Cracked Teeth & Fractures


Advances in dental technologies are helping people keep their natural teeth longer.  During a tooth’s lifetime, it is often exposed to many crack-inducing habits such as clenching, grinding and chewing on hard objects.  These habits often make our teeth more susceptible to cracks.  

Although all dentists are trained in the diagnosis and treatment of cracked teeth, many rely on our endodontic expertise in diagnosing and treating complicated and difficult cases, such as cracked teeth. Early diagnosis of cracked teeth is extremely important, as they often start small and progress slowly over time.  The earlier it is detected and treated, the better the chance of saving your tooth.    

WHY DOES A CRACKED TOOTH HURT

Inside each tooth, you will find pulp tissue, which contains blood vessels, nerves and connective tissue.  When the tooth is cracked, chewing causes minor movement of the hard outer pieces, which causes irritation in the pulp.  This can be detected by a sharp momentary pain, when biting pressure is released, quickly closing the crack.  Repeated chewing motion causes the irritated pulp tissue to become inflamed until the point that it can no longer heal itself.  At this time, the tooth will not only hurt when chewing, but may also become sensitive to temperature.  Extensive cracks and cracks that have gone untreated, can lead to infection of the pulp, the bone and gum tissue surrounding the tooth.  

Our office has the advantage of having 3D CBCT imaging and Surgical Microscopes to more effectively diagnose and treat each case. This equipment allows us to visualize radiographic and clinical, evidence of a crack. Click here to learn more about our technology.

TYPES OF CRACKS

Craze Lines

Craze lines are tiny, shallow cracks that only affect the enamel of the tooth. They are more common in adults from normal wear and tear.  Craze lines cause no pain and are of no concern beyond appearances.  You dentist may advise you on the most appropriate course of action.

Fractured Cusp

A fracture may result if a cusp (the pointed part of the chewing surface) becomes weakened.  In the case of a fracture cusp, the weakened cusp may break off on its own, or may be removed by a dentist. If fracture line too close to the pulp, root canal treatment is recommended prior to placing a crown to restore the tooth to its full function.  

Cracked Tooth

This type of crack begins on the chewing surface of the tooth and extends vertically down towards the root.  In this case, the pulp tissue is most often damaged and root canal treatment is needed to treat the injured pulp.  After treatment is completed, your dentist will restore the tooth with a full crown to bind the tooth and prevent the crack from progressing.  Early detection and treatment is essential in saving these teeth.  If left untreated, cracks become worse, eventually resulting in the loss of the tooth.  

Split Tooth

A split tooth is often the result of an un-treated cracked tooth.  It is identified by distinct segments of mobility.  The position and extent of the crack will dictate if any portion of the tooth is salvageable.  In some cases, endodontic treatment and restoration with a full crown can be used to save a major portion of the tooth.

Vertical Root Fracture

A vertical root fracture begins in the root of the tooth and extends up toward the chewing surface.  This type of fracture may go unnoticed for some time, as they often cause minimal signs and symptoms.  A vertical root fracture is often discovered when the surrounding bone and gum become infected.  These fractures are most often untreatable, requiring extraction.  However, in some cases, the tooth can be saved by surgically removing the fractured root (Root Resection).

WILL MY TOOTH COMPLETELY HEAL?

The fracture in a cracked tooth will never heal, unlike a broken bone.  In spite of treatment, some cracks may continue to progress, resulting in loss of the tooth.  

Endodontic treatment and proper restoration of a cracked tooth aids in relieving pain and reducing the likelihood that the crack will become worse.  Once treated, most cracked teeth continue to function for years.

At NSBENDO, we take the time to thoroughly assess the risk factors in every case.  When needed, we use 3D imaging CBCT scans and clinical microscopic examinations to evaluate the case.