Skip to Content

Does a broken tooth need to be removed?

Having a broken tooth can be painful and concerning. You may wonder if the tooth can be saved or if it needs to be removed and replaced with something artificial like a crown, bridge or implant. There are several factors that determine whether a cracked or broken tooth requires extraction or not. Read on to learn more about broken teeth treatment options.

What causes teeth to break?

There are a few common causes of broken teeth:

  • Trauma – A direct blow to the mouth from a sports injury, car accident, fall, etc. can crack or chip a tooth.
  • Grinding – Clenching or grinding your teeth, also called bruxism, puts excessive force on teeth and can cause fractures over time.
  • Tooth decay – Untreated dental caries (cavities) can weaken tooth structure leading to cracks and breaks.
  • Large fillings – Having a very large dental filling can weaken a tooth and make it prone to fractures.
  • Dental procedures – Sometimes teeth can get cracked during dental treatments like root canals, tooth extractions, or crown preparations.

Types of tooth fractures

Not all cracked teeth are the same. Fractures can range from minor to severe. Some classifications of tooth fractures include:

  • Craze lines – These are tiny cracks in the enamel that don’t extend to deeper layers.
  • Fractured cusp – A piece of the biting edge breaks off but the rest of the tooth is intact.
  • Cracked tooth – A crack extends from the chewing surface down into the dentin but doesn’t split the tooth completely.
  • Split tooth – A crack splits the tooth all the way down into the nerve and root.
  • Vertical root fracture – A crack extends down the root of the tooth.

Signs of a cracked or broken tooth

Some signs that may indicate a tooth fracture include:

  • Pain when chewing or biting down
  • Sensitivity to cold or hot temperatures
  • Pain when releasing a bite
  • Spontaneous pain not caused by any stimulus
  • A visible crack in the tooth
  • A chip or piece of tooth that has broken off
  • Swelling around the tooth
  • Discoloration around the fracture line

Diagnosing a cracked tooth

Only a dentist can definitively diagnose a cracked tooth. They will examine the tooth visually and use a dental probe to feel for any cracks or fractures. Additional tests may include:

  • Bite test – Having you bite on a dental instrument to isolate the cracked tooth
  • Transillumination – Shining a light through the tooth to illuminate any cracks
  • Dye test – Using a colored dye that seeps into the cracks and makes them more visible
  • Magnification – Using magnifying loupes or a microscope to examine the tooth closely
  • X-rays – Dental X-rays may reveal the fracture line in some cases

The dentist will determine how severe the crack is and how far it extends into the tooth structure. From there, they can advise whether the tooth can be saved with a filling or crown or if extraction is required.

Treating minor tooth fractures

Small cracks like craze lines and fractured cusps may not require treatment if they aren’t causing symptoms. But if there is pain or discomfort, options for repairing minor fractures include:

  • Dental bonding – Applying a composite resin material over the crack to reinforce the tooth.
  • Filling – Placing a traditional dental filling over the fracture.
  • Crown – Covering the entire tooth with a dental crown to strengthen it.

As long as the crack doesn’t extend below the gum line, this type of fracture has a good prognosis with proper dental treatment.

Treating cracked teeth

For cracks that do extend into the dentin beneath the enamel but don’t split the tooth in two, treatment aims to prevent the crack from getting worse. Options include:

  • Root canal – If the nerve is irritated, a root canal is done to remove the nerve and infection.
  • Crown – A dental crown covers and supports the remaining tooth structure.
  • Extraction – If the crack is too severe, extraction may be necessary.

The prognosis depends on the location and severity of the crack. With swift treatment, many cracked teeth can be restored and saved.

Treating a split tooth

A tooth split all the way down into the root is considered a catastrophic fracture. This usually requires extraction since the tooth cannot be restored. However, some exceptions include:

  • If it is a front incisor tooth, the dentist may try bonding or splinting it to the adjacent teeth.
  • If part of the tooth root remains intact, it may be possible to do a root canal and place a crown to save part of the tooth.

But in most cases of a completely split tooth, removal is the only option.

Replacing an extracted tooth

When a severely cracked or split tooth requires extraction, it needs to be replaced with something artificial to prevent the surrounding teeth from shifting. Options include:

  • Bridge – Adjacent teeth are crowned and an artificial tooth is placed between them.
  • Partial denture – A removable acrylic device with artificial teeth to replace missing teeth.
  • Dental implant – A titanium screw is placed in the jawbone to replace the tooth root and support a dental crown.

Your dentist will advise you on the best tooth replacement option for your unique situation.


In summary, here are some key points to keep in mind regarding broken teeth:

  • Small cracks and chips can often be repaired, but large fractures usually require extraction.
  • A proper diagnosis from your dentist is important to determine the severity of the crack.
  • Completely split teeth almost always need extraction since they cannot be restored.
  • Extracted teeth must be replaced with something artificial like a bridge, partial denture or implant.
  • Seeing a dentist right away for any cracked or broken tooth is essential to get proper treatment and save as much of the natural tooth as possible.


While minor cracks and fractures can often be repaired, severely broken teeth usually require extraction and replacement with something artificial. It’s important to get an accurate diagnosis from your dentist to determine the extent of the damage. They can advise you on the best treatment options to save as much of your natural tooth structure as possible. With prompt care, many cracked teeth can be restored. But severely split teeth cannot be saved and must be removed to prevent further complications.