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At Contemporary Endodontics, our Team of Endodontists are pleased to offer a wide range of Endodontic Services, including treatment for cracked teeth. Since people are living longer and dentists are helping keep teeth longer, teeth are being exposed to years of crack inducing habits. Particularly, clenching, grinding, and chewing hard things such as ice can result in cracks and fractures in teeth. Typically teeth with cracks/fractures do not show on radiographs (x-rays). Hence, cracked and fractured teeth can especially be difficult to locate. When the outer hard tissues of a tooth are fractured or cracked, chewing can cause movement of the pieces, and the pulp becomes irritated. Often this results in a momentary, sharp pain which eventually progresses to include thermal sensitivity. In time the cracked or fractured tooth, similar to other teeth with pulp degeneration, can begin to hurt on its own.
Does your tooth feel like it “zaps” you when biting on it? Well, that’s not enough to know it’s cracked or fractured. Unfortunately, cracked and fractured teeth exhibit a variety of symptoms. If your tooth is cracked/fractured, you might feel occasional pain when chewing, particularly between bites as you release the pressure on your teeth. You might also feel pain when you eat or drink something hot or cold. Cracks and fractures are fairly difficult to diagnose because the pain comes and goes, and cracks/fractures only rarely show up on x-rays. Because of this, you may see your dentist several times before the crack is diagnosed.
Not all cracked and fractured teeth hurt. It really depends on the severity of the crack, and the response of the pulp to the irritants allowed into the tooth. Commonly it’s not until they become symptomatic that we get involved. A crack/fracture can make the tooth sensitive due to the movement of the fractured tooth pieces and/or leaking irritants into the pulp and even allow bacteria to come right in causing eventual infection of the tooth. Let’s take a closer look at a normal healthy tooth.
Inside the tooth, under the white enamel is a hard layer called the dentin, and there is the soft inner tissue called the pulp. The pulp contains blood vessels, nerves, and connective tissue. The pulp is a vestige of what originally formed your tooth when you were a kid!
When the outer hard tissues of the tooth are cracked, the chewing can cause movement of the pieces, and the pulp can become irritated. When biting pressure is released, the crack can close quickly, resulting in a momentary, sharp pain. Irritation of the dental pulp can be repeated many times by chewing. Eventually, the pulp will become damaged to the point that it can no longer heal itself. The tooth will not only hurt when chewing but may also become sensitive to temperature extremes. In time, a cracked tooth may begin to hurt all by itself. Extensive cracks can lead to infection of the pulp tissue, which can spread to the bone and gum tissue surrounding the tooth.
No single test or technique provides the correct diagnosis of 100% of the time. In fact, if a restoration is present, it can become quite difficult to diagnose without removing the restoration or drilling a hole into the tooth. Most of the time, we use a transilluminating light and see if the light transmits from one side of the tooth to the other. Of course, fillings don’t transmit the light the same, so it’s even harder to tell when cracks or fractures are present in teeth with restorations. A trained eye can spot the difference.
That depends on if the crack/fracture is caught early enough, often only a restoration that holds the tooth together will be needed. Once the pulp begins to degenerate and/or becomes infected, it must be treated endodontically if the tooth is going to be maintained. Like cracks in a windshield, cracks in teeth can often remain small or progress slowly over time. I believe that the sooner a crack or fracture is detected and appropriate treatment delivered, the better the chance of maintaining your tooth.
The treatment of your cracked tooth depends on the type, location, and severity of the crack.
Unlike a broken bone, the fracture in a cracked tooth will never completely heal. In fact, even after treatment, it is possible that a crack may continue to worsen and separate, resulting in the loss of the tooth.
The treatment you receive for your cracked tooth is important because it will relieve pain and reduce the likelihood that the crack will worsen. Once treated, most cracked teeth continue to function and provide years of comfortable chewing. Talk to your dentist and/or endodontist about your particular diagnosis and treatment recommendations. They will advise you on how to keep your natural teeth and achieve optimum dental health.
While cracked teeth are not completely preventable, you can take some steps to make your teeth less susceptible to cracks.
If you experience symptoms of a fractured or cracked tooth, see your dentist immediately. If detected early enough, a cracked/fractured tooth can often be more likely to be maintained.