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It happens in the 2nd scene of the episode, "A Man's Teeth Are Not His Own". The gang, Rob, Buddy and Sally are working on a sketch about toothache, but Rob wants to do one about a piano player with a back itch, which he does along with Sally.

After the funny bit, Rob takes a bite from his chicken sandwich and breaks a tooth on a bone! He feels guilty about going to another dentist instead of his neighbour, friend and dentist Jerry Helper. Hence the title of the episode!

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Q: What is the Dick Van Dyke Show episode where Dick Van Dyke needs to scratch his back while playing piano in a scetch?
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