Cracked Teeth

My dentist told me that I might have a cracked or fractured tooth. What should I know about this?

Cracked teeth show a variety of symptoms, including erratic pain when chewing, possibly with release of biting pressure, or pain when your tooth is exposed to temperature extremes. In many cases, the pain comes and goes, and dentists may have difficulty locating which tooth is causing the discomfort. When the outer hard tissues of the tooth are cracked, chewing can cause movement of the pieces, and the pulp (or nerve tissues) inside the tooth can become irritated. When biting pressure is released, the crack can close quickly, resulting in a momentary, sharp pain. Irritation of the dental pulp can be repeated many times by chewing. Eventually, the pulp becomes damaged to the point that it can no longer heal itself. Extensive cracks can lead to infection of the pulp tissue, which can spread to the bone and gum tissue surrounding the tooth. Unlike a broken bone, the fracture in a cracked tooth never heals. In spite of treatment, some cracks may continue to progress and separate, resulting in loss of the tooth. The root canal treatment you receive for your cracked tooth is important because it will relieve pain and reduce the likelihood that the crack will worsen. Once treated, most cracked teeth continue to function and provide years of comfortable chewing. Upon the completion of your root canal treatment, your family dentist will permanently restore your tooth with a crown. This crown provides maximum protection, but does not guarantee success in all cases. Talk to your dentist/endodontist about your particular diagnosis and treatment recommendations. There are many different types of cracked teeth. The treatment and outcome for your tooth depends on the type, location, and severity of the crack.

Examples of Cracked Teeth

Craze Lines

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.

Fractured Cusp

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 is usually relieved. A fractured cusp rarely damages the pulp (nerve tissues), so root canal treatment is seldom needed. The tooth is usually restored by your family dentist with a full crown.

Split Tooth

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 can never 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 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. However, endodontic surgery is sometimes appropriate if a portion of the tooth can be saved by removal of the fractured root.