Why are my front teeth chipping?
A few years ago, I began noticing that my front teeth were starting to chip. First the chips were small and my dentist filed them down, but they keep chipping and I’m afraid that one day they might break right off. Help!
It’s not always a simple fix…
Of course, it is difficult to give an appropriate answer until a proper exam and bite analysis has been done, but you have a right to be concerned. Although enamel is the hardest substance in the body – twice the hardness of bone – teeth can fracture for any number of reasons. If there was no sudden trauma or injury that occurred causing them to break, then we have to look at other possible causes.
The front teeth are slender, single rooted teeth. They are designed to bite into food not chew like the larger, multi-rooted molars. When atypical forces are applied to these teeth, they will eventually begin to break down as well as the surrounding jawbone that supports them.
Let’s look at some of the possible causes for chipped front teeth:
1. Injury/Trauma – When a front tooth has received a “hit”, parts of the tooth can break. If just the crown portion *fractures, then the extent of repair depends on how severe the break was. A small, simple break can be fixed with matching tooth coloured filling material with or without pins for reinforcement. If the break is more complicated and the nerve centre of the tooth has been damaged, then a root canal will be performed before the broken tooth is repaired. The extent of the trauma will often determine the likelihood of future maintenance for the tooth. Even a filling that is placed on a small, fracture can fall out repeatedly simply because the chemical bond between the tooth and the filling material is weaker than the bonds of natural enamel. Longer term solutions like veneers or full coverage crown may be recommended.
*Fractured root – Because there are many degrees of cracked or chipped teeth, it is important that you see your dentist for a proper clinical and radiographic examination. The treatment and outcome will depend on the type, location and extent of the break. Early intervention is very critical as delaying treatment can result in the loss of your tooth.
2. Grinding/Clenching – This can be a very destructive force upon teeth causing them to fracture and become loose. Because it is usually a unconscious habit, it is difficult to control without the aid of an bruxism appliance. Nowadays, your dentist may also recommend the use of Botox to relax the facial and jaw muscles involved in the dynamics of bruxism. Until this habit is under control, teeth and their supporting structures will continue to wear and breakdown.
3. Missing teeth – Losing teeth, either due to trauma or disease, and not replacing them with a suitable, long-term solution causes fewer teeth to do the work of many. The forces in the mouth during chewing and clenching can reach a staggering 150 lbs/square inch. These forces are naturally designed to be distributed throughout the dental arches and the work shared by 28 to 32 teeth. It is when fewer teeth are expected to withstand this tremendous load that we begin to see destruction to the jaws, muscles, teeth, and gums. Ideally, a dentist will perform a comprehensive evaluation of the dental collapse that is occurring in a patient’s mouth. Only then can a proper recommendation be made.
4. Bite – Sometimes, after orthodontic treatment, tooth repair, tooth loss or injury, a person’s bite can become off-kilter. If your upper and lower teeth are not meeting properly, or teeth have shifted from their original positions, the aforementioned forces can be brought to bear on a few teeth before the rest of the dentition realigns itself in the chewing process. This constant high biting, unequal distribution of forces and readjusting of the jaws can cause havoc to the teeth and muscles. A bite analysis is performed, high bite areas are identified and then readjustments can be made so that the entire bite is equalized. Sometimes, the collapse of the dental arches and teeth over the years requires more comprehensive intervention with a treatment plan that involves a considerable amount of readjusting and opening of the bite.
5. Post Ortho – Sometimes. after completing orthodontic treatment to correct crooked or misaligned teeth, other bite issues arise. It is important that you stay in touch with your orthodontist so that they can re-evaluate your bite periodically. Orthodontics is a complex dental specialty and treatment outcomes may vary from person to person. If you have developed TMJ, grinding, or other problems after your braces have been removed, further treatment considerations and adjustments may have to be made.
Expectations vs Reality
There’s an old Neil Young lyric that comes to mind when we talk about expectations, “They give you this, but you pay for that.”
Nobody wants to be sold a false set of goods or have unexpected treatment outcomes, but sometimes, what seems like a simple fix can actually be a problem that is not easily resolved the first appointment. Your dentist may have initially concluded that filing down your teeth will fix your bite, but continuing to do so will just cause another set of issues without determining what the real source of the problem is.
When the uncertainties of a dental issue are fully explained beforehand and something has to be repaired again or requires additional maintenance and readjusting, then it’s no surprise to the patient nor the dentist. If you are returning time and time again for the same issue then a decision has to be made. Has your dentist recommended a long term solution but you are not ready to commit financially? Are you expecting a quick fix or patchwork dentistry? Perhaps, the dentist cannot determine the source of your problem and needs to refer you to another dentist for further evaluation.
There are risks and benefits involved with treatments in all healthcare professions. This is why communication is so very important. Disappointment, misunderstanding and frustration can be avoided when a dentist helps a patient understand and manage a situation that may be more complicated or chronic in nature.
When a patient is offered solutions, but for whatever reason, decides not to comply with treatment recommendations, then they need to understand the possible future implications of their decision. However, if a particular problem persists after repeated dental visits and following all of your dentist’s advice, then it is reasonably acceptable to ask your dentist to refer you to a dentist more specialized in your particular dental issue.
There is nothing quite as long lasting and as strong as your natural teeth. Preventing dental disease, breakdown and injury in the first place is your best bet for avoiding the uncertainties of some treatments that may require on-going monitoring, modification or even re-treatment.
If you are new to the area or just searching for a dental family to call your own, Dr. Sam Axelrod and his team of caring professionals are always here to help. We’re just a phone call away to answer any questions or concerns you may have.
Your in Better Dental Health,