Chewing Ice Fractured My Premolar in Half

Quick answer: Ice is harder than enamel and colder than your tooth can comfortably handle. Crunching it repeatedly puts teeth through thousands of small thermal and mechanical shocks, and eventually one of them splits. If you crack a tooth on ice, stop chewing on that side and get seen within a day or two.

The call

Rina, 34, from Nofei Aviv, arrived in August having crunched her way through most of a Beit Shemesh summer. She knew the habit was a bad one. She had not expected it to end with an audible snap over a glass of iced coffee and half a tooth loose in her mouth.

She was not in severe pain, but the tooth was sensitive to air and she could not close her teeth together properly on that side.

What we found

The lower right first premolar had fractured through the middle, from the biting surface down towards the gum on the cheek side. The outer half was mobile and attached only by gum tissue. Underneath, the fracture line stopped just above the gum margin, which is the finding that decides everything.

A fracture that stops above the gum is restorable. A fracture that runs below the bone level usually is not, because there is nothing left to seal a crown against.

We tested the nerve. She had a sharp but brief response to cold and no tenderness to tapping, meaning the pulp was inflamed but not irreversibly damaged. Premolars are particularly prone to this pattern; they have a narrow waist and two cusps that act like a wedge under load.

What we did

We removed the loose fragment, which came away almost cleanly, and dressed the exposed dentine to settle the sensitivity. Rather than crowning it that day, we placed a well-sealed temporary restoration and waited ten days. On a tooth with an inflamed nerve, that pause is worth it — if the pulp is going to declare itself, you would rather it did so before the crown is cemented, not after.

The tooth quietened down. We then prepared it for a full-coverage crown, taking care to keep the margin on solid tooth all the way round.

The outcome

The crown went on three weeks after the fracture. The nerve stayed healthy and no root canal was needed. Rina has not stopped drinking iced coffee, but she has stopped chewing what is left in the glass. We also checked her ferritin, since a compulsion to chew ice is sometimes linked to iron deficiency and is worth ruling out.

What to do if this happens to you

1. Keep any fragment, and stop chewing on that side entirely.
2. Avoid temperature extremes. Exposed dentine responds to cold air as much as cold drinks.
3. Do not wiggle a loose piece. If it is still attached, leave it — it is protecting the tooth underneath.
4. Rinse with warm salt water after eating.
5. Be seen within a day or two. The sooner the tooth is covered, the better the odds of avoiding a root canal.
6. Stop the habit. A cracked tooth is rarely the only one under strain; the others have had the same treatment.

Cracked a tooth in Nofei Aviv or anywhere in Beit Shemesh? Call Ramat Beit Shemesh Urgent Dental Care on 055-985-8845 or WhatsApp https://wa.me/972559858845. Harav Kook 28/1, Beit Shemesh.

Based on real cases treated at the clinic. Names have been changed.