Emergency assessment and stabilisation
We check how deep the break goes, X-ray the root if there was an impact, smooth sharp edges and seal exposed dentine or pulp with a protective dressing the same visit.
About this treatmentDental condition · Wimpole Street, Marylebone
Broken tooth: what to do in the first hours and how it is rebuilt
A tooth that loses a substantial piece, whether from a fall, an unlucky bite on a crust or a large old filling finally giving way, needs looking at even when it does not hurt. Enamel has no nerve supply, so the absence of pain tells you nothing about how deep the fracture runs. Beneath the enamel sits dentine, which is porous and quickly becomes sensitive, and beneath that the pulp, which if exposed will become infected without protection. The sooner the tooth is sealed, the more of it we can keep and the simpler the eventual repair. At Wimpole Street we assess the depth of the break, stabilise the tooth and then plan a restoration that suits how much tooth remains.
Recognising it
How it usually feels
A missing corner, cusp or large chunk of tooth
You may find the fragment in your mouth or notice a sudden gap with your tongue.
A rough edge catching the tongue or cheek
Fractured enamel is razor-like and can ulcerate soft tissue within a day.
Sharp twinges with cold air, drinks or sweet food
Exposed dentine transmits temperature and sugar changes to the nerve.
Pain on biting or releasing
Indicates a crack still running into the remaining tooth, or a flexing fragment.
A pink or red dot in the break
The pulp is exposed or very close; this needs sealing promptly.
Bleeding or bruised gum around the tooth
Common after impact injuries; the root and socket may also be affected.
Behind the symptoms
What's going on
- 01
Impact injuries
Falls, cycling accidents, sports collisions and the occasional elbow account for most broken front teeth. Because the upper incisors project furthest forward they take the brunt. A knock can also loosen or displace the tooth, so we check the root and socket as well as the crown.
- 02
Biting something unexpectedly hard
Olive stones, cherry pips, bone fragments, crusty bread and ice concentrate enormous force on a tiny point. A healthy tooth usually survives; one with a crack line or a big filling often does not.
- 03
Heavily filled teeth
A large filling leaves thin walls of enamel and dentine that flex with each chew. Over years these walls fatigue, and eventually a cusp shears away, frequently taking part of the filling with it. This is the commonest way back teeth break in adults.
- 04
Decay hollowing the tooth out
Decay spreads sideways under enamel, leaving a shell that looks intact from outside. The first sign of the problem can be that shell collapsing during an ordinary meal.
- 05
Grinding and clenching
Sustained nightly loading creates micro-cracks that join up over time. Grinders tend to break several teeth over the years unless the forces are managed with a guard.
- 06
Root-treated teeth without a crown
A tooth that has had root canal treatment is drier and more brittle, and the access cavity removes much of its core. Without a crown to hold it together, fracture is a recognised risk.
Before your appointment
What you can do today
- Rinse gently with warm water and, if you have the fragment, keep it in milk or saliva; occasionally it can be bonded back on.
- Cover a sharp edge with sugar-free chewing gum or orthodontic wax from a chemist to protect your tongue and cheek until you are seen.
- Avoid chewing on that side and steer clear of very hot, cold or sweet food and drink.
- Take over-the-counter pain relief as directed on the pack if needed, and check with a pharmacist if you take other medicines.
- Do not try to file, glue or fill the tooth yourself; temporary filling kits are acceptable only as a short-term cover over a non-bleeding break.
These are holding measures, not a substitute for an examination. Use any pain relief exactly as directed on the pack and check with a pharmacist if you take other medicines.
In the chair
How we treat it at Wimpole Street
Composite build-up
For breaks that leave most of the tooth intact, the missing section is sculpted in layered tooth-coloured resin and bonded in one appointment.
About this treatmentOnlay or crown
When a cusp or a large proportion of a back tooth has gone, a ceramic onlay or full crown wraps and protects what remains. Two visits with a temporary in between.
About this treatmentRoot canal treatment
If the pulp is exposed or has become infected, the nerve space is cleaned and sealed before the tooth is crowned.
About this treatmentExtraction and replacement
A tooth fractured below the gum or split through the root cannot be saved. It is removed and replacement with an implant or bridge is discussed.
About this treatmentFees
Costs to expect
An emergency assessment at Wimpole Street, including any X-rays and a protective dressing, is expected to be around £95. Composite repairs for smaller breaks start from £185 as a filling or from £395 as a cosmetic build-up on a front tooth.
Where more of the tooth has gone, a crown or onlay is indicative from £995. Root canal treatment, if the nerve is involved, is around £695 for a front tooth and £895 for a molar, and is quoted in addition to the crown. Extraction starts from £250, with implant or bridge replacement planned and priced separately. You receive the full plan in writing before committing.
Figures are indicative prices for Wimpole Street and are confirmed in a written plan once a dentist has examined you. Fees match our South Kensington and St Paul's clinics.
Don't wait if
When to see a dentist
- Any break large enough to feel with your tongue or see in a mirror.
- Pain that is constant, throbbing or waking you at night.
- A visible pink or red spot in the fracture, or bleeding from inside the tooth.
- The tooth feels loose, has moved position or the bite feels wrong after an impact.
- Swelling of the gum or face around the tooth, which suggests infection.
- A head injury or loss of consciousness accompanied the accident: seek medical care first.
FAQ
Common questions
Not for long. The outer enamel has no nerve, so a painless break can still be deep. Exposed dentine picks up bacteria and becomes sensitive within days, and a break that reaches the pulp will lead to infection. A prompt assessment lets us seal the tooth while the repair is still simple.
Sometimes, for a clean fracture of a front tooth where the fragment is intact and has been kept moist. Bonding it back can give an excellent match. More often the fragment is unusable and the tooth is rebuilt in composite or ceramic instead, but bring it along in case.
By how much sound tooth is left and where the load falls. A break confined to one corner with strong walls remaining suits composite. If a cusp has gone on a back tooth, or the walls are thin, a crown or onlay is needed to stop the rest splitting. We show you the tooth on a photograph and explain the reasoning.
It depends how far. A break slightly below the gum can sometimes be restored after minor gum reshaping. A fracture that runs down the root, or splits the tooth vertically, generally means extraction, and we would then talk through replacement options.
Modern composites come in many shades and translucencies and are layered to mimic enamel and dentine. A skilled build-up on a single front tooth is very hard to spot. Ceramic crowns and veneers offer even closer colour stability for larger repairs.
Marylebone, W1
Wimpole Street opens 1 October 2026
Leave your details and we will be in touch when the Marylebone diary opens. If the problem cannot wait, the same clinicians are already seeing patients in South Kensington and at St Paul's.
Related conditions
Opening 1 October 2026
Wimpole Street is not yet seeing patients. Until then, please book or call our South Kensington clinic on 020 7183 2362 or our St Paul's clinic on 020 7183 3709. Questions about the new clinic: wimpolestreet@md.co.uk.
Until we open
Need an appointment before 1 October 2026?
The same clinical team already works from two other Medical & Dental clinics. Book at either one now and, if you prefer, move your ongoing care to Wimpole Street once the doors open.
South Kensington
- 20 Old Brompton Road, London SW7 3DL
- Open seven days a week
- 020 7183 2362
St Paul's, City of London
- 5 Ave Maria Lane, London EC4M 7AQ
- Open Monday to Friday
- 020 7183 3709
