What is a Cracked Tooth?
A healthy tooth is covered with strong, hard enamel. In some cases, this enamel gets cracked, which exposes the inner layers of the tooth, resulting in sensitivity and sometimes great pain, especially during chewing.
A visible crack on a molar. Sometimes the crack may not be visible even if the tooth is symptomatic.
Signs of a Cracked Tooth
- Consistent pain and discomfort when biting on affected tooth.
- Extra sensitivity to hot and cold foods or liquids, and sometimes to sweet foods.
Causes of a Cracked Tooth
- Accidentally biting on something hard (e.g. nuts) during chewing.
- Nightly grinding or clenching of teeth (bruxism) which results in higher loading forces on teeth, leading to more wear and cracks.
- Large existing restorations that have weakened the tooth.
- Trauma.
Different Types of Cracked Tooth and Their Treatment
FRACTURED CUSP
When a fragment of a tooth breaks off whilst the rest of the tooth structure remains intact, this is known as a fractured cusp. As long as the pulp is not exposed, the tooth can be restored with a bonded filling or a crown.
Molar with a fractured cusp. Only the dentine is exposed. The tooth can be restored with a bonded filling or a crown.
CRACKED TOOTH
A cracked tooth happens when the enamel surface suffers a clean break and exposes the dentine, but the tooth itself has not separated into pieces. Unfortunately, such a crack cannot be sealed with a filling, as the tooth will flex during chewing and the crack will reappear and lead to pain and sensitivity.
When biting on a cracked tooth, the tooth will flex and the crack widens, resulting in pain or great sensitivity.
The best option is to brace and reinforce the cracked tooth with a crown to prevent the crack from expanding further.
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If the crack is deep and has caused pulp inflammation, a root canal treatment would be necessary to eliminate the affected pulp tissue and to prevent future pain and infections.
Read more: What is a Root Canal Treatment?
In severe cases where the crack has extended past the gum and into the roots (known as a root fracture), the tooth is no longer treatable and an extraction would be the best option.
SPLIT TOOTH
A split tooth occurs when the crack extends deep enough to separate the tooth into 2 pieces. Usually, at least one portion will be loose, and sometimes the gums will start to swell and bleed around the tooth. Sadly, the tooth is no longer salvageable and needs to be extracted immediately to prevent a serious gum infection.
A split tooth necessitating an immediate extraction.
Another example of a split tooth, with the X-ray image showing a crack line extending into the roots.
How the split tooth looks like – a quarter of the entire tooth above the gum has separated. The tooth is not restorable, and has to be extracted.
Will My Cracked Tooth Heal After Treatment?
Unlike a broken bone, a cracked tooth will not heal itself. The crack will remain and may progress further and deeper, resulting in poorer restorability. Even placement of a crown on a cracked tooth, which provides the best protection, may not guarantee success in all cases, especially when the crack has extended into the roots (considered as a root fracture).
However, for the majority of patients, a crown with or without root canal treatment will relieve pain and reduce the risk of the crack worsening. As such, the tooth can be retained in the mouth and can continue to be functional.
How to Prevent Cracked Teeth from Happening?
- Avoid chewing on hard objects such as ice, nuts and bone.
- If you have been told that you grind or clench your teeth at night when you sleep, have a nightguard done and wear it nightly to reduce stress on your teeth.
- Wear a protective mouthguard when playing contact sports to reduce the risk of trauma to your teeth.
A customised nightguard for people who grind their teeth at night.
If you suspect that you have a cracked tooth and would like a consultation, you can request an appointment by clicking here or on the button below:
Some content adapted from American Association of Endodontists (AAE) website.Back to top
