Cracked Teeth

What is a cracked tooth?

A cracked tooth is a tooth that has become broken.

Do all teeth crack in the same way?

No. Teeth can crack in several different ways:

• Cracked tooth: This is when a crack runs from the biting surface of the tooth down towards the root. Sometimes it goes below the gum line and into the root. A cracked tooth is not split into two parts but the soft, inner tissue of the tooth is usually damaged.
• Craze lines: These are tiny cracks that affect only the outer enamel of the tooth. They are common in all adult teeth and cause no pain. Craze lines are a sign that a tooth is/ has been under stress.
• Cracked cusp: The cusp is the pointed part of the biting surface of the tooth. If a cusp becomes damaged, the tooth may break. You will usually get a sharp pain in that tooth when biting.
• Split tooth: This is often the result of an untreated cracked tooth. The tooth splits into two parts. Vertical root fractures are cracks that start in the root and go up towards the biting surface. Vertical root fractures occur in back teeth that have had a root canal but no protective restoration such as a crown or onlay.

Why do teeth crack?

Many things can cause teeth to crack, such as:

• Extreme tooth grinding, which can put the teeth under enormous pressure.
• Large fillings that weaken the tooth, especially large amalgam filllings.
• Chewing or biting on something hard: for example popcorn kernels, crusty bread, ice, boiled sweets, fruit stones or meat bones.
• A blow to the chin or lower jaw.
• Gum disease, if there has been bone loss. This could make the teeth more likely to suffer from root fractures.
• Sudden changes in mouth temperature.

How can I tell if I have a cracked tooth?

The signs can be difficult to spot and the symptoms will vary. You may get pain from time to time when you are chewing, especially when you release the biting pressure. Extreme temperatures, especially cold, may cause discomfort. Or you may be sensitive to sweetness, but with no signs of decay. A small area of the gum near the affected tooth may swell.

If the pain is severe, take pain relief like you would normally take for a headache. Always check with your doctor or pharmacist if you are taking any other medication.

Why don't cracks show up on a dental x-ray?

Unfortunately, dental x-rays sometimes don't show up the cracked tooth. This is because the x-ray beam must be parallel to the crack before it can penetrate it.

However, sometimes other signs of a crack may show up. With a vertical root fracture, if the crack has been there long enough, vertical bone loss near to the root can be seen. We may use a bright light or magnification to find the crack. We may also use a special dye to follow the course of the crack.

Will I need to have treatment?

Yes. It is important to get advice as soon as possible to help the treatment be more effective. If they are not treated, cracked teeth can lead to the death of the nerve. The tooth could need root canal treatment. In severe cases the tooth can actually split in two. If this happens we will not be able to save the tooth and it will need to be extracted.