What should you do if a tooth is broken and the root is still in the gums?

Symptoms of a tooth broken at the gum line

A tooth that has broken at the gum line usually has characteristic fractures or a missing portion. However, the injury may also not be noticeable if the location of the damaged tooth does not allow adequate visual examinations.

Whether you can see the tooth fracture or not, you will most likely feel discomfort in your tooth. It can range from sensitivity to sweet and sour foods or high and low temperatures to the constant pain. 

When a tooth breaks at the gum line, bleeding may also occur. Swelling is especially common when root fragments remain in the gums. In addition, you may develop tooth discoloration.

If your tooth has broken off at the gum line and you feel no pain, this may indicate that the damage has affected the nerve and caused its death. When the nerve/pulp inside of a tooth dies, you may not feel any unpleasant sensations at all.

Treatment for a broken tooth with root still in gums

To treat a broken tooth at the gum line, you should make an emergency appointment with your dentist as soon as possible. The dental specialists could offer you some of the following treatment options depending on the severity and progress of the damage.

Tooth fragment reattachment

If you still have a fragment of your tooth, your dentist may be able to reattach it with dental adhesive. Your dentist will clean the broken pieces and place them in their original positions. Then, the dentist will secure them with a dental adhesive. To solidify the adhesive, your dentist will use a special light.

After the procedure, the dentist will make sure the reattached portion blends with your tooth. To do this, your dentist will shape, contour, and polish it. You may also need a dental crown to further protect the restored tooth.

Tooth repositioning

A broken tooth requires repositioning if the physical impact pushes it out of its original position. This condition is called tooth extrusion.

Your dentist may decide to reposition the tooth and return it to its socket. The dentist will be able to stabilize it with a dental splint or wire until the surrounding tissues heal properly.

Root canal treatment

Root canal treatment could save the structure of a broken tooth.

Your dentist will clean the pulp chamber of your tooth and remove the nerve inside. This clears your tooth of possible infection. Then, the dentist will place a dental filling in the cavity.

In general, dentists fabricate dental crowns to further protect the restored tooth after the root canal treatment is completed.

Dental onlays and crowns

As mentioned earlier, dentists usually provide a dental crown to secure a tooth after root canal treatment. A dental crown is a tooth-shaped cap that is placed over your tooth. It helps restore the treated tooth’s strength, shape, and size. Ceramic, porcelain, metal alloys, and combinations of these can be used for dental crowns.

If the damage to your tooth is not too extensive, your dentist may prefer an onlay. It is similar to a filling, but it covers a larger portion of the tooth structure. Porcelain, composite resin, and gold are popular onlay materials. Similar to crowns, onlays are custom-made in dental laboratories.

Tooth extraction

If the damage to your tooth is too extensive, which leads to a non-restorable condition, your dentist may prefer to perform an extraction. This procedure may take more time for a broken tooth with a root remaining in the gum. The dentist may need to make incisions in your gums and split the tooth into smaller pieces to remove it properly.

Certain teeth, such as the third molars, may need stitches after the procedure to facilitate the healing process. This will also protect the gums from potential infection and prevent excessive bleeding.

Causes and prevention of a broken tooth at a gum line

Physical trauma, whether it is a blow to the face or biting solid food or inedible objects, is one of the most common causes of broken teeth at the gum line.

Enamel decay makes teeth more susceptible to fractures. Poor dental hygiene, a diet rich in sweet and acidic foods, and teeth grinding can weaken enamel and an overall tooth structure.

Although the dental damage sometimes cannot be prevented, you can ensure that your teeth become stronger and less prone to fractures. For example, you can take care of your good oral hygiene regularly by visiting your dentist every 6 months, address any dental conditions as soon as possible, and reduce sweet and acidic foods in your diet. In addition,  you can wear a mouthguard during contact sports and at night if you suffer from bruxism (excessive grinding of the teeth).