Cracked Teeth

It is not uncommon for people to develop cracks in their teeth over time from normal wear and tear. It is especially common in people who grind their teeth due to stress.

How do I know if my tooth is cracked?

Cracked teeth may cause intermittent pain when chewing, especially common is a sharp, quick pain during release from biting pressure. Cracked teeth may also become very sensitive to temperature extremes such as a cold glass of water or a warm cup of coffee. In many cases, the pain will come and go, and oftentimes general dentists have difficulty locating which tooth is causing the discomfort.

Why does a cracked tooth hurt?

Under the hard enamel and dentin surface of a tooth is the inner soft tissue called the pulp, which consists of nerves, blood vessels, connective tissue, and various cells. When the outer hard tissues of a tooth are cracked, chewing can cause the cracked portions of the hard tissue to move along the crack line and irritate the nerves in the underlying pulp tissue and create quick, sharp pain. Over time, the pulpal tissue will become damaged to the point that it can no longer heal itself. At that point, the tooth may also become sensitive to temperature extremes. Over time, a cracked tooth may begin to hurt even at rest. Without a crown on the tooth, cracks tend to get deeper with time and can eventually expose the pulp tissue to bacteria from the oral cavity, and this often spreads to the bone and gum tissue surrounding the tooth.

How will my cracked tooth be treated?

There are many different types of cracked teeth. The treatment and outcome for your tooth depends on the type, location, and extent of the crack. Below are a few examples of different types of cracks.

Craze Lines

Craze lines are tiny cracks that affect only the outer enamel, but not hard underlying dentin layer and therefore do not typically require treatment. These cracks are extremely common in adult teeth. Craze lines are very shallow, cause no pain, and are of no concern beyond appearance.

Fractured Cusp

When a cusp (the pointed part of the chewing surface) becomes weakened, a fracture can develop. The weakened cusp may break off by itself or may have to be removed by a dentist.

A fractured cusp rarely damages the pulp, so root canal treatment is seldom needed. Your dentist will usually restore your tooth with a full crown.

Cracked Tooth

This type of crack extends from the chewing surface of the tooth vertically towards the root. A cracked tooth is not completely separated into two distinct segments. Because of the position of the crack, damage to the pulp is common. Root canal treatment is frequently needed to treat the injured pulp. Your general dentist will help restore your tooth with a crown after the root canal in order to hold the pieces together and protect the cracked tooth.

At times, the crack may extend below the gingival tissue line. Early diagnosis is important. Even with high magnification and special lighting, it is sometimes difficult to determine the extent of a crack. A cracked tooth left untreated will only get worse, sometimes resulting in the loss of the tooth. Early diagnosis and treatment are essential to save cracked teeth.

Split Tooth

A split tooth is often the long-term result of a cracked tooth. A split tooth is identified by a crack with distinct segments that can be separated. Unfortunately, a split tooth cannot be saved.

Vertical Root Fracture

Vertical root fractures are cracks that begin in the root of the tooth and extend toward the chewing surface. They often show minimal signs and symptoms and may, therefore, go unnoticed for some time. Vertical root fractures are often discovered when the surrounding bone and gum become infected. Treatment usually involves extraction of the tooth.

After treatment for a cracked tooth, will my tooth completely heal?

Unlike a broken bone, the fracture in a cracked tooth will not heal. In spite of treatment, some cracks may continue to progress and separate, resulting in eventual loss of the tooth. Placement of a crown on a cracked tooth provides maximum protection but does not guarantee success in all cases.

The treatment for a cracked tooth is important because it will relieve pain and reduce the likelihood that it will get worse. Once treated, most cracked teeth continue to function and provide years of comfortable chewing.

What can I do to prevent my teeth from cracking?

While cracked teeth are not completely preventable, you can take some steps to make your teeth less susceptible to cracks.

• Don’t chew on hard objects such as ice, un-popped popcorn kernels or pens.
• Don’t clench or grind your teeth.
• If you clench or grind your teeth while you sleep, talk to your general dentist about getting a retainer or other mouth guard to protect your teeth.
• Always wear a mouth guard or protective mask when playing contact sports.