Cracked teeth are becoming more common than ever before. People are living longer, and dentists are helping keep teeth live longer as well. That means teeth are being exposed to more years of chewing hard things, clenching and grinding. Fractures/cracks typically do not show on x-rays, making it more difficult to locate. Depending on the severity of the crack, symptoms may include a momentary sharp pain to chewing, temperature sensitivity, or even the release of biting pressure.
Why does a cracked tooth hurt?
Not all cracked teeth hurt. When it does, chewing can cause movement of the cracked pieces of our tooth, which irritates the pulp within the tooth.
Pain upon release of biting pressure can occur because the crack closes quickly, resulting in a transient sharp pain. Repeated chewing irritates the pulp. Also, the depth of the crack can cause irritation and possibly degeneration to the pulp tissue. Eventually when the pulp becomes damaged the tooth may consistently hurt. The pain may include hot or cold sensitivity as well.
Can a cracked tooth be saved?
It depends on the location and depth of the crack, as well as your symptoms. Sometimes only a restoration or crown is needed. At times root canal therapy followed by crown placement is needed to remove the damaged pulp to restore the tooth to normal function. We are specially trained to treat cracked teeth, and utilize the operating microscope to assist in visualization. Often we can determine the location and severity of the fracture, even into the depths of the root.
Types of Fractures
Crazelines- These are tiny cracks on the outer enamel and more common in adults. They are usually superficial and generally require no treatment unless for cosmetic purposes.
Fractured cusps- When a cusp becomes weakened, a fracture may result. Part of the cusp may break off or may need to be removed by your dentist. Depending upon the extent of the fracture, the pulp may also become damaged. Root canal therapy is needed if the pulp is damaged and subsequent crown by your dentist is placed. Often only a replacement crown by your dentist is needed to resolve the problem.
Fractured edge Fractured cusp
Cracked Tooth - This type of crack extends from the chewing surface of the tooth down towards the root, and sometimes below the gum line.
Usually endodontic therapy is necessary to repair the damaged pulp followed by crown placement. If left untreated a cracked tooth may worsen, resulting in the loss of the tooth.
Split tooth- This develops as a result from worsening of a cracked tooth. Now there are two segments of the tooth that can be separated from each other. Unfortunately, even with today's technology, a split tooth can never be saved intact. Unlike bone, cracked segments in teeth will never heal.
Yet, the position and extent of the fracture will determine whether any portion of the tooth can be saved with endodontic treatment and further dental procedures.
Vertical root fractures- A vertical root fracture originates at the root end and extends towards the chewing surface. Sometimes they are hard to spot and may show no or minimal symptoms. X-rays may show bone loss around the root. Often they involve trauma or teeth that has had endodontic therapy. If the tooth can be saved, treatment involves endodontic surgery.