Cracked Tooth

Do you have a cracked tooth?

 You feel searing tooth pain while chewing certain foods and experience hot and cold temperature sensitivity. Dental x-rays show that you are cavity-free, yet the discomfort persists. Unfortunately, it may not just be sensitive teeth – you could be experiencing the symptoms of cracked tooth syndrome.
Did you know the tooth enamel is the hardest substance in the human body? In fact, it’s harder than your bones! Though teeth are built to last, they are still susceptible to cracks and fractures.

What is Cracked Tooth Syndrome?
Cracked tooth syndrome is a condition in which a tooth is cracked, yet remains intact. Cracks may be small and minute or large and visible. They may occur along the crown of the tooth near the cusp or deep beneath the gum line. All cracks, big and small, should be considered serious and require endodontic evaluation.

Cracked tooth syndrome can occur in any tooth, though it is most common in the molars – especially those weakened by previous fillings and restorations. Other causes include tooth grinding, physical trauma and tooth decay.

Unlike cavities, which may cause chronic aching, cracked tooth symptoms are often inconsistent and may persist for many months without diagnosis. Examples include:

  •  Pain when chewing
  •  Pain brought on by exposure to hot and cold temperatures
  •  Pain after releasing a bite

Left untreated, a cracked tooth can worsen, causing infection and additional pain. Anyone experiencing these symptoms should visit an endodontist immediately, as early diagnosis and treatment may improve treatment outcomes. An endodontist will examine the tooth visually take x-rays. The tooth may also need to be opened and examined microscopically to identify tiny and minute cracks otherwise not visible to the human eye

Treatment for Cracked Tooth Syndrome

Cracked tooth treatment is contingent on the type of crack present in a tooth. Most tooth fractures are described in one of four ways – fractured cusp, cracked tooth, split tooth or vertical root fracture.

Fractured Cusp

A fractured cusp is defined by a crack that affects the crown near the chewing surface. These cracks may cause part of the tooth cusp to fall off, exposing the pulp beneath. A fractured cusp is typically addressed with root canal treatment.  

Cracked Tooth

A cracked tooth is defined by a crack extending vertically from the chewing surface toward the tooth root. This type of crack may be treated with a root canal in the early stages of pulp exposure. Teeth with cracks that extend below the gum line and into the root of the tooth may require extraction.

Split Tooth

A split tooth contains a complete crack extending from the top of the crown and into the root. Because split teeth have significant pulp damage, they always require extraction.

Vertical Root Fracture

A vertical root fracture is a crack occurring in a tooth that has already undergone endodontic treatment. The fracture occurs at the tip of the root, where it may go undetected until an abscessed infection has formed. In some cases, Apicoectomy surgery may successfully salvage the tooth, though some patients require an extraction.

Co-authored by Dr. Fay Mansouri


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