Background. There are few reports in the literature regarding estimates of the occurrence of tooth fractures. Most studies have assessed tooth fractures in people seeking dental care, which may underestimate the incidence of the problem. Methods. This study sought to estimate the incidence and prevalence of cusp and restoration fractures, as well as root fragments in participants in the Florida Dental Care Study, a diverse representative sample of community-dwelling residents of four north Florida counties made up of people who seek dental care regularly and those who do not. Participants received a dental examination and an inperson interview at baseline and at a 24-month follow-up session. Results. At least 20 percent of the participants were diagnosed as having bulk restoration fractures, cusp fractures or root fragments at the baseline visit. At the 24-month follow-up session, 26 percent of the participants had at least one new occurrence of these problems. Of those subjects presenting with tooth fracture, 25 percent had multiple teeth affected. African-Americans and people who sought care on a problem-oriented basis experienced twice the rate of cusp fracture and a higher rate of root fragments as did those who sought care on a regular basis. These data represent consecutive prevalence estimates rather than the true incidence, in that fractures that occurred after baseline may have been treated in the intervening 24 months. Thus, these data represent "lower-bound" incidence estimates. Conclusions. These results suggest that restoration fractures, cusp fractures and root fragments are a significant dental health problem, and that selected segments of the population are at greater risk of developing these problems. Clinical Implications. These data are useful for dentists in understanding the magnitude of the problem and the potential progression of fractures and root fragments.