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Tooth enamel is the hardest substance in the human body. It is very protective and can endure strong forces. However, chips can occur if the forces are strong enough, a tooth is decayed, or the enamel is thin or damaged. A chipped tooth is sometimes referred to as a cracked tooth, but they are actually different dental conditions. Those differences will determine how your dentist will diagnose and treat the problem.

When a tooth chips, a piece breaks off above the gum line. That piece may be small or large. Small chips often only affect the enamel, and you might not feel any tooth pain. Larger chips may expose a nerve, which can result in pain or sensitivity. In either case, you have lost a part of your natural tooth structure. All chips should be examined by your dentist to determine if treatment is necessary to prevent further damage, tooth decay and restore the normal appearance of your tooth.

By contrast, a crack is a fracture in the tooth but may not result in a loss of tooth structure. The most common and least significant form of crack is called a "craze line," which is confined to the enamel. Cracked teeth can allow bacteria to grow within the tooth, leading to decay. They can worsen over time due to a variety of factors. As a result, deeper cracks that spread through multiple tooth layers (enamel and dentin) generally impact the long-term integrity of your tooth more than chips.

Chipping a front tooth is relatively common, especially in children. This is because a child's front teeth often project forward while their jaws are still developing, leaving the top of the tooth more exposed to impacts. This is especially true of children who have a thumb or pacifier habit which can make the front teeth tip outward even more.

Back teeth can also chip. A chip on one of the pointed chewing surfaces of a back tooth is called a broken cusp. These chips are often the result of biting or chewing hard substances and are more likely to occur when there is underlying tooth decay.

Chipped teeth can be a blessing in disguise. A chip can help disperse some of the force from an impact. If your tooth withstood the full force of an impact without chipping, the energy could be transferred to the tooth root, resulting in damage to fragile nerves and blood vessels. This could lead to an abscess or other issues that may require extensive treatment.

• Chewing hard foods, seeds, or ice.
• An impact to the face, jaws, or teeth.
• Using your teeth improperly.
• Misaligned teeth: If your upper and lower teeth don't align properly, bite forces may be concentrated on just a few teeth, increasing bite stress and leading to chips.

• Grinding or clenching your teeth can increase forces on your teeth and cause them to chip.

• Sports or activities (especially without proper mouth and face protection).
• Trips, falls, or accidents of any kind that impact the teeth, face, or jaws.
• Thumb-sucking or pacifier use in children.
• Weakened enamel (which may be from lack of proper exposure to fluoride).
• Untreated tooth decay.
• Tooth restorations like fillings, inlays, and root canals.
• Existing dental problems such as abfractions or tooth wear.
• Previously chipped or cracked teeth.

Chips on front teeth are typically visible. You may only notice a chipped back tooth as your cheek or tongue feels a rough spot or sharp edge. A chipped tooth may not cause pain or sensitivity. You may not know you have a chipped tooth until your dentist diagnoses it at a dental exam.

You should schedule an appointment with your dentist:

• When you become aware that you have chipped a tooth, even if it doesn't hurt.
• If you are experiencing pain or increased sensitivity to hot or cold. Keep in mind that tooth pain and sensitivity may come and go.
• If the chip was due to an accident or impact. In addition, your teeth and jaws may have sustained other injuries that you can't detect.

Your dentist can usually diagnose a chipped tooth with a visual examination. In some cases, X-ray images or photographs may be taken to determine the extent of the chip and if it has impacted any nerves or blood vessels. X-ray images may be taken weeks or months apart to evaluate the area for changes over time.

If you have a chipped tooth, your dentist will diagnose the severity of the chip and determine if the chip has made your tooth more susceptible to tooth decay or infection. The examination may also help your dentist identify other related problems. The dentist will also determine whether the bite relationship between the upper and lower teeth has changed.

• Mouthguards: If you or a child participates in sports or activities that may cause facial impacts, wearing a mouthguard can help prevent chipped teeth. For contact sports, additional protection such as helmets, cages or face shields may be necessary to adequately protect the teeth and jaws.
• Protect toddlers from hard or angled surfaces.
• Get children to stop thumb-sucking or using pacifiers as early as possible.
• Avoid hard foods and ice. Chewing ice or biting down on hard candy, pretzels, seeds, or popcorn kernels are often the cause of chipped teeth.
• Brush and floss to avoid tooth decay and periodontal disease that can weaken teeth.
• Avoid using your teeth improperly.
• Occlusal guards: If you have the habit of grinding or clenching your teeth, an occlusal guard can prevent chipped teeth.
• Orthodontics: Misaligned teeth can increase your risk of chipping a tooth.

It's important to note that your dental insurance may not extend to all situations involving tooth injuries. This is especially true in cases of trauma or when multiple injuries have occurred. While you might end up seeing a dentist for evaluation and treatment, your treatment may need to be coordinated through your medical provider.

Initial home care: If someone has a chipped tooth, make an appointment to see the dentist as soon as possible. Meanwhile, follow these steps:

• Rinse the mouth with warm, salty water.
• If there is minor bleeding in the mouth, use a piece of damp gauze to apply pressure to the area until the bleeding stops. Severe bleeding should be evaluated as soon as possible by an appropriate health care professional. For more serious trauma to the head, face or neck, call the medical emergency number in your area for a more rapid response.
• Take an over-the-counter pain reliever if needed.
• If you can't see a dentist immediately, many pharmacies sell dental cement that may temporarily cover the remaining tooth. Depending on the chip's location and shape, temporary cement may not remain in place for long.
• Eat soft foods, and avoid hot or cold food and beverages until you can see a dentist.

Professional treatment: Depending on the location and the extent of the chip, a chipped tooth may be treated in a number of ways.

• Small chips can often be smoothed and polished without the need for additional treatment.
• Chips that inflict more significant damage to the tooth enamel may require a veneer, filling, inlay, onlay or crown to restore normal appearance and function. These options help protect the inner layers of the tooth from irritation, infection, and tooth decay.
• Additional treatments may be required if a chip has damaged a large portion of a tooth's clinical crown, or exposed the tooth's nerve. These treatments may include a core buildup, insertion of structural posts, or root canal therapy, along with a final restoration such as a crown.
• Depending on what caused the chip, additional treatment may be needed to prevent the tooth from chipping again. This is especially true if you have a habit of grinding or clenching.