What to Do About a Broken Molar

Located at the back of the mouth and on the top and bottom of the jaw, molars are the teeth responsible for chewing and turning solid food into pulp that can be swallowed.

Despite their excellent strength, with the ability to handle up to 171 PSI of pressure, these grinders still can be chipped, cracked or broken with enough force and with the help of weakened teeth.

The degree of injury determines whether you notice the defect immediately or after a while. With complete fractures, the associated pain makes the injury recognizable instantly as opposed to minor chips.

Like other fractures, a broken molar is a medical emergency, and you need to see a dentist promptly. Whether the break is above or below the gum line, prompt treatment is required to prevent the occurrence of potentially severe dental complications.

Causes

Molar fractures are associated with:

• Increasing age, as they are more common in those above 50 years

• Teeth grinding

• Biting hard foods like popcorn kernels

• Large dental fillings that weaken the tooth

• Trauma or direct blow to the jaw

Types of Teeth Breaks

A tooth break can involve one or more layers of the root, enamel, or both. Consequently, teeth fractures are classified into:

• Cracked: a crack runs vertically from the biting surface to the gum line or beyond

• Craze line: tiny cracks on the outer surface of the teeth only

• Cusp fracture: a painless crack around a dental filling

• Split tooth: a crack dividing the tooth into two

• Vertical root fracture: cracks starting from below the gum line and extending towards the biting surface.

Symptoms of a Broken Molar

The signs and symptoms of a broken depend on the nature of the injury. Tiny cracks below the gum line might be asymptomatic and remain unnoticed.

Severe injuries, such as those resulting from blows to the jaw, often present with considerable pain because of the associated destruction of the tooth structure.

In some instances, the pain comes and goes based on your activity. When you eat sugary or cold substances or bite down too hard, soreness might increase. And it can be difficult to distinguish the pain of a broken molar from that of a cavity.

When the break is above the gum line, chances are you will feel a jagged piece of the tooth with your tongue. Bleeding from a broken molar usually only occurs with severe injuries like complete fractures. You might also have inflamed gums.

What to Do Next

Like other dental emergencies, a cracked or broken molar requires immediate medical action. As soon as you notice a broken tooth, you should see a dentist for thorough examination and treatment.

If a piece of your molar breaks off, put it in milk or saliva (spit into a container) and carry it with you when you go to the dentist. The doctor might glue the piece back to the broken tooth. A break below the gum line might necessitate extraction to avoid complications.

Sometimes it is impossible to find a dentist who can treat you immediately, especially at night and in remote areas. In such instances, you should call the dental office for advice. You can also call an urgent care of an emergency room for advice.

While planning to see a dentist, avoid chewing with the injured molar. Try to eat with the uninjured side to avoid worsening the fracture. (Odds are the pain will take care of this for you.)

Use an ice pack on the outside of your mouth around the affected tooth to prevent swelling.  Over-the-counter painkillers like NSAIDs can also help with pain relief and swelling prevention before you see the dentist.

Once you notice a broken molar, you should visit a doctor even if you are not experiencing severe symptoms.

Treatment

Treatment options for a broken molar range from simple gluing back to more advanced alternatives like root canal and extraction. After examining your tooth, your dentist will recommend any of the following treatments:

• Gluing: If a piece of your tooth breaks off, your dentist can reattach it using special glue.

• Bonding: Entails using a plastic resin to fill in the defect left by the broken piece.  Suitable for minor fractures.

• Cosmetic contouring: Instead of bonding or gluing, your dentist might recommend rounding and polishing the rough edges of the broken tooth to make them relatively smooth.

• Veneer: If you have a break above the gum line with a considerable amount of residual teeth enamel, a thin, plastic, or porcelain covering is placed over the front of the broken molar.

• Crown: Used instead of a veneer if enamel loss is significant. The crowns are made of ceramic or porcelain and fit over the broken tooth.

• Root Canal: When the fracture extends into the pulp of the broken molar, there is a lot of pain. Removal of the damaged pulp and associated neurovascular structures can prevent further weakening of the tooth.

• Extraction: Molars broken below the gum line might be quite difficult to correct. In severe cases, tooth extraction might be the only viable option of alleviating the pain and preventing complications.

Recovery

Recovery of a broken molar depends on the degree of injury and type of treatment. Your dentist might recommend careful observation with no prescribed treatment in minor injuries, which can heal within weeks. Procedures such as veneer placement and root canal require multiple visits to the dentist’s office.

Costs

The cost of fixing a broken molar varies based on the severity of the break and procedure needed to repair it. Typically, endodontic therapies such as extraction with tooth replacement cost much higher than simple procedures like reattaching tooth fragments.

Cost might also vary with the region. Talk to your dentist about the average cost of a procedure beforehand. Insurance usually covers some of the dental procedures.

Prevention

You can reduce the risk of molar fracture by:

• Adopting good teeth and gum care

• Avoiding hard foods or chewing hard materials

• Wearing a dentist-prescribed mouth guard if having bruxism or playing contact sports

• Regular dental visits also reduce the risk of molar breakage

Complications if Untreated

If a cracked molar is left untreated, the fracture is likely to extend with time. The damage can increase beyond repair, culminating in eventual tooth loss. Secondary infections can also develop on fractured molars, causing swelling around the affected tooth.

Frequently Asked Questions