Save or Extract

My tooth has broken: can it be saved?

It is not the size of the break that decides, but how far down it goes

Two breaks of the same size can lead to two completely different outcomes, because what decides it is where the break is. On this page we explain the four types of break, which ones are repaired with a filling, which ones mean extraction, and what you should do with a broken tooth in the first few hours.

Short answer

Most broken teeth can be saved; what decides it is how far down the break goes. A break confined to the enamel and dentine is repaired with a filling or a crown. A break that reaches the nerve needs root canal treatment first, then a crown. When the break line goes below the gum line, there is no sound wall left for a crown to hold on to, so the outcome becomes an extraction. With a vertical root fracture, which splits the root along its length, there is no option to save single-rooted teeth: the fracture line opens up a pathway for bacteria that cannot be sealed.

What decides it: Where the break is in relation to the gum
What the decision needs: Examination and X-rays
The broken piece: Keep it in milk and bring it with you
Is it urgent?: Yes, if there is pain, bleeding or swelling

Medically reviewed by Bilge Ilgın, Dentist · ImplantologyLast reviewed 2026-08-31

Which part of the tooth has broken

From the outside in, a tooth has enamel, which is hard but does not flex; the softer dentine; the pulp, which carries the tooth's nerve and blood vessels; and the root, which is embedded in the jawbone. Which layer the break stops in decides what the treatment will be; that is why 'my tooth has broken' is not a diagnosis on its own, but covers four separate situations at once.

A break confined to the enamel and dentine is the most common type and the easiest to deal with. A corner or cusp of the tooth breaks off while you are biting on something hard; the rough surface catches your tongue and you feel slight sensitivity to cold, but there is no throbbing pain. Because the break has not reached the nerve, the tooth stays alive and a composite filling is enough; if the piece that broke off is a cusp that takes the load of chewing, a crown or an onlay is needed.

When the break reaches the pulp, that is, the nerve, the picture changes. A red spot or slight bleeding can be seen on the broken surface; cold and air cause sharp pain, and this pain carries on after the trigger has gone. The tooth can still be saved, but a filling is not enough: the exposed nerve tissue is covered with a special material or removed with root canal treatment. Waiting costs you the nerve, because the exposed pulp is in contact with bacteria.

When the break goes below the gum line, the problem is not the tooth itself but the lack of a sound wall for the crown to hold on to. If the edge of the crown sits inside the gum, that area cannot be cleaned and becomes permanently inflamed. The way out is to lower the level of the gum and bone, or to pull the root up orthodontically; the further down the break is, the lower the chances of either working.

A vertical root fracture is a separate category: the fracture splits the root along its length, from top to bottom. The reason it cannot be saved is not its size but its position. The line runs inside the bone, along the surface of the root, and opens up a direct pathway for bacteria; there is no filling that can seal this pathway, because there is no surface to work on. As the bacteria advance, the surrounding bone resorbs. The signs are easy to miss: a vague discomfort when you bite, a small bump on the gum at a single point, or a narrow pocket that keeps getting deeper. It is more common in teeth that have had root canal treatment and have a metal support (a post) placed inside them.

These four do not lead to the same outcome. The first two end with the tooth staying in place; with the third, it depends on how many millimetres down the break stops; with the fourth, what needs discussing is not saving the tooth but when it will be replaced and with what.

Which breaks can be saved, and which cannot

The breakdown below becomes clear after an examination and X-rays. Seeing yourself in the second list does not mean the tooth will be taken out today; it only means the option we will talk about changes.

The tooth can be saved

If the break is confined to the enamel and dentineA tooth that has lost a corner or cusp, where the break has not reached the nerve, is repaired with a filling, or with an onlay or crown if more has been lost. Root canal treatment is not needed; we monitor whether the nerve stays alive for a while.
If you have the broken pieceEspecially with front teeth, we bond your own piece back in place; your own enamel gives a much better colour match than can be achieved with filling materials.
If it has reached the nerve but the root is soundWith root canal treatment followed by a crown, the tooth stays in place. A break reaching the nerve does not mean you have lost the tooth; it makes the treatment one step bigger.
If the break is just below the gum lineWe lower the level of the gum and bone to expose the sound wall, or pull the root up orthodontically. If the break is close to the gum line, these approaches work.

Saving it is unlikely to hold

A vertical root fractureA fracture that splits the root along its length cannot be sealed; a filling, a crown or root canal treatment will not make this line watertight. What we will talk about here is not saving the tooth but when we replace it and with what.
If the break is far below the gum lineIf the amount of bone that has to be removed to expose the sound wall is so large that it weakens the support holding the root, any restoration will not last long.
If the tooth has split in two along its lengthA crack running down from the chewing surface splits the tooth into two pieces over time. If the pieces move independently, keeping the tooth as a whole is not an option.
If the tooth has already been treated many timesIf large fillings and previous root canal treatment have already cost the tooth a lot of its structure, the remaining walls cannot support a new restoration. Trying once more gives a short-lived result.

How we reach the decision with a broken tooth

This sequence is for diagnosis, not treatment. At the end, you will know where the break ends and, based on that, which option is realistic for your tooth.

1
What to do in the first few hours
Rinse your mouth with warm water, apply light pressure with a clean piece of gauze if there is bleeding, and hold something cold against your cheek from the outside. If you have found the broken piece, do not let it dry out: keep it in milk or your own saliva and bring it with you.
2
Send us your X-ray or a photo
If you have a panoramic X-ray, send it through the form; if not, a clear photo of the broken tooth taken with your phone is enough for an initial assessment. We write to you within 24 hours about which options are on the table.
3
Clinical examination
We talk about how the break happened and whether that tooth already had a filling or root canal treatment; a sound tooth broken by a knock and a root-filled tooth that broke on its own are not read in the same way. Then we trace the break line: staining, shining a light through the tooth and a bite test on each cusp in turn show how far down the crack goes. A deep, narrow pocket measured with a probe is an early sign of a vertical root fracture.
4
X-rays and, if needed, a CBCT scan
A standard X-ray does not always show a break; when the beam does not line up with the break line, the crack cannot be seen. If a root fracture is suspected, we ask for a cone beam CT (CBCT) scan. This is where the decision becomes clear.
5
We assess the nerve and talk through the options
A cold test shows whether root canal treatment is needed; in teeth broken by a knock, the nerve goes into shock in the first few days, so we repeat the test at intervals. Finally, we explain openly how many visits each option needs and what is left if it fails.

The options for a broken tooth

None of them is better than the others; where the break is decides which one is right. The right order always starts with the least invasive.

A composite filling, or bonding the broken piece back on

The solution for breaks confined to the enamel and dentine, completed in a single session. If you have the piece with you and it still fits properly, we bond your own piece back on; if not, we rebuild the shape with composite.

An onlay or a crown

If the piece that broke off is a cusp that takes the load of chewing, a filling is not enough, because the same force breaks the same place again. An onlay or crown that wraps around the remaining tooth spreads the load across the whole tooth. This is our first choice for back teeth and for people who grind their teeth.

Root canal treatment followed by a crown

If the break has reached the nerve, the tissue inside the tooth is cleaned out, the canal is filled and a crown is made on top. Because a tooth that has had root canal treatment loses some of its flexibility, leaving it without a crown is asking for another fracture.

Adjusting the gum level, or pulling the root up

If the break is just below the gum, we lower the level of the gum and bone to expose the sound wall, or pull the root up orthodontically. If the break is very far down, this extra time does not pay off.

Extraction and an implant

If the tooth cannot be saved, we replace it with an implant. We carry out the extraction and the implant in the same session; this shortens the treatment time and preserves the contour of the soft tissue. Our main field of work is many missing teeth; for a single broken tooth, a single-tooth implant or a bridge is the better route.

What you need to know when deciding

We write these down not to frighten you but so that you can ask the right questions whichever dentist you see. If a dentist does not tell you these things of their own accord, ask.

No pain does not mean the break is small

A vertical root fracture progresses silently for a long time; in a tooth that has had root canal treatment, the nerve tissue that would give the warning has already been removed. Even when there is no pain, bone is resorbing around the fracture line.

A standard X-ray does not always show a break

If the fracture line is not parallel to the X-ray beam, it will not be visible on a two-dimensional X-ray. An assessment that says there is no break because nothing showed up on the X-ray is based on incomplete information.

A break does not stop by itself

The force of chewing lands on the same line every day; within months, a small crack turns into a tooth with a broken-off cusp, and that in turn into a break that goes below the gum. A break that could be repaired with a filling today will need a crown or root canal treatment if it is put off.

A crown on a weak base does not last long

A crown made when the wall underneath is inadequate looks fine for a while, then leaks at its edge, and decay starts underneath it. You do not want to be back at the same point two years later, and with less bone.

Our protocol is not the right place for a single broken tooth

Implant72's protocol of fixed teeth in three clinical days was designed for many missing teeth. If you have a single broken tooth, the right route is treatment aimed at saving it first and, if that does not work, a single-tooth implant.

What to expect afterwards

The course below applies when extraction and an implant are chosen. With a break repaired with a filling or a crown, there is no separate healing period; you go back to your normal life the same day.

The first 48 hours
Some swelling and tenderness are normal. A cold compress and the painkiller we give you take care of this. We ask you to take a break from smoking and hot drinks.
The first week
The swelling goes down. We ask you to avoid hard and hot food and to brush the area gently. If you have stitches, they are removed according to the clinic's follow-up plan.
The first three months
During this period the implant's integration with the bone progresses, and you still need to be careful when chewing.
Once it has healed
Care is no different from a natural tooth. If the break was caused by teeth grinding, a night guard also comes in at this point.

Message us right away if

Your pain does not ease with medication. Tell us about pain that gets worse after the first few days or does not respond to medication.
Swelling increases after the third day. Swelling goes down as you heal; if it is increasing, call us.
You have a fever or difficulty swallowing. These are signs of a spreading infection. Call without waiting.

What determines the cost

We do not give a single figure on this page, because the right figure can only be given once we have seen where the break ends, and the difference between a composite filling and an extraction plus an implant is very large. Send us your X-ray or a photo and we will share the scope and the figure in writing. These are the items that determine the price:

Where the break ends: A break confined to the enamel and dentine and a break that goes below the gum are not the same procedure; one involves a single-session filling, the other gum surgery and a crown.
Whether root canal treatment is needed: If the break has reached the nerve, root canal treatment is added to the plan; if not, this item does not come into it at all.
The type and material of the restoration: A composite filling, an onlay and a full crown mean different work and different materials. We tell you in writing at the outset which brand of material we use.
The number of teeth affected: If several teeth are at risk at once because of teeth grinding or old, large fillings, planning them all together means fewer visits.

Frequently asked questions

My tooth has broken but it doesn't hurt at all. Do I still need to see a dentist?

Yes. Pain shows whether the break has reached the nerve; it does not show how far down it goes. A break that has not reached the nerve progresses without causing pain, and its edge gets a little bigger with every bite. A painless break is not an emergency, but it is not something to put off either.

I kept the piece that broke off. Is it any use?

Yes, especially with front teeth. When your own piece is bonded back in place, it gives a much better colour match than can be achieved with filling materials. The only condition is that the piece does not dry out: keep it in milk or your own saliva, and do not wrap it in a tissue and put it in your pocket. If the piece has dried out, we rebuild the shape with composite.

I can't get to a dentist tonight. What should I do?

Rinse your mouth with warm salt water, apply light pressure with gauze if there is bleeding, and hold something cold against your cheek from the outside. If the sharp edge is scratching your tongue, get some temporary dental wax from a pharmacy and press it over the edge. Do not put a painkiller tablet directly on your gum; it burns the tissue. If the swelling is growing quickly, you have a fever or you are struggling to swallow, go to A&E.

Is there really nothing that can be done about a vertical root fracture?

There is no method that saves the tooth as a whole, because the fracture line is inside the bone and has no surface that can be reached; this line, which cannot be sealed, becomes a permanent pathway for bacteria. In molars with several roots, if the fracture is limited to one root, we remove that root and preserve the rest of the tooth. Otherwise, what needs to be done is to take the tooth out before more bone resorbs and plan what will replace it.

If an extraction is needed, can I have the implant on the same day?

Yes, and that is the route we prefer. If the bone walls of the extraction socket are sound, we place the implant in the same session; this shortens the treatment time and preserves the contour of the soft tissue. If there is active infection in the area, we treat that first and do not place an implant in the same session.

Does 'implants in 72 hours' apply to a single broken tooth too?

This protocol was not designed for a single tooth. The reason we can provide fixed teeth in three clinical days is that a strategic implant locks mechanically into the hard outer layer of the jaw, the cortical bone; a conventional implant anchors in the softer, spongy bone inside, so you have to wait for it to fuse. This difference really pays off when many teeth are missing. For a single broken tooth, the right route is treatment aimed at saving the tooth first and, if that does not work, a single-tooth implant.

Why don't you put prices on the page?

Because the costs of the options on this page are very different from one another, and we cannot tell which one applies to you without seeing where the break ends. Any figure we wrote would either frighten you unnecessarily or change at the clinic. Send us your X-ray or a photo and we will share the scope in writing, item by item.

Sources

Send your X-ray and we will tell you which option is realistic for your tooth.

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Next step

Send your X-ray and we will talk through the options.

Share your CBCT or panoramic X-ray. We will write back within 24 hours on which option is realistic for your tooth.

Get an assessment