Cracked Teeth

Cracked teeth demonstrate many types of symptoms, including pain when chewing, temperature sensitivities, or even pain upon the release of biting pressure. It is also common for pain to come and go, making it difficult to diagnose the cause of discomfort. 

Chewing can cause micro-movement of the cracked pieces of your tooth.  The pulp within the tooth may then become irritated. At the same time, when biting pressure is released, the crack can close quickly sometimes resulting in sharp pain. Eventually, the pulp will become damaged and tooth will consistently hurt, even when you are not chewing. It is possible that cracks can lead to infection of the pulp tissue, which can spread to the bone and gum surrounding the problematic tooth.  Additionally, if untreated long enough, cracks may become so severe that endodontic procedures may not be a viable solution and the tooth must be extracted.  Prompt treatment of cracked teeth is essential.

Types of Cracks

A depiction of craze lines on teeth

Craze lines

These are tiny cracks that only affect the outer enamel of the tooth. These cracks are more common in adults. These types of cracks are superficial and are usually of no concern.

An example of a tooth with a fractured cusp

Fractured Cusp

When a cusp (a tip of a chewing tooth) becomes weakened, a fracture may result. The cusp may break off completely or may need to be removed by a dentist. A fractured cusp rarely damages the pulp, so root canal is may not be necessary. Your dentist will usually restore the tooth with a full crown.

A sample of a tooth showing a treatable cracked tooth

Treatable Cracked Tooth

This type of crack extends from the chewing surface of the tooth and vertically migrates towards the root. In some cases, the crack may extend below the gum line. It is possible for the crack to extend further into the root. Damage to the pulp is commonplace. In this case, root canal treatment is usually necessary. A cracked tooth that is not treated will worsen, resulting in the loss of the tooth. Therefore, early detection is essential.

Significant crack on one wall of a tooth. This tooth required extraction.
Less significant crack on one wall of a tooth. This tooth was restorable.
A depiction of a tooth split with distinct segments

Split Tooth

A split tooth is usually the result of an untreated cracked tooth. It can be identified by a crack with distinct segments which splits the tooth into two or more segments. This type of tooth can rarely saved intact. Yet, the position and extent of the problem will dictate whether any portion of the tooth can be saved. Sometimes, endodontic treatment by the doctors and restoration by your dentist can be used to save a portion of the tooth.

Fracture line on one wall of a tooth which was found to continue along the whole tooth & along the opposing wall. This tooth required extraction.

An example of a vertical fracture starting at the tooth's root

Vertical Root Fracture

A vertical root fracture generally begins at the root tip and extends towards the chewing surface of the tooth. Unfortunately, they show minimal symptoms and may go unnoticed. Diagnosis of a vertical root fracture is often very difficult. Treatment involves endodontic surgery if a portion of the tooth can be saved by removal of the fractured root. Otherwise the tooth will have to be extracted.

Fiber Optic Light used in addition to the microscope for diagnosis of a vertical root fracture.