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Cracked teeth are a common reason for needing endodontic treatment. Some cracks cannot be prevented, while others are due to oral habits; regardless, root canal treatment is often required to relieve pain and save a fractured tooth from needing to be extracted. 

Causes of Cracked Teeth

Sometimes you might immediately know that you’ve cracked a tooth, while in other cases, a patient may not realize it until days or even weeks after the fact when they begin to experience dental pain. The most common causes of cracked teeth include:


Bruxism is a term used to describe teeth grinding and jaw clenching. Often, bruxism occurs during sleep, so patients may be unaware of these habits. Bruxism places a great deal of pressure on the teeth, leaving them vulnerable to fracture.

Dental Restorations

A dental restoration may also make a tooth more prone to cracking. Large dental fillings can compromise a tooth and cause it to weaken. In such circumstances, a tooth may crack on its own or it may be more likely to crack from bruxism, eating difficult foods, or dental trauma.


Chewing or biting into hard or tough foods is another common cause of cracked teeth. Other times, something hard, such as a small pebble, may be hidden in a food item and accidentally bitten into. It should also be noted that biting or chewing non-food items, including fingernails, ice, and pens, can also cause a tooth to crack.

Dental Trauma

Dental trauma may involve a fall, an accident, a blow to the mouth, or a sports injury. We strongly recommend wearing a mouthguard to prevent such injuries if you participate in sports.

Temperature Changes

Temperature changes within the mouth can cause teeth to crack. An example is if you were to eat a food that scalded your mouth, then drank ice water to cool it down.


As we age, our teeth become worn from daily use. This leaves them more vulnerable to cracks. In fact, most cracked teeth occur in patients over the age of 50.

Types of Cracks

Not all cracked teeth require endodontic treatment. Some types of cracks are merely aesthetic, while others may require a tooth to be extracted.

Craze Lines

Craze lines are shallow cracks in the enamel layer of the tooth. Commonly caused by wear and tear, craze lines do not require endodontic treatment or compromise the health of your tooth.

Fractured Cusp

Fractured cusps may or may not require root canal treatment, depending on how close the fracture is to the pulp of the tooth. 

Cracked Tooth

Endodontic treatment is usually required for a cracked tooth, as these cracks begin on the chewing surface of the tooth and extend vertically to the root. The pulp tissue is usually damaged with this type of crack. After root canal treatment, the tooth structure will be restored to prevent the crack from extending below the gumline.

Split Tooth

Split teeth are often the result of cracked teeth that are left untreated. Some split teeth can be saved with prompt endodontic treatment, while others may require extraction.

Vertical Root Fracture

A vertical root fracture originates in the root of the tooth and extends upwards. Because of their location, this type of fracture may go unnoticed; vertical root fractures are often discovered only when the surrounding bone and gum become infected. These fractures typically require extraction, although in some cases, the tooth can be saved by surgically removing the fractured root with a procedure called root resection.

Learn More About Cracked Teeth

To learn more about cracked teeth and endodontic treatment, contact us today to schedule an appointment at one of our six North Shore & Boston-area locations for a consultation.

Often, you know immediately when you’ve cracked a tooth. In other circumstances, you may not realize that your tooth is cracked until you receive a diagnosis from a dentist or endodontist. If you think you may have a cracked tooth, here’s what you need to know.

Signs of a Cracked Tooth

There are a number of symptoms of a cracked tooth. The most common include:

  • Erratic pain when chewing
  • Pain with the release of biting pressure
  • Sensitivity to hot and cold temperatures

Cracked teeth hurt because when the outer surfaces of the tooth are fractured, the pieces move when chewing, irritating the pulp inside the tooth and causing discomfort. When the crack in a tooth reaches the pulp tissue, bacteria can enter the crack and cause infection of the pulp. If infection occurs, the erratic pain you once felt may become constant.

Diagnosing a Cracked Tooth

Although the symptoms you experience are a sign that your tooth is cracked, the only way to know if that’s the case is to receive a diagnosis from a dentist or endodontist. Because cracked teeth are difficult to diagnose without advanced imaging and microscopes, your dentist may refer you to our office for diagnosis and treatment.

Our endodontists diagnose a cracked tooth by:

  • Asking you about any recent injuries that may have caused your tooth to crack.
  • Feeling and visually examining your teeth using a surgical microscope in order to identify the crack.
  • Using 3D CBCT imaging for a 360-degree view of each tooth

With cracked teeth, early diagnosis and treatment is key. This gives us the best possible chance of saving your tooth from needing to be extracted.

Treating a Cracked Tooth

There are three treatment options for cracked teeth:

  • Aesthetic treatments, which are used primarily for shallow cracks and craze lines that only affect the tooth enamel. Such treatments are performed by your general dentist or a cosmetic dentist, not by an endodontist.
  • Root canal treatment, which is recommended when a crack has caused irritation or infection in the pulp of the tooth. The root canal treatment removes the pulp, then cleans, shapes, and disinfects the canal before sealing the tooth to prevent reinfection. Following a root canal, the tooth is typically restored with a dental crown.
  • Extraction, which is only recommended when a root canal treatment isn’t an option. The most common reasons for extraction are vertical root fractures, although split teeth may also require extraction.

The prognosis after root canal treatment for a cracked tooth is good. In most cases, cracked teeth that have been treated with endodontic therapy have a long lifespan and continue to function for years or even decades to come. In contrast, a tooth that is extracted will need to be replaced with a dental bridge or implant, which requires additional appointments with your dentist and more care and maintenance than your natural tooth.

Learn More About Cracked Teeth

If you have a cracked tooth and you’d like to set up a consultation with one of our endodontists, contact us today.

Endodontists specialize in the diagnosis of dental pain. Severe dental pain can disrupt patients’ lives, making it difficult to eat, sleep, speak, and go about their normal activities. With care from a skilled endodontist, you will be able to get back to your routine quickly.

Dental Pain Symptoms

Dental pain often develops suddenly, with symptoms varying from mild to severe. At times, the pain may even be debilitating. Some of the most common symptoms of dental pain include:

  • Dull, achy pain
  • Sharp, jabbing pain
  • Pain when biting
  • Pain with hot or cold stimulus
  • Throbbing pain
  • Jaw pain

Symptoms can be intermittent or constant; some patients only experience pain when eating, while for others, the pain is lingering. You may experience some level of relief with over-the-counter pain relievers, but once they wear off, the pain returns.

How Endodontists Diagnose Dental Pain

While a general or family dentist may be able to diagnose dental pain as well, only endodontists have advanced dental technology that helps them quickly identify the cause of your discomfort and recommend a treatment to alleviate your pain and save your natural tooth.

During your appointment, one of our endodontists will go over your risk factors and examine your teeth. If needed, we use clinical microscopic examination, 3D imaging, and CBCT scans to determine the origin of your pain. In most cases, teeth can be saved with endodontic therapy. We will collaborate with your dentist to recommend the best course of treatment.

Causes of Dental Pain

Some of the most common causes of dental pain include:

Tooth Decay

When tooth decay spreads inward from the enamel and reaches the pulp of a tooth, it can cause severe pain, sensitivity, and necrosis of the nerve if left untreated.

Inflammation of the Pulp

Also known as pulpitis, inflammation of the pulp can cause sensitivity to temperature, pain when biting, a dull ache in the jaw, and referred pain in the ear, head, or temple. Root canal treatment will alleviate this pain.

Cracks and Fractures

Cracks and fractures can occur as a result of wear and tear, dental trauma, or biting down on a hard object. Sometimes this type of dental injury is immediately identifiable, as it can be seen or felt, but other times, a hairline crack is only visible upon microscopic examination. Cracks and fractures can cause dull pain, sensitivity, or sharp pain when biting in a certain way. 

Dental Abscess

When bacteria builds up inside the pulp area of the tooth, it can cause a dental abscess. Signs of an abscess include pain when biting, swelling, persistent bad breath, extreme sensitivity to temperature, and a small bump on the gums near the tooth. Dental abscesses require urgent attention.

Schedule an Appointment for Dental Pain

If you’re experiencing dental pain, it’s important to see your dentist or endodontist as soon as possible. The earlier your symptoms are diagnosed and treated, the better your outcome is likely to be. Contact us today to schedule an appointment at one of our six North Shore or Boston-area locations.

Traumatic dental injuries are a common reason for patients to receive referrals to our practice. Often the result of an accident or sports injury, dental trauma doesn’t have to mean losing your tooth when you’re able to receive prompt endodontic care. Endodontists have the advanced training, expertise, and technology to save injured teeth in the following circumstances:

Fractured Teeth

A tooth with a minor chip and no pain is likely a matter of aesthetics that can be repaired by your general dentist. When a tooth has a more significant chip, fracture, or crack, it can cause the pulp at the center of the tooth to become inflamed and possibly infected. In these situations, endodontic care is needed.

A crown fracture that damages or exposes the pulp can cause painful sensitivity and difficulties biting and chewing. Once the pulp is compromised, your options are to have the tooth extracted or to get root canal treatment. Root canal treatment is recommended, as an extracted tooth must be replaced, which can be costly, time-consuming, and presents its own set of risks.

If a fracture extends from the crown to the root or if your tooth is split, it may require extraction.

Luxated Teeth

A traumatic dental injury can result in a luxated, or dislodged, tooth. A luxated tooth can be pushed sideways, down out of its socket, or up further into the socket. When this occurs, an endodontist will place the tooth back into its proper position and stabilize it with a splint. Root canal treatment is typically started several days after the injury.

There is some new research indicating that children under the age of 12 may not need a root canal in such circumstances, even when an adult tooth is involved. The stem cells present in the tooth pulp in children can be stimulated to complete root growth and promote healing. Should we decide to delay root canal treatment for your child, close follow-up will be needed to ensure that the tooth is healing properly.

Avulsed Teeth

The medical term for a tooth that has been knocked out is an avulsed tooth. This means that the tooth has been completely knocked out of the socket. While it’s natural to panic in such a situation, there is a chance that your tooth can be saved if you act quickly and get prompt treatment, preferably within 30 minutes.

It’s important to know how to handle an avulsed tooth. Never touch the root; instead, hold the tooth by the crown. Gently rinse off any debris if the tooth fell out of your mouth and, if you can, place the tooth back into the socket. If you’re not able to do this, put the tooth in a small cup of dairy milk or saliva.

Call our office as soon as you’re able so we can begin preparing for your visit. When you arrive, your endodontist will evaluate your tooth, ensure that adjacent teeth were not injured, and put the tooth back into the socket. A splint will be used to stabilize the tooth and you will return within a week or two for a root canal.

Schedule an Appointment with NSBENDO

If you need endodontic care following a traumatic dental injury, contact us today to schedule an appointment at one of our six North Shore and Boston-area locations.