Cracked, Fractured, Loose or Displaced Tooth Fragments and Restorations
Brief description of condition
Lost, chipped, fractured or loose filling; cracked, chipped, fractured or split tooth or part of tooth; loose or displaced crowns, bridges or veneers.
Key signs and symptoms
Typically may include:
- Pain (general and localized; tenderness to bite)
- Sensitivity to hot, cold and sweet and chewing of food
- Open cavity
- Section of tooth or filling missing
- Sharp edge on tooth
- Mobile section of tooth or teeth
- Mobility or loss of restoration
- Trauma to the soft tissues of the tongue, lips or cheek from sharp edges of the fracture site
- Gingival inflammation
- Recurrent caries
If it is known or suspected that the patient has inhaled a piece of tooth, filling or restoration, send the patient immediately to emergency medical care via NHS 24.
If the patient has an open cavity or fractured tooth, either provide a temporary dressing or advise the patient to use an emergency temporary repair kit which can be purchased at a pharmacy.
Recommend optimal analgesia.
If the painful symptoms are not relieved with optimal analgesia, advise the patient to seek urgent dental care.
If pain is relieved or is not a significant component, advise the patient to seek non-urgent dental care.
If tooth fragments or fillings, consider:
- Smoothing any rough edge, removing any loose or displaced tooth fragments or defective fillings.
- Providing a temporary palliative dressing or permanent filling.
- Pulp therapy (direct pulp cap, pulpotomy or root canal treatment) if fracture involves the pulp.
- Extracting if the tooth is not restorable.
If crowns, bridges and veneers, consider:
- Recementing the restoration with a temporary or permanent cement, depending on the integrity of the tooth beneath and whether a new restoration is needed.
- Providing temporary coverage.
- Making permanent replacements.
- Providing a new crown for a primary tooth.
The maximum recommended dose of painkillers that takes into account the patient's age and is within the normal safe limits.