You know exactly what it means, when you hear that typical "crack" as you bite down on your morning sesame seed bagel. Then, you spit out that little white piece of tooth that just snapped off as you were enjoying your breakfast. Now you have to address your broken tooth.

A tooth can fracture with three degrees of severity, each one requiring a different treatment to restore. The first way a tooth can fracture involves only the outer layers of the tooth, the dentin and the enamel. In these cases when the tooth sustains a simple fracture, it can be restored with a restoration if it's in the front, or a crown if it's in the back, depending on the amount of tooth structure remaining. If a significant portion of the tooth is missing it may be necessary to place a core build-up prior to placing crown. A core is a large filling that replaces the missing tooth structure and provides support, giving the crown something to be cemented to.

When a fracture is more complex the nerve tissue of the tooth, called the pulp, is also involved. These fractures expose the pulp tissue to the oral cavity and contaminate it with bacteria. Complex fractures, in addition to a crown restoration, also involve treatment with root canal therapy because the pulp tissue immediately becomes infected. If left alone, without performing a root canal, the pulp dies and becomes a constant irritation to the body. Necrotic pulp tissue can eventually develop into a chronic infection in the jaw bone, called an abscess. A dental abscess can cause severe pain and swelling, and should be prevented whenever possible.

The final way a tooth can break is when a fracture develops and propogates down the root of the tooth. When this happens, and the fracture extends below the gumline and the jaw bone, the tooth cannot be saved and it must be extracted. Thankfully, most fractures like this can be prevented by going to your dentist every six months for examination, x-rays, and cleanings, to diagnose, treat, and eliminate fractures before they cause significant problems.

Here are some important questions you can ask your dentist when your tooth breaks.

Can the tooth be saved?

Will my tooth need a root canal?

Is there enough tooth structure remaining to restore it with a crown?

Will a restoration (filling) be enough to restore my tooth?