Cracked Teeth

 

Everyone has cracks and craze lines in their teeth, just look in a mirror closely and you will see some in the crowns of your front teeth.  Most of these will never be problematic.  However, sometimes the cracks can extend deeper toward the pulp or jawbone and become a major source of concern for a patient.  Cracks can occur in our teeth during clenching, grinding and even during normal function by chewing inadvertently on hard objects.   Other crack inducing habits include chewing on ice, hard candies and cough drops. 

Cracked teeth can demonstrate many types of symptoms, including erratic pain when chewing, possibly with release of the biting pressure, and pain to cold and sometimes hot.  These symptoms are an indication the pulp is being irritated and possibly damaged.  It is also common for the pain to come and go, making it difficult to diagnose the cause of discomfort.  In addition, the cracks can be tiny and below the gingiva causing their detection to be difficult or impossible.  If your dentist suspects a crack, but is having a difficult time locating the involved tooth, you might be referred to us for help.

Chewing a certain way or on a particular location on the tooth can cause movement of the cracked pieces of your tooth, which might cause you to experience pain.  It is also common when the biting pressure is released, the crack can close quickly, also resulting in sharp pain. Eventually, the pulp will become damaged to a point that it can no longer heal itself and the pain will worsen and become more consistent, even when you are not chewing.  Extensive cracks can lead to infection of the pulp tissue, which can spread to the bone and gum surrounding the problematic tooth.   Eventually, if the problem is not addressed there is high probability the tooth will be lost.

The advice you are given for a cracked or fractured tooth usually depends on the extent of the damage.  Your dentist might refer you to us to assist in the diagnosis and possibly the treatment of a cracked tooth.  Early detection is important as it gives us the best opportunity of relieving your pain, reducing the likelihood of the crack worsening and saving your tooth. 

If your tooth has a minor crack it is possible all you will need to solve the problem is a crown, which reinforces your tooth and keeps the crack from moving when you function.  If the crack has caused damage to your pulp, then your tooth will need endodontic treatment before your general dentist restores the tooth with a full crown.  If it is determined the crack or fracture is very deep and extends below the gingiva and into the jawbone, it is possible your tooth will have a hopeless prognosis and might require extraction.

Once treated, most cracked teeth continue to function normally and provide years of comfortable chewing.  Sometimes, however, there might still be biting pain or it is possible the crack could worsen over time and a decision might eventually be made to extract the tooth.  Early diagnosis and treatment are essential in our efforts to save a cracked tooth.  

types of cracks

Craze lines

These are tiny cracks that only affect the outer enamel of the tooth. These cracks are more common in adults. These types of cracks are superficial and are usually of no concern.

 

Fractured Cusp

When a cusp becomes weakened, a fracture may result. The cusp may break off or be removed by a dentist. A fractured cusp might not damage the pulp, so root canal treatment isn’t always necessary. Your dentist will usually restore the tooth with a full crown.

 

 

Cracked Tooth

This type of crack extends from the chewing surface of the tooth and vertically migrates towards the root. In some cases, the crack may extend below the gum line. It is possible for the crack to extend further into the root. Damage to the pulp is commonplace. In this case, root canal treatment is usually necessary. A cracked tooth that is not treated will worsen, resulting in the loss of the tooth. Therefore, early detection is essential.

 

 

Split Tooth

A split tooth is usually the result of an untreated cracked tooth. It can be identified by a crack with distinct segments. This type of tooth can never be saved intact. Yet, the position and extent of the problem will dictate whether any portion of the tooth can be saved. Sometimes, endodontic treatment by Dr. Marshall and restoration by your dentist can be used to save a portion of the tooth.

 

 

Vertical Root Fracture

A vertical root fracture begins at the root and extends towards the chewing surface of the tooth. Unfortunately, they show minimal symptoms and may go unnoticed for a period of time. Treatment might involves endodontic surgery if a portion of the tooth can be saved by removal of the fractured root. Otherwise the tooth will have to be extracted.  The prognosis is usually very poor.