Cracked and fractured teeth are common dental problems. As people retain their natural teeth longer (due to advances in dental technology), the likelihood of cracked teeth increases. There are many reasons why teeth may crack, for example, biting on hard objects, trauma, grinding and clenching of teeth. All of these behaviors place the teeth under extra strain and render them more susceptible to cracking.
When tooth enamel is cracked, pain can become momentarily debilitating. When no pressure is exerted on the crack there may be no discomfort. However, as the cracked tooth performs a biting action, the crack widens. The pulp and inner workings of the tooth then become exposed, and painful irritation occurs. As pressure is released again, the two parts of the crack fuse back together, and pain subsides. If left untreated, the pulp becomes irreversibly damaged and constantly painful. The resulting pulp infection can affect the bone and soft tissue surrounding the tooth.
Symptoms of a cracked tooth may include:
Unexplained pain when eating.
Sensitivity to warm and cold foods.
Pain with no obvious cause.
Difficulty pinpointing the location of the pain.
What kind of cracks can affect the teeth?
There are many different types of cracked teeth. The treatment and
outcome for your tooth depends on the type, location, and extent of the
Craze lines are tiny cracks that affect only the outer enamel. These
cracks are extremely common in adult teeth. Craze lines are very
shallow, cause no pain, and are of no concern beyond appearances.
When a cusp (the pointed part of the chewing surface) becomes
weakened, a fracture sometimes results. The weakened cusp may break off
by itself or may have to be removed by the dentist. When this happens,
the pain will usually be relieved. A fractured cusp rarely damages the
pulp, so root canal treatment is seldom needed. Your tooth will usually
be restored with a full crown by your dentist.
This 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 dentist
will then restore your tooth with a crown to hold the pieces together
and protect the cracked tooth. At times, the crack may extend below the
gingival tissue line, requiring extraction. A nontreatable tooth is
shown in the graphic above.
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 that is not treated will progressively worsen,
eventually resulting in the loss of the tooth. Early diagnosis and
treatment are essential in saving these teeth.
A split tooth is often the result of the long term progression of a
cracked tooth. The split tooth is identified by a crack with distinct
segments that can be separated. A split tooth cannot be saved intact.
The position and extent of the crack, however, will determine whether
any portion of the tooth can be saved. In rare instances, endodontic
treatment and a crown or other restoration by your dentist may be used
to save a portion of the tooth.
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 may involve extraction of the tooth.
However, endodontic surgery is sometimes appropriate if a portion of the
tooth can be saved by removal of the fractured root.
How are cracks in the teeth treated?
There are many different types of cracked teeth. Some can only be exposed using X-ray machines, while others are clearly visible to the naked eye. In cases where the tooth root is affected, root canal therapy is the most viable treatment option. The pulp, nerves and vessels of the tooth will be removed, and the resulting space will be filled with gutta-percha. A crown or filling will be added to stabilize the tooth and it will continue to function as normal.
When the crack is too severe for the tooth to be saved, the dentist will perform an extraction. There are a number of restorative options in this case, such as bridges, dental implants and partial dentures. All of these structures can restore biting, chewing and speaking functions.
If you have any questions or concerns about cracked teeth, please ask your dentist.