Broken Down Teeth

If small enough, the rough area can be smoothed over with a polishing drill and left as is. The dentist will need to know why the tooth chipped to prevent it happening again. Some common reasons are trauma (knocked it), bit hard on something, weakened enamel from acid erosion (such as acid reflux, frequent softdrink or lemon consumption), weakened teeth from previous dental fillings, or dental decay.

Front teeth can be filled with white composite resin, as an immediate fix. Front teeth are the first contact with food, and are under a lot of strain everyday. Enamel is very strong, however once a piece has broken, the replacement material – white composite resin – is nowhere near as strong. It is advised not to bite hard on composite resin, as repeated breakages can occur. Stronger materials like Porcelain or Zirconia provide excellent aesthetics and longevity. Cosmetic porcelain veneers are ideal for small breaks. Ceramic crowns (below) are the strongest of all dental restorations.

When the tooth sends out pain signals, it is letting you know the problem is serious. Aim to visit a dentist ASAP to get the pain under control. Early attention can result in the dentist filling the tooth. Sometimes the dentist will use medicine under the filling to disinfect the tooth first. However sometimes the tooth is too far gone. With a toothache or swelling, instead of a filling the dentist may advise to have root canal treatment, or have the tooth removed. 

Using dental floss,  minimizing sugar and removing anything stuck in the hole can delay the pain until the dentist can see you. Book now online Ballina or Goonellabah.

The stresses on molar teeth are even higher than front teeth. When a breakage needs repairing, we have a choice of materials to fix the hole.

• • White materials placed directly into the hole. Composite resin is a standard filling material, however it does have limitations. It is not as strong as the enamel so it can break or weardown over time. A major concern is leakage under the fillings. Regular monitoring with Xrays will help monitor this risk. Daily flossing will reduce this risk considerably.

• Metal amalgam placed directly into the hole. This very strong metal filling does not wear or break or leak as much as composite resin. However it has fallen out of fashion due to its grey appearance. Many people still have old amalgams in their teeth, which is testament to their enduring nature. Some amalgam blends have undesirable properties like swelling with time, causing cusps to fracture.

As both these materials have problems, dentist may recommend some more long term restorative options. Cast crown restorations are stronger and often outperform standard fillings. They require more production time, and consequently cost more than a filling. However the extra expense pays off long term with teeth lasting for years, instead of repeated refilling.

Front teeth are called incisors. Their job is to cut into food and slice off bite sized chunks. They are the first point of contact when biting into all sorts of textures, including fingernails, chip packets and olive pitts. Incisors that have been repaired with composite resin may repeatedly break, causing distress to the patient and the dentist. That’s when it’s time to bring in the big guns – Crowns.

Here the front tooth has a fracture line where the tooth has split. It had to be cut back to a peg shape to allow for the “thimble” shaped crown to slide over the top. The bracing effect holds the fractured tooth together, allowing the patient to bite with confidence again.

Ceramic crowns look great because they match the colour of the teeth. If cosmetics are of high concern then zirconia crowns can perform very well on the front teeth. For the very back molar teeth however, gold can be a better performer in the long run. Being a metal, gold can be very thin and very strong, which means the dentist only needs to cut a limited amount of tooth back to fit the crown. Ceramics have problems with being generally more bulky and also they can wear the opposite teeth down from a grinding effect. Gold is much more gentle on the teeth.

When root canal therapy is complete, the tooth is considerably weaker. Firstly the middle of the tooth has been drilled deeply, which means there is greater leverage on the cusps. Biting forces can cause the tooth to crack in half. Secondly there is no reflex reaction within the tooth when something excessively hard is encountered. Without a nerve to feel the crack starting, the tooth can shatter unexpectedly.

Crowns can help prevent the shattering, splitting and breaking of teeth after root canal therapy by bracing the tooth. Indeed in the preparation of a crown, more tooth needs to be removed to make space for the crown. However a skilful dentist will know how to minimise the cutting to give the optimum fit. For example using gold allows the dentist to cut less tooth and keep the tooth stronger.

A crack running through a tooth can turn nasty. It may start as a bit of a twinge when eating and then progress to a stronger pain. It is important to get some support around the tooth before it breaks completely. A crown can offer this circumferencial support, by wrapping around the tooth.

If the tooth is not supported in time, the crack may reach the nerve causing a strong toothache. Don’t leave it too long. Appointments available at Ballina or Goonellabah.

Bridges are a similar process to having a crown placed, however bridges usually span across 3 teeth or more and replace missing teeth. You do not need a bridge if you have no gaps or had any teeth removed.

The Maryland bridge is the most economical little bridge , both in cost and in the amount of tooth that needs to be removed. Here only 2 slots were placed in the neighbour tooth and the false tooth is supported by a small “wing” of metal. These mini-bridges are excellent for filling a gap at the front of the mouth. Maryland bridges are good for teeth that have never had fillings previously. The procedure takes 2 visits, allowing the technician to make the metal ceramic bridge. Maryland bridges are an alternative to dental implants.

The full coverage bridge is a very strong option of holding onto the neighbours with crowns that cover the entire tooth. This option is good for broken down teeth, where support is needed to reconstruct the teeth either side of the gap. Bridges may have a metal substructure with porcelain on top, or they can be entirely made of white zirconia. They look very similar to natural teeth. As three or more  teeth are often joined together, special interdental cleaning brushes are needed to keep the bridge hygienically clean.

When we talk about cost we can talk about money. But the other cost of cutting away healthy tooth to fit the bridge is possibly more valuable. That’s where the skill of your dentist comes in. A dentist with a little engineering nous can cut LESS tooth away causing LESS sensitivity and giving the teeth a better chance of surviving the drill. Heavy handed dentistry can end up causing after pain, toothache and even pulp death.

Ask for Dr Kim Davies to do your bridge preparation for the best long term outcome for the teeth and the bridge.

Price Estimates (as at 2021):
A crown on a single tooth is $1600

A two unit bridge is like 2 crowns. Our fee ranges from 3000 to $3500.

A three unit bridge ranges from $3500 to $4000

Bridges on implants need to be quoted individually, and are slightly more expensive.

An implant is the gold standard for replacing a missing tooth. The metallic implant can be surgically placed into the jaw bone (by a specialist) and a false tooth is then added to it a few months after healing. Implants can replace a single tooth or multiple lost teeth.

Costs vary but are estimated at $5000 – $6000 per tooth.

There needs to be good bone for this procedure so it may not be suitable for everyone. For example smokers have a higher failure rate. Bridges or dentures may be more suitable.

Palatal coverage means the denture stays up with surface tension across the roof of the mouth. Lower dentures do not hold on the lower jaw so well. Implants can be considered for better stability of a full lower denture.

Prices range from $700 to $1600
These are made with metal wires that clasp onto the teeth. The gums are covered in pink acrylic and the teeth are white. Although they are less expensive than metal cast dentures, the fit is not as intimate and these dentures can move around a little. They tend to be more bulky than a metal denture, and cover the gums more, which makes them less hygienic. Not recommended in people with high decay risk or periodontitis. Acrylic dentures can be modified and added to as required.

Price ranges from $1500 – $1900
Cast metal dentures offer a precision of fit, making them potentially more stable and comfortable. The metal can be thin, allowing less coverage of the gums, which is more hygienic. Very strong and long lasting, provided they are not dropped or distorted. Metal clasps may be visible, however most of the visible part is white teeth and pink gum. Aesthetic clasps can be used (white clasps).

Made from a flexible fabric, Valplast dentures are comfortable on the gums. There are no metal clasps as the denture hugs the teeth with the pink resin. These dentures are very cosmetic, however because they cover more gums, they are less hygienic than metal dentures. The denture is made by injection moulding, so future modifications (like adding more teeth) is not possible.

Duraflex is an improved, newer material, similar to Valplast.