Cracked Teeth

Cracked Teeth

Cracked teeth are one of the most challenging problems in dentistry to diagnose and treat. The crack may be invisible on a standard X-ray. Symptoms can come and go, jump from one tooth to another, and disappear entirely between visits. The right treatment depends entirely on where the crack is, how deep it goes, and whether it has reached the pulp inside the tooth. Getting that diagnosis right is the difference between saving the tooth and losing it.

Cracks rarely appear out of nowhere. They develop over time from habits and stresses most people don't think about: clenching or grinding, chewing ice or hard candy, biting down on an unexpected piece of bone or popcorn kernel, or simply years of wear on a tooth that has already had a large filling. Trauma from a fall or a sports injury can also cause a crack instantly. The signs are usually inconsistent: a sharp pain when biting that vanishes when you release pressure, lingering sensitivity to hot or cold, or vague discomfort that's hard to pinpoint to a specific tooth. If a tooth feels "off" but won't behave the same way twice, a crack is often the reason.

Endodontists categorize cracked teeth into five distinct types, and the treatment changes for each one. Craze lines are tiny surface cracks in the enamel that are extremely common in adult teeth and almost always require no treatment. Fractured cusps occur when a piece of the chewing surface breaks off, usually around an existing filling, and can typically be repaired with a new crown. A cracked tooth describes a vertical crack running from the chewing surface toward the root. If caught early, before the crack reaches the pulp, it can often be saved with root canal therapy and a crown. A split tooth is a cracked tooth that has progressed until the tooth has separated into distinct segments, and in most cases the tooth cannot be saved intact, though sometimes a portion can be preserved. A vertical root fracture begins at the root and extends upward, often discovered only when the surrounding bone and gum become infected, and these typically require extraction.