Do you have a cracked tooth?

When you bite down you feel a sharp pain?  Maybe it quickly disappears and perhaps you ignore it.  You avoid certain foods or chew only on one side your mouth to compensate. Sometimes it hurts more when you let go after biting down, than when you bite down, so it is hard to pinpoint the source.  These are all signs of Cracked Tooth Syndrome.

Detecting a cracked tooth can be difficult.  You may not be able to tell which tooth is causing your distress.  It could sometimes feel like the top, when it is the bottom tooth, for example.  Cracks can be small hairline fractures, or they can completely break off a cusp.  Teeth may become sensitive to temperature extremes, and the pulp (nerve) could be damaged.  The treatment for cracked teeth typically is to place a crown to hold the tooth together.  Sometimes a root canal is needed to treat the tooth if the nerve has been affected, and then a crown. If you have symptoms it is best to have it checked by the dentist.

Habits such as clenching, grinding, and chewing on hard objects subject your teeth to incredible forces.  When you have larger fillings present, the likelihood of fracturing a cusp or part of your tooth tends to be higher.  Cracked teeth do not always show any visible signs of damage, but may present a variety of symptoms, including intermittent or spontaneous pain when chewing and sensitivity to sweets, heat and/or cold.  This erratic pain can make diagnosis a challenge.

Why Do Cracked Teeth Hurt?
When the outer hard tissues of the tooth are cracked, chewing can cause pain due to the flexion of the fractured pieces. Each time you bite down the movement back and forth sends a message that something is wrong to the nerve of the tooth, and to the gum tissue surrounding the tooth. The pulp (nerve) can become irritated. As the biting pressure is released, the crack can close quickly, resulting in sharp pain. Irritation of the gum and nerve can be repeated many times while chewing. Eventually, the nerve can become damaged to the point where it can no longer heal itself. The tooth will not only hurt during chewing but may become sensitive to extreme temperatures. In time, a cracked tooth may begin to hurt all by itself. Extensive cracks will lead to infection of the pulp tissue. Infection can spread to the bone and gum tissue that surround the tooth. When this happens, there can be a potential of tooth loss, if not treated with a crown and sometimes a root canal. Fractures can extend vertically, and in such a way as to cause the tooth to be non-salvageable.  In this case, the only option is to extract the tooth.

Types of Cracked Teeth

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 appearance. Sometimes these can develop into larger fractures.
Fractured Cusp:  Cusps become weakened by large fillings or trauma.  Fractures sometimes result. The weakened cusp may break off or need to be removed. When this happens, since the flexing cusp has been lost, the pain from chewing will usually be relieved. A fractured cusp sometimes damages the nerve, creating the need for a root canal. A crown is the standard treatment for a fractured cusp.
Cracked or Split Tooth
Cracked teeth will be restored with a crown to hold the pieces together and protect the cracked tooth. Sometimes these types of cracks require root canal therapy or extraction. if the crack extends below the gum. Vertical root fractures are cracks that begin in the root of the tooth and extend toward the chewing surface. Often teeth that are vertically fractured need to be removed. It depends on how far down the fracture has developed.  Early diagnosis is important. It can be challenging to determine the extent of a crack. A cracked tooth that is not treated will progressively worsen, and eventually result in the loss of the tooth. Early diagnosis and treatment are essential to saving these teeth.

If left untreated, a tooth can vertically fracture or split the roots.  Treatment when fracture occurs is extraction.

Cracked Tooth Syndrome

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Prevent Fracturing your Teeth
* Avoid grinding & clenching
* Don't use your teeth as  tools
* Avoid ice, popcorn, hard candy
* Wear a mouthguard
* Have large fillings covered
   by a crown to prevent cracks
* Have regular dental exams

​​Angela Hilton-Foley, DMD

(813) 891-1212

Cosmetic & Family Dentistry