity with hot of cold foods, so take appropriate action there. Otherwise don't worry.
posted by le morte de bea arthur at 7:03 AM on May 16

Oh, and mine didn't hurt at first either. It started out as a small flake from the tooth and then things got ugly.
posted by MasonDixon at 7:04 AM on May 16

Get a good strong mouthwash if you're worried about infection - that and a tooth repair kit should hold the germs at bay until you see the dentist.
posted by le morte de bea arthur at 7:04 AM on May 16

This just happened to me with my bottom left front tooth a couple weeks ago - It probably has nothing to do with your dental hygene (mine didnt). Provided you're not missing too much of the tooth the dentist can use a resin to rebuild it, it wont hurt and it will feel just like it did before when they are done (maybe a bit more smooth). Mine happened as a result of me grinding my teeth at night and wearing down the enamel which gradually weakend the tooth to the point where it was at risk to be chipped. I hope this eases your worries a bit!
posted by Hellafiles at 7:09 AM on May 16

Keep it clean. Brush and swish with Listerine/warm salted water/hydrogen peroxide.

You most likely sheared a cusp off, you could have fractured it long ago and the piece finally gave out. It is a pretty common thing. A lot of the time, before they finally break away, you get little twinges as you chew. This is the loose piece flexing apart, after it breaks away, most people no longer have that sensitivity.

If you aren't in pain now, you most likely will not be, the irritation now is if it is sharp, your tongue can become scraped up. If it is a little sharp, you can lightly file it with a fingernail file to dull it just a bit. Waxes or store bought kits rarely stay in place, and they don't really help out unless you need the clove/eugenol medication in them to soothe a toothache.

Two weeks, as long as you aren't in pain, won't do more damage.
posted by Jazz Hands at 7:10 AM on May 16

This happened to me a couple of years ago. You are probably going to lose the tooth.

That's a bit alarmist! The same thing happened to me in November and I won't get around to having the dentist fix it until May 30 (it just needs filled), and I still feel no pain.
posted by cincinnatus c at 7:11 AM on May 16

I bit a hard thing about 18 months ago and lost around a quarter of a wisdom tooth (it was already weakened by a filling). The tooth has never hurt, isn't sensitive to heat or cold. I make sure to brush it carefully because of the extra nooks and crannies. The biggest problem is what Jazz Hands mentioned, it's sharp and occasionally I cut my cheek on it. Yes, I'm seeing a dentist (next week).

I wouldn't panic and think that the tooth is going to become a terrible problem in the two weeks before you see a dentist. Go easy on it if it hurts, but my experience was that it changed almost nothing for me.
posted by tomble at 7:19 AM on May 16

Oops, I forgot to address the other questions. I can give you likely scenarios, but with the condition of the tooth unknown and not knowing how your dentist likes to fix these things... I am not your dentist, blah,blah, blah...

1. The simplest and least expensive: Everything is completely fine with the nerve and there is minimal tooth structure lost. Could be restored with a simple filling, albeit a large one.

2. The nerve is fine, tooth can be restored with a crown, or a build-up and a crown. That tooth does not have an existing filling, if it had one, some dentists like to remove existing fillings so they can be absolutely sure no problem lurks below it. Then they refill the tooth with a strong resin core build-up and then prep for the crown.

3. The nerve is traumatized/diseased/dying/dead: Not likely in your case, but if so you will need a root canal and then a post/core build-up and a crown.

4. Alternative to #3, you opt to not go for the expense of the restorations, and either decide to live with the broken tooth until such time it does cause you pain and then extract, or you decide to have it out right away.


I would keep to a softer diet in the meantime, it is very unlikely that more breaks away, but be cautious anyway. If it is a little sensitive to hot and cold things, don't expose it to those extremes, you are keeping the nerve from settling down and working on healing itself.
posted by Jazz Hands at 7:22 AM on May 16 [1 favorite]

Try explaining to the receptionist what has happened, and ask them to give you first refusal on any appointment cancellations that come up before then.
posted by bifter at 7:39 AM on May 16

It is quite likely to get infected at which point the pain will become terrible and your dentist will insist on a round of antibiotics to subdue the infection before doing the extraction. During this time you will be in terrible pain.

Well. I'm certainly no shining example of great dental health, as my roommates complain about the noise of my grinding my teeth through the walls, but: I cracked a really sizeable portion of my tooth last year. I have no dental insurance (thanks, permalancing!) so it's been hanging out like that for a year. I don't feel anything when I drink hot and cold things, so I don't think there's much root damage. I'm in no pain whatsoever. I'm not suggesting you shouldn't see a dentist, but you might not be in tortuous pain in the meantime, either.
posted by zoomorphic at 7:49 AM on May 16

Also, while I suspect my own mangled molar is going to be excised, I've cracked many a tooth before due to grinding: when the dentist catches the gap early on, he'll usually take a molding of your entire mouth, fill in the missing portion with porcelain, and maybe give you a mouth guard (depending on why you cracked your tooth).
posted by zoomorphic at 7:51 AM on May 16

I've had 1/4 of a tooth in my mouth for over 2 years. I've never had any trouble with it, so I've never had it fixed. If it's not giving you any gyp, not loose, etc, I shouldn't worry too much about it.

That's not to say you shouldn't see a dentist, but it's not really that major a problem.
posted by Solomon at 8:05 AM on May 16

Did that tooth once have a filling? Sometimes this happens if you get decay around the edge of the filling. Happened to me, though it took an asphalt face-plant to knock it loose. You might lose the tooth, but more likely, you'll just need a crown (bastards are really expensive if you don't have insurance). If it doesn't hurt, you can probably wait until your appointment. Just keep it very clean. Every time you eat something, make sure there's no food stuck to it.
posted by ErWenn at 8:23 AM on May 16

What Jazz Hands said: It depends on the severity of the break. I had a tooth that lost a piece due to a filling that had gotten corroded (or whatever it is that metal fillings do). It was fine (from my point of view) for five years until another piece broke off. That was fine for about two weeks, until I got an outrageous toothache and had to have an emergency root canal and crown extension, because the second break was below the gumline. So I guess the moral of the story is: getting it fixed sooner rather than later is probably a good idea, but if you're in no pain now, you stand a good chance of being OK until your appointment.
posted by oneirodynia at 10:02 AM on May 16

I don't know the condition of your tooth, obviously, but you don't necessarily have anything to worry about. I chipped a cusp off a molar last March; it had been hanging on by a thread anyway, since I have a large filling in that tooth. My dentist told me I had two choices: build up the filling, which would probably chip off again due to the positioning; or a crown, which I could hold off on as long as it didn't hurt and I kept it clean. I opted to leave it alone. I'm finally getting the crown in a couple weeks, although I could wait even longer if I needed to.

Definitely see a dentist, but waiting a couple weeks shouldn't hurt.
posted by kiripin at 10:03 AM on May 16

That happened to me. I let it go a long time till I finally was able to get it capped. If you aren't in pain you are probably fine till you get to the doc. I was.
posted by konolia at 10:06 AM on May 16

In my case, the dentist just had a puzzle-piece of tooth made and glued it into place. It's ten years old and holding.

If it becomes sensitive, plain old dental wax will help. But when you do see the dentist, be sure to ask if it looks like you need a night guard for tooth-grinding -- you don't want to find this out the hard way, trust me!
posted by bunji at 11:38 AM on May 16

I have also lost a sizable portion of a tooth, which has been out for a very long time now and is still not fixed. It doesn't hurt and my dentist says I should receive an an appointment for an extraction ... some time. He didn't seem to be in a hurry unless I was in excruciating pain.
posted by beerbajay at 1:28 PM on May 16

well I don't know how bit a "fair bit" of a molar is, but when this happened to me (I think I lost like 1/2 of one of the points) my dentist wasn't worried. She said teeth are composed of layers of enamel like onions, and sometimes bits just flake off. And that it would smooth itself out over time. No shots, no filing, no rebuilding, nothing.

I am wondering why they're making you wait two weeks, however. That really seems excessive. Did you tell them what had happened? They should work you in.
posted by GardenGal at 8:59 PM on May 16