Because we are living longer and more stressful lives, we are exposing our teeth to many more years of crack-inducing habits such as clenching, grinding, and chewing on hard objects. These habits make our teeth more susceptible to cracks. Your endodontist may be able to treat a cracked tooth to prevent further damage to the tooth structure and tissue.
Cracked teeth may not show any visible signs of damage, but will present with a variety of symptoms, usually erratic pain when chewing and pain or sensitivity to heat and cold. In many cases, the pain may come and go, making it difficult for your doctor to locate.
Why Cracked Teeth Hurt
When the outer hard tissues of the tooth are cracked, chewing can cause movement of the pieces, and the pulp 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 will become damaged to the point that it can no longer heal itself. The tooth will not only hurt when chewing but may also become sensitive to temperature extremes. In time, a cracked tooth may begin to hurt all by itself. Extensive cracks can lead to infection of the pulp tissue, which can spread to the bone and gum tissue surrounding the tooth.
Types of Cracked Teeth
There are many different types of cracked teeth. The treatment and outcome for your tooth depends on the type, location, and extent of the crack.
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.
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 endodontist. When this happens, the pain will usually be relieved. A fractured cusp rarely damages the pulp, so root canal treatment is seldom needed. Your tooth will usually be restored with a full crown by your dentist.
This crack extends from the chewing surface of the tooth vertically towards the root. A cracked tooth is not completely separated into two distinct segments. Because of the position of the crack, damage to the pulp is common. Root canal treatment is frequently needed to treat the injured pulp. Your dentist will then restore your tooth with a crown to hold the pieces together and protect the cracked tooth. At times, the crack may extend below the gingival tissue line, requiring extraction.
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 cannot 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 therefore go unnoticed until the surrounding bone and gum become infected. Treatment may involve the 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.
If a fracture is suspected by either Dr. Gear or your referring dentist, a CBCT scan will be ordered to gain valuable 3D information about the potential fracture.
Preventing Cracked Teeth
While cracked teeth are not completely preventable, you can take some steps to make your teeth less susceptible to cracks.
- Don't chew on hard objects such as ice, unpopped popcorn kernels, or pens.
- Don't clench or grind your teeth.
- Wear a mouthguard or protective mask when playing contact sports.
Early diagnosis is important. Even with high magnification and special lighting, it is sometimes difficult to determine the extent of a crack. A cracked tooth that is not treated will progressively worsen, eventually resulting in the loss of the tooth. Early diagnosis and treatment are essential in saving these teeth.