There are 7 ways to fix a tooth, from a quick bonding repair to a dental implant, and the right one depends on how much is left. In a perfect world, your teeth would stay strong and white for life. In reality, most people need to repair a tooth at some point. This guide walks through each option in plain language.
Why Teeth Need Repair
Teeth can be damaged in many ways. Decay can hollow out a tooth from the inside. Acidic foods and drinks can wear away enamel. A bite on something hard can chip or crack a tooth. Gum disease can expose roots and weaken support. And sometimes old repairs simply wear out. Fillings crack, crowns loosen and a tooth that had a root canal years ago can develop a new infection.
The good news is that modern dentistry has a fix for almost every kind of damage. The general rule is simple: save as much of your natural tooth as you can, and choose the least invasive option that will last. Dr. Steven Haywood, who has more than 35 years in practice, will explain which choices fit your tooth and why.
The 7 Ways to Fix a Tooth
These options are listed roughly from the smallest repair to the most complete replacement.
1. Dental Bonding
Bonding uses a tooth-colored composite resin that's shaped directly on your tooth. It's best for small cosmetic problems on healthy teeth: chips, minor cracks, stains and small gaps. The surface is gently prepared, the resin is applied in layers and sculpted, and a curing light hardens it in seconds. A final polish blends it in.
Bonding is usually done in one visit, often without numbing, and is typically the most affordable cosmetic fix. Resin isn't as strong or stain-resistant as porcelain, so it may need touch-ups over time. Learn more about cosmetic bonding or read about this affordable one-visit tooth fix.
2. Porcelain Veneers
Veneers are thin, tooth-shaped shells that are bonded to the front of your teeth. They work well when the tooth underneath is healthy and free of decay but doesn't look the way you want. A veneer can hide a chip or crack, cover deep stains, close gaps and make slightly crooked teeth look straight.
Porcelain resists stains and reflects light much like enamel. In some cases, very thin prepless veneers need little or no change to the natural tooth. See porcelain veneers for more on how they're planned and placed.
3. White Fillings
When decay creates a cavity, the damaged part is removed and the space is filled. Southern York Smile Care is a mercury-free office and doesn't place silver fillings. Instead, it uses tooth-colored, BPA-free white fillings that bond to the tooth.
Because white fillings bond to the tooth, they often need less drilling than older metal fillings. That leaves more of your own enamel and dentin in place. If you have old silver fillings that are cracked or worn, ask about replacing them. Learn more on the white dental fillings and mercury-free dentistry pages.
4. Inlays and Onlays
Sometimes a cavity or old filling is too large for a regular filling but not large enough to need a full crown. That's where inlays and onlays come in. They're made outside the mouth to fit the tooth exactly, then bonded in place, which is why they're sometimes called indirect fillings.
- An inlay fits inside the cusps (the raised points) of a back tooth, in the center of the chewing surface.
- An onlay covers one or more cusps as well, giving more protection to a weakened tooth.
Both keep more natural tooth than a crown, while adding strength a large filling can't.
5. Crowns
A crown covers the whole visible part of a tooth. It restores shape, strength and appearance when a tooth is badly broken, heavily filled or weakened. Crowns are commonly placed after a root canal, on teeth with extensive decay, as the anchor teeth of a dental bridge and as the top of a dental implant.
Crowns can be made from metal, porcelain fused to metal or all-ceramic materials. All-porcelain crowns have no dark metal edge at the gumline and look very natural. Learn more on the all-porcelain crowns page. If a tooth's nerve is infected, a root canal usually comes first.
6. Gum Treatment and Soft Tissue Grafts
Not every tooth problem is in the tooth itself. When gums pull back, they expose the root, which can cause sensitivity, root decay and bone loss. A soft tissue graft moves or adds gum tissue to cover an exposed root and protect it. Gum procedures can also be cosmetic, such as reshaping an uneven gumline or a "gummy" smile.
The first step is treating any gum disease that caused the problem. Your dentist will recommend the right care for your gums, which may include treatment in the office or a referral when a graft is needed. See gum disease treatments and the cosmetic gum lift for more.
7. Dental Implants
When a tooth can't be saved, it needs to be removed and replaced. A dental implant is a small post placed in the jawbone that acts like a new root. Once it heals, a crown is attached on top. Implants look and feel like natural teeth, don't rely on neighboring teeth for support and help keep the jawbone from shrinking.
Dr. Haywood is a Fellow of the International Congress of Oral Implantologists and uses Green CT 3D imaging to plan implant placement. Learn more on the single tooth implant and dental implants pages.
Which Fix Is Right for Your Tooth?
The best option depends on how much healthy tooth remains, where the tooth is, your bite and your goals. A front tooth with a small chip may need only bonding. A back tooth with a large old filling may do better with an onlay or crown. A tooth that's cracked below the gumline may need to be replaced. Your dentist will show you what they see, using an intraoral camera and digital X-rays, and explain the trade-offs.
Southern York Smile Care is out of network with every insurer: you pay at the visit and the office files the claim for reimbursement. CareCredit and Cherry payment plans are available. See the financing page for details.
Whatever repair you choose, it will last longest with good daily care. Brush twice a day, clean between your teeth, limit sugary snacks and keep up with your checkups. If you grind your teeth, a night guard protects both your natural teeth and your repairs.
Get Your Tooth Checked in Shrewsbury
If you have a chipped, cracked, decayed or missing tooth, call Southern York Smile Care at (717) 235-3871 or request an appointment. The office is at 4 S. Main St in Shrewsbury and sees patients from York, southern York County and northern Baltimore County.
DDS cum laude 1987, US Air Force residency, NYU cosmetic training and Fellow of the International Congress of Oral Implantologists, with 35+ years in practice.
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