A root fracture is one of the most serious forms of dental injury and is often missed without careful clinical and radiographic assessment. Unlike visible chips or surface cracks, a root fracture occurs below the gumline, affecting the tooth’s root rather than the crown.
Root fractures are time-sensitive. Within emergency dentistry, suspected root fractures are evaluated based on fracture direction, position along the root, tooth mobility, and surrounding bone involvement. Early diagnostic assessment helps determine whether the tooth can be stabilised and monitored safely or whether removal is necessary to prevent infection, bone damage, or persistent pain.
Because prognosis depends heavily on early detection and appropriate stabilisation, timely assessment plays a critical role in preserving treatment options.
At Deepcar Dental, patients from Deepcar, Sheffield North, Stocksbridge, Oughtibridge, Wadsley, and Barnsley are assessed by Dr Ibraheem Ijaz, a GDC-registered Principal Dentist with advanced training in restorative, digital, and emergency dentistry.
A root fracture may cause:
Root fractures can sometimes be painless initially, which is why professional assessment is essential after dental trauma.
Root fractures most commonly occur due to:
Yes. A suspected root fracture should always be treated as a dental emergency.
Movement of the tooth can worsen the fracture, increase infection risk, and reduce the chance of saving the tooth. Prompt stabilisation and imaging significantly improve outcomes.
Root fractures are classified based on the direction of the fracture line and its position along the root, both of which directly influence stability, healing potential, and long-term prognosis.
The main types include:
Horizontal root fractures
A fracture running across the root, often caused by direct trauma.
Vertical root fractures
A fracture running lengthwise along the root, commonly associated with structural weakness or previous dental treatment.
Oblique root fractures
A diagonal fracture combining features of horizontal and vertical patterns.
In general, fractures closer to the crown and those with a vertical orientation tend to be more unstable and carry a poorer prognosis than fractures closer to the root tip.
Diagnosis requires careful clinical and radiographic assessment, often using multiple techniques.
1. Clinical Examination
2. Digital X-Rays
3. Advanced Imaging (CBCT, if required)
4. Mobility and Percussion Testing
5. Vitality Testing
Treatment focuses on stabilising the tooth where possible, preventing infection, and determining whether long-term preservation is achievable.
Treatment planning is guided by:
Immediate measures aim to reduce movement and pain, including:
Definitive management depends on fracture type and prognosis and may include:
Vertical root fractures are generally not repairable, while some horizontal or oblique fractures may be monitored or treated conservatively.
Delaying assessment may lead to:
Early stabilisation offers the best chance of preserving the tooth when possible.
Do:
Avoid:
Some horizontal fractures may stabilise with splinting, but vertical fractures do not heal.
Certain fractures are not visible on standard X-rays and require 3D imaging.
No. Treatment depends on fracture type and location.
Root fractures require prompt diagnosis to determine whether the tooth can be stabilised or must be removed. Early evaluation improves outcomes and reduces complications.