What Should I Do About a Molar Broken Off at the Gum Line

If your molar breaks at your gum line, you’ll likely be able to feel the missing part of your tooth with your tongue. You may feel the jagged and sharp edge of the remaining fragment left in your gum.

It will likely be clear that your tooth is broken with a visual inspection of your mouth. However, it may be difficult to see your molar yourself without the special tools and lights that a dentist has access to.

If you can see the broken tooth, it might appear yellow or pink from exposed dentin and pulp inside your tooth. If it appears black or dark brown, it may be a sign of tooth decay.

You may also taste blood from broken blood vessels inside the tooth or from cuts in your gums or tongue.

If the inner pulp is exposed, you’ll likely experience pain from exposed nerve roots. In some cases, the broken tooth might not hurt at all or the pain may come in waves.

Sharp edges left from the broken tooth may also cause inflammation of your surrounding gum or tongue from rubbing.

Cold or sweet foods or drinks will also likely cause pain.

For a broken tooth, and all other dental emergencies, visit your dentist as soon as possible. The sooner your dentist can examine your tooth, the better the chance that you’ll have a good outcome without complications.

If your molar is broken beneath your gum line, there’s a good chance that the damage is significant enough to require extraction.

If you’re traveling and don’t have access to your hometown dentist, you can also try calling dental clinics in your area to see if they can fit you in. Most dentists leave time in their schedules for treating emergencies. If you can’t get into a dental clinic, visit the emergency room.

Teeth that are broken beneath the gum line are known as subgingival fractures.

Whether your tooth can be saved depends on how deeply the tooth is broken and how quickly you get treatment.

Your dentist might have to recontour your bone with a procedure called a crown lengthening to be able to fix your broken tooth.

If you can find the fragments of your broken tooth, your dentist may be able to bond it back together. But if the damage extends below your gum line, it will likely need to be extracted.

Reattaching broken fragment

Reattaching the broken tooth may be possible in some cases. But the deeper your tooth is broken, the harder it becomes to bond it together.

Reattaching your original tooth can provide aesthetically pleasing results since the tooth provides you with a natural color and texture.

Reattachment is a relatively simple procedure. Your dentist will use one of several bonding agents, such as Prime, Bond NT, or Dentsply.

Your dentist may combine this technique with a root canal if the pulp is exposed.

Root canal

A root canal may be combined with reattachment techniques or fillings.

A root canal is a procedure that involves removing the pulp that contains the nerves and blood vessels from the center of your tooth and replacing them with a rubbery filling.

This procedure is performed when the inside of your tooth is infected or inflamed.

Extrusion techniques

Extrusion (moving your tooth very slowly out of the socket) is a technique your dentist may use to save a tooth broken below your gum line.

During this technique, you’ll wear braces or aligners that induce downward force over many weeks on the broken tooth to pull the top of the tooth above your gum line.

Once the top of the tooth is exposed, your dentist can apply a crown.

Filling or crown

If the damage is minor, which is unlikely if the break is below your gum line, your dentist may be able to use a filling made from a tooth-colored composite resin to fix the broken tooth.

Your dentist may also be able to cap your tooth with a crown. A crown is an artificial top for your tooth that can cover the exposed portion. They can be made of composite resin, ceramics, or metal alloys.

If there isn’t enough tooth exposed to hold the crown in place, your dentist may perform a crown lengthening. During this common procedure, your dentist recontours your gum line to uncover more of the tooth.

Tooth extraction or replacement

If your tooth is unable to be repaired, your dentist will likely recommend having the tooth pulled.

Some replacement options for the tooth include:

• Dentures are false teeth that fit over your gums. They can replace one or more teeth.
• Endosteal implantsare artificial roots used to hold replacement teeth.
• Dental bridgesare false teeth that are held in place by the teeth on either side.

Your mouth will likely be sore after treatment, and pain may get worse once local anesthetic wears off. But the pain should get better over the next few days provided that you don’t develop an infection.

If you had a root canal, your dentist may recommend avoiding chewing with the broken tooth for a few days or sticking to soft foods and liquids. You should be able to return to your usual diet when the tooth heals.

Your dentist will likely also tell you to avoid drinking from a straw for 24 hours and to limit physical activity for a day or two.

Broken teeth are susceptible to decay since they don’t have their protective enamel to cover the blood vessels and nerves inside.

If you don’t get your broken tooth treated, you risk:

• infection
• abscess
• nerve damage

Once an infection starts, the bacteria can spread to your bone or surrounding teeth and gums. In serious cases, it can lead to an infection of your jaw bone.

Some of the most common causes and contributing factors of a broken tooth include:

• biting something hard, especially by accident
• untreated cavities that lead to tooth decay
• recurrent cavities
• aging teeth
• sudden changes in mouth temperature
• chronic teeth grinding (bruxism)
• weakness caused by a filling

Facial trauma from accidents and sports injuries can also lead to a broken tooth. However, it’s more common for trauma to lead to a broken front tooth than a molar.

You can prevent a broken molar by:

• avoiding chewing on ice, hard candy, or other hard foods
• limiting your intake of sugary food
• avoiding using your teeth to cut things
• wearing a mouth guard when playing contact sports
• brushing and flossing your teeth regularly
• avoiding clenching and grinding your teeth
• wearing a retainer or mouth guard if you grind your teeth in your sleep

If one of your molars breaks below the gum line, you should see your dentist immediately. If it’s not possible to see your dentist, contact another dental clinic in your area or visit the emergency room.

In some cases, your dentist may be able to save your tooth. The quicker you act, the more likely you are to save the tooth. Acting quickly also decreases your risk of developing an infection from exposed nerves and blood vessels.