Cracked Tooth

While the term may sound extreme, cracked teeth are actually quite common in adults. Treatment can range from none at all to root canal, crown, or tooth extraction in more severe cases.

Like most dental injuries, the treatment and ability to save the tooth will depend on the severity of the crack, whether or not it has extended into the root, how long it has been in place, and whether there are any other extenuating circumstances.

The key to successful treatment of cracked teeth is early detection and appropriate treatment. If you believe you may have a cracked tooth, make an appointment with your dentist as soon as possible.

A cracked tooth can take many forms, from shallow craze lines (cracks only in the outer surface of the tooth) limited to the outer surface of the tooth enamel to fractures that extend through the chewing surface of the tooth and into the root.

Oftentimes, these cracks are too small to be visible to the naked eye. X-rays may not even be sufficient for identification, in which case other methods of diagnosis like light examination (transillumination) or dental dye must be employed. While cracks may occur in any type of tooth, they are most common in molars, teeth with large fillings, and teeth that have had multiple fillings.

Cracks are not entirely preventable – however, they usually result from biting on something very hard, such as an ice cube or popcorn kernel. Grinding (bruxism) and clenching are also common causes.

Cracked teeth exhibit several characteristic signs and symptoms; however, you may be unable to tell if the symptoms are due to a crack or another type of dental problem.

Typically, cracked teeth will cause pain with biting pressure and pain during chewing (especially upon release), as well as sensitivity to heat or cold. Pain may come and go; in some cases, you may experience hardly any pain at all.

You may also see discoloration or even a light brown line running vertically through your tooth. If you notice any of these symptoms, make a dentist appointment as soon as possible. Left untreated, cracked teeth can lead to oral disease and infection.

The symptoms of a cracked tooth will vary depending on the type of crack and its severity. Because of the off-and-on nature of the pain and other symptoms - and the fact that cracks often do not show up on X-rays - your dentist may have some difficulty locating the tooth that is causing the problem.

Cracked tooth syndrome (CTS) refers to the group of symptoms that a person may experience if they have a cracked tooth. The following are common symptoms but keep in mind that cracks can exist without any symptoms whatsoever.

Be aware that these symptoms can also be indicative of other oral injuries. Your dentist may first need to rule out conditions such as endodontic or periodontal abscess, pericoronitis, sinusitis, hypersensitivity, and bruxism.

Your dentist will be able to provide a final diagnosis following a thorough examination, but here are some possible symptoms of a cracked tooth:

With a cracked, fractured, or split tooth, you may experience pain when chewing. This pain is most notably felt after biting down, when you release the bite. Pain when chewing or biting can range from mild to severe. The pain may come and go, and may be difficult to localize to a particular tooth.

Cracked teeth may experience increased sensitivity to cold or hot foods and liquids, as well as sensitivity to sweets. Reactivity to temperature and flavor may feel like mild throbbing or a sharp nerve reaction depending on the depth of the crack and whether or not the tooth’s sensitive pulp has been exposed.(1)

In most cases, a cracked tooth will not create a constant ache (such as that experienced with a cavity or abscess). Pain will be most evident when chewing or when the tooth is exposed to heat or cold, as mentioned above. Depending on the depth of the crack and the amount of the tooth’s sensitive pulp that is exposed, intermittent pain may occur without pressure or chewing. 

Gum swelling is another common symptom of a cracked tooth and may occur at or around the fracture. Swelling may be tender to the touch, and heat and redness are also possible. Swelling indicates that the crack has injured the tooth pulp, leading to infection of the pulp.

A cracked tooth that is left untreated for a duration of time can result in a pulp infection. This requires immediate treatment, as infection can spread to the gums and bone. Besides swelling, you may notice fever, increased pain, tender glands, and bad breath.(2) If any of these symptoms develop, make an appointment with your dentist as soon as possible to avoid further complications.

If you think you may have a cracked tooth, see a dentist right away because saving a cracked tooth depends on the amount of damage your tooth has experienced and how far the crack has spread.  The earlier a crack is diagnosed and treated, the more likely it is to have a favorable outcome. Once treated, most cracked teeth will continue to provide many years of pain-free chewing.

_Sources:

_{1 Simmons, S. (31 January, 2017). Diagnosing what it's cracked up to be: A lesson in endodontics. Retrieved from https://www.dentistryiq.com/clinical/endodontics/article/16366420/diagnosing-what-its-cracked-up-to-be-a-lesson-in-endodontics.}

_{2 Frank, C. (16 October, 2017). Cracked Tooth. Retrieved from https://www.healthline.com/health/cracked-tooth#complications.}