Broken Teeth Don’t Always Get On Your Nerves

Here’s a common conversation at the dental office:

Me: Have you had any dental problems since the last time you were in?

Patient: No, they are all still there in my mouth so nothing’s wrong that I know of.

Me: Well, let’s get some X-rays and do an exam with the doctor just to make sure.

Patient:  I’d rather not.  Nothing hurts so I’m pretty sure it’s all just fine. I just want my teeth cleaned. I’m in a hurry.

AND low and behold there’s a broken tooth like the one at the top of this page!

Bad dental conditions like decay and periodontal disease don’t hurt at first.  I spend a lot of time at work explaining why these issues often lack symptoms.  We take X-rays just so we can find cavities before they creep into the nerve canal and cause discomfort.  We use little probes to perform periodontal screenings because no one really feels an infected pocket in their mouth until it’s pretty far gone.  I’m totally accustomed to cavities and gum disease being a surprise to my patients. But for some reason, I’m still always caught off guard when I see a broken tooth and the person in my chair doesn’t feel pain.  I’m even more taken back when they don’t even realize a tooth is broken at all.

The reason some people aren’t in agony when they break a tooth is because we are all wired differently and our nerves literally vary in shape, size and location.  To explain how, let’s take a look at the parts of a tooth

The enamel is a hard outer shell that’s as strong as volcanic glass

The dentin is the more porous second layer MUCH softer than enamel

The inner pulp chamber is where we have feeling because that’s the nerve

If you are fortunate enough to break a tooth and not have pain, it’s one or more of the following reasons:

• The nerve of the tooth is not vital (a “dead tooth”)
• The nerve has calcified or closed in
• The break was superficial and didn’t get past the dentin
• The nerve canal is deeply embedded in the tooth
• Sometimes medications can mask symptoms

Usually broken teeth can be repaired with crowns.  Often times,  root canal therapy needs to be completed first to assure that bacteria won’t involve the nerve of the tooth and cause infection and/or pain during and after the tooth is being fixed. In some cases, a tooth will need to be removed if it cannot be salvaged.

Want a few tips for reducing your chances of breaking a tooth?  That’s coming up in a future blog!

Did you ever break a tooth and NOT call your dentist right away?

Comment below and tell me why!