Cracked teeth

How a cracked tooth feels

You may notice:

• sharp pain when you bite down, or when you release the bite
• pain that comes and goes rather than a constant ache
• sensitivity to hot and cold

Because the pain comes and goes, it can be hard to tell which tooth is causing it. If you’re hurting now, call us. We make every attempt to see you the same day.

Why it hurts when you bite and let go

When you chew, the pieces on either side of a crack move slightly and irritate the pulp, the soft tissue of nerves and blood vessels inside the tooth. When you let go, the crack closes quickly, and you feel a brief, sharp pain.

Repeated over time, that irritation can damage the pulp until it can no longer heal. The tooth may then hurt with hot and cold, or on its own, and an infection can spread from the pulp into the bone and gum around the tooth.

How we treat each kind of crack

Your treatment, and how well the tooth does, depends on the kind of crack, where it is and how far it runs. Dr. Brasseale treats cracked teeth under the surgical operating microscope. Even with that light and magnification, how far a crack runs can be hard to judge, which is one more reason to have a tooth checked as soon as symptoms start.

Craze lines

Craze lines are tiny cracks in the outer enamel. They’re very common in adult teeth, cause no pain and need no treatment. They affect only how a tooth looks.

Fractured cusp

A cusp is one of the raised points of the chewing surface. When one is weakened, often around a large filling, a piece can break off on its own or may need to be removed, and the pain usually stops once it does. A fractured cusp rarely harms the pulp, so a root canal is seldom needed. Your dentist usually restores the tooth with a crown or a new filling.

Cracked tooth

This crack runs from the chewing surface down toward the root, without splitting the tooth into separate pieces. Because of where it runs, the pulp is often damaged, and root canal treatment is frequently needed. Your dentist then places a crown to hold the tooth together and protect it. If the crack extends under the gum line, the tooth can’t be saved and has to be removed.

With this kind of crack, catching it early matters most. Left untreated, the crack tends to spread, and the tooth can eventually be lost. When the crack is found before the pulp is badly damaged, an early crown is often enough. In a six-year study of cracked teeth caught while the pulp could still recover, about four in five were treated with a crown alone and never needed a root canal.

Split tooth

A split tooth is usually what a cracked tooth becomes over time. The crack has divided it into separate pieces, so it can’t be saved whole. Depending on where the crack runs, part of the tooth can occasionally be kept with root canal treatment and a crown from your dentist.

Vertical root fracture

This crack starts in the root and runs up toward the chewing surface. It often causes few signs at first, so it can go unnoticed until the bone and gum around the tooth become infected. Treatment may mean removing the tooth, though endodontic surgery can sometimes save it by removing the cracked root.

Keeping a cracked tooth working for years

Treatment relieves the pain and lowers the chance that the crack gets worse, and most treated cracked teeth keep working comfortably for years. A crown gives a cracked tooth the most protection, though it can’t guarantee the result. Root canal treatment has a good track record with cracked teeth, while teeth with a deep gum pocket beside the crack tend to do less well.

A crack in a tooth doesn’t heal the way a broken bone does, and some cracks keep spreading even after treatment. Dr. Brasseale will talk with you about your diagnosis and the best way to keep your natural tooth.

Habits that help protect your teeth

Clenching, grinding and chewing on hard things all make teeth more likely to crack. You can’t prevent every crack, but you can lower the risk:

• Avoid chewing ice, unpopped popcorn kernels and pens.
• Try not to clench or grind your teeth.
• If you clench or grind in your sleep, ask your dentist about a night guard.
• Wear a mouth guard or protective mask when you play contact sports.

If a tooth already hurts when you bite or let go, call us.