Cracked Tooth

Dr. Levin treats patients with common dental problems such as cracked or fractured teeth. As people retain their natural teeth longer due to advances in dental technology, the likelihood of cracked teeth increases. There are many reasons why teeth crack: biting on hard objects, trauma, grinding and clenching of teeth. These behaviors place the teeth under extra strain, a vulnerable position that is more susceptible to cracking.

When tooth enamel is cracked, pain can become momentarily debilitating. In the absence of pressure on the crack, there may be no discomfort. However, as the cracked tooth performs a biting action, the crack widens. The pulp and inner workings of the tooth then become exposed, and painful irritation occurs. As pressure is released again, the two parts of the crack fuse back together, and pain subsides. If left untreated, the pulp becomes irreversibly damaged and constantly painful. The resulting pulp infection can affect the bone and soft tissue surrounding the tooth.

Symptoms of a cracked tooth include:

• Unexplained pain when eating.
• Sensitivity to warm and cold foods.
• Pain with no obvious cause.
• Difficulty pinpointing the location of the pain.

What kind of cracks can affect the teeth?

There are multiple ways in which a tooth can be cracked. The particular type of crack determines what type of treatment is viable. In a case, where the crack is not too deep root canal therapy can be performed. This allows the natural tooth to remain in the mouth. In other situations, the tooth is too badly damaged requiring extraction.

Here is a brief overview of some common types of cracks:

Crazes – These cracks are tiny vertical cracks that do not place the teeth in danger. Most dentists consider the scratches on the surface of the teeth to be a normal part of the tooth anatomy. A craze rarely requires treatment for health reasons. However, a wide variety of cosmetic treatments can be performed to reduce the undesirable aesthetic impact.

Oblique supragingival cracks – These cracks only affect the crown of the tooth without extending below the gum line. Usually, the affected part of the tooth eventually breaks off. The result will be minor pain for the patient because the tooth pulp (the nerves and vessels) will remain unaffected.

Oblique subgingival cracks – These cracks extend beyond the gum line often beyond the beginning of the jawbone. When a piece breaks off, it will usually remain attached until the dentist removes it. Oblique subgingival cracks are painful requiring a combination of periodontal surgery to expose the crown. As well endodontic treatment is needed to place a crown or other restorative device.

Vertical furcation cracks – These cracks happen when the roots of the tooth separate. This type of crack affects the nerve of the tooth in most cases. Because the tooth will not separate completely, root canal therapy and a crown can usually save the tooth.

Oblique root cracks – These cracks tend to not affect the surface of the tooth at all. In fact, the damage is only apparent below the gum line and sometimes the jawbone. Root canal therapy may be possible depending on how close the fracture is to the tooth surface. Nevertheless, extraction is almost the only option after suffering this classification of fracture.

Vertical apical root cracks – These cracks occur at the apex, the tip of the root. Therefore, the tooth does not require extraction from a dental perspective. However, many patients request an extraction because of the high degree of pain. Root canal therapy alleviates the discomfort for a while but most often teeth affected by such cracks are extracted.

How are cracks in the teeth treated?

There are a variety of ways in which teeth can crack. Some cases can only be exposed using X-ray machines, while others are clearly visible to the dentist’s eye.  When the tooth root is affected, root canal therapy is the most effective treatment option. The pulp, nerves, and vessels of the tooth will be removed, the resulting space will be filled with gutta-percha. A crown or filling will be added to stabilize the tooth allowing it to function as normal.

When the crack is too severe for the tooth to be saved, the dentist will perform an extraction. There are a number of restorative options such as: bridges, dental implants, and partial dentures. These structures will  restore biting, chewing, and speaking functions.

If you have any questions or concerns about cracked teeth, please contact Dr. Levin’s office.