I broke a small piece off one of my lower front teeth about 11 months ago. Although the chip is small, it irritates my lip and makes me avoid smiling.

My dentist has repaired it with bonding several times, but each repair falls off within a few days. I am 17. Can a chipped tooth ever regrow on its own, or what would be the best long-term solution? – Thanks. Carlo from NV

Carlo,

Repairing a chipped lower front tooth is not always as simple as replacing the missing piece. The way the front teeth meet during biting has a major influence on whether the repair will last.

Why Do Lower Incisor Repairs Sometimes Come Off?

The repaired edge can be exposed to significant biting forces every time the mouth closes.

Many chipped lower incisors break because they repeatedly contact the backs of the upper front teeth. When composite bonding is placed, it must be positioned to avoid heavy contact during normal function. If the restoration is left in an area that receives excessive pressure, it may eventually separate from the tooth.

The position of the tooth can make all the difference. In the example pictured, the composite remained intact on tooth #24 but detached from tooth #25. The reason appears to be the position of tooth #25, which sits slightly farther forward than its neighbor. Because it protrudes more, it would likely contact the upper teeth first, placing greater stress on the bonded edge every time the patient bites.

How Can a Dentist Reduce Stress on the Repaired Tooth?

Balancing the bite is an important part of treatment.

Successful repairs often require more than replacing the missing tooth structure. They also require careful adjustment of the tooth’s position so biting forces are shared evenly.

This may involve:

• Reshaping the tooth so it no longer contacts first.
• Ensuring all the lower front teeth meet the upper teeth evenly.
• Choosing a restoration that can withstand the patient’s bite.
• Evaluating the bite after treatment to reduce the chance of another fracture.

In the example, Dr. Bell achieved this by placing two porcelain veneers and reducing the prominence of tooth #25. A similar result may also be possible with expertly placed composite bonding.

What If Specialized Cosmetic Dentistry Is Difficult to Access?

In areas where experienced cosmetic dentists are uncommon, smoothing the rough edges of the chipped tooth may provide relief by preventing irritation to the lip. While this does not restore the missing tooth structure, it can improve comfort until more comprehensive treatment becomes available.

Plano, Texas, female dentist Dr. Miranda Lacy sponsors this post. She caters to anxious patients.