Cracked tooth types , symptoms and treatment

Cracked tooth types , symptoms and treatment

Ignoring the symptoms of a cracked tooth can lead to further dental problems down the road, including infection and even tooth loss.

Reasons Teeth Crack

Just like a chipped tooth, there are several reasons teeth crack.  A strong tooth sometimes cracks because of an accident or a blow to the mouth.  But more often than not, a tooth is weakened first before it eventually cracks.

As you age, your teeth weaken from the daily forces of chewing, biting, and grinding.  In some cases, you might not even realize the exact moment in which your weakened tooth finally cracks.

Amalgam fillings are notorious for causing the right conditions for crack development in teeth. 

Bruxism provides intense forces which can cause hairline cracks to form and then develop to become significant, tooth-threatening fractures. 

Root canal treatment instrumentation and post placement way may cause outline cracks or even fractures 

Inside our teeth is a dense network of nerves and blood vessels known as the pulp. When the pulp is irritated it can make our teeth one of the most sensitive parts of our body. This sensitivity means we may experience pain as a symptom of a cracked tooth.

Cracked tooth may be associated with malocclusion proplems as abfraction or attrition . 

Types of Cracked Teeth

There are actually several distinct types of cracked teeth. Treatment depends on which type of crack you have, its location in your mouth, and its severity.  Here are the five types of cracked teeth:

Craze lines. These are super-small cracks in the enamel (the strong outer covering) of teeth. They cause no pain and don’t require any treatment.

Fractured cusp. This kind of crack generally occurs around a dental filling. It usually doesn’t affect the pulp of the tooth (the soft center of the tooth where nerves, connective tissue, and blood vessels are) and as a result doesn’t cause much pain.

Cracks that extend into the gum line. A tooth that has a vertical crack that extends through it but hasn’t yet reached the gum line is generally savable. However, if the crack extends into the gum line, that tooth may need to be extracted. Prompt treatment offers the best chance of saving the tooth.

Split tooth. This is a tooth with a crack that travels from its surface to below the gum line. It can actually be separated into two segments. With such an extensive crack, it’s unlikely the entire tooth can be saved, but only a portion of it.

Vertical root fracture. This type of crack begins below the gum line and travels upward. It often doesn’t produce much in the way of symptoms, unless the tooth becomes infected. Chances are the tooth will have to be extracted.usually due to filling with high force lateral condensation techniques or forcefully engaged root canal post .

Horizontal root fracture usually due to trauma, it's prognosis depends on crack or fracture position

Symptoms of a cracked tooth

Not every cracked tooth will produce symptoms. But when it does, common ones include:

# pain when chewing or biting, especially when you release the bite

# sensitivity to heat, cold, or sweetness

# pain that comes and goes, but is rarely continuous

# swelling of the gum around the affected tooth in advanced times 

Diagnosing a Cracked Tooth

It can be frustratingly difficult to locate and diagnose a cracked tooth.  This is because cracked teeth may not be visible during a dental exam or show up on an x-ray. Also because proprioception of the tooth isn't found on tooth layers but around it .

By biting down on a small item like a plastic stick or a wood dowel called "tooth sloth" , one tooth at a time also by placing a light directly on the tooth or use dark-colored dye to highlight fracture lines.

Identification of cracked teeth may occur by visual inspection with the unaided eye, although many times diagnostic tests must be used to detect the crack. Removal of restorations and revisualization may be necessary, although most cracks occur in teeth with no or minimal restorations .

Treatment of a Cracked Tooth

Treating a symptomatic cracked tooth as soon as possible improves the chances of saving the tooth. Even if the crack in your tooth is small, it can expand with the pressure of biting and eating, eventually turning from a cracked tooth to a split tooth. If the crack in your tooth becomes large enough, it could become vulnerable to decay. If untreated, tooth decay can spread to the pulp and cause a larger infection, eventually leading to a dead tooth or even tooth loss.

Treatment depends on the size of the crack, where it’s located, your symptoms, and whether the crack extends into the gum line. Depending on those factors, your dentist may recommend one of the following:

Bonding

With dental bonding, the dentist uses a plastic resin to fill the crack, restoring its look and function.

Crown

A dental crown is a prosthetic device usually made of porcelain or ceramic. It fits over the damaged tooth or caps it.

With advances in technology, some dentists can mill a porcelain crown right in the office and place it that day With proper care, a crown can last a lifetime.

Root canal therapy

When a crack is so extensive it extends into the pulp, your dentist, or a specialist such as an oral surgeon or endodontist, will recommend a root canal to remove damaged pulp and restore some integrity to the tooth. This procedure can prevent the tooth from becoming infected or weakening further.

Extraction

When the structure of the tooth, and the nerves and roots that lie below it, are very damaged, removing the tooth maybe your only option.

No treatment

Many people have tiny, hairline cracks in the enamel of their teeth. If these cracks don’t affect appearance and don’t produce pain, you may advise leaving them alone.

How the dentist repairs cracked tooth depends on the location and type of crack. Some don’t need repair, some might require filling the crack or place a crown over the tooth to protect it from further damage.

If a tooth splits, the dentist will need to remove part of the tooth and repair it with bonding, an onlay or a crown. If the split is severe, the tooth will need to be extracted.

Since there is a range of severity for cracked teeth, the best thing to do is call your dentist right away if you feel pain or suspect a cracked tooth. And of course, maintaining your healthy smile with twice annual oral exams can help your dentist diagnose a problematic crack before it becomes unmanageable.

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