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Cracked Teeth

How do I know if my tooth is cracked?

Cracked teeth exhibit a variety of symptoms. If your tooth is cracked, you might feel occasional sharp, jolting, 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 are difficult to diagnose because the pain comes and goes, and cracks rarely show up on x-rays. Because of this, you may see your dentist several times before the crack is diagnosed.

Why does my cracked tooth hurt?
A crack in a tooth usually affects the soft inner tissue of the tooth called the pulp. The pulp contains blood vessels and nerves. When it is damaged, it causes pain. That is why a cracked tooth hurts-the pulp is damaged. To relieve the pain and save your tooth, the pulp needs to be gently treated.

Why have I been referred to an endodontist?
Endodontists are dental specialists who diagnose and treat oral and facial pain. They specialize in root canal (endodontic) treatment, including any treatment for the inner soft tissues of the tooth. During dental school, all dentists are educated in treating the dental pulp. In addition to dental school, endodontists receive two or more years of advanced education in this kind of treatment. They study root canal techniques and procedures in greater depth, including the treatment of cracked teeth. For this reason, many dentists choose to refer their patients with cracked teeth to endodontists.

Why does my cracked tooth need to be treated? As mentioned earlier, cracks in teeth often affect the inner tissue of the tooth, the pulp. The pulp contains blood vessels, nerves and connective tissue. When a tooth is cracked, chewing can cause movement of the separate pieces of the tooth. This movement irritates the pulp and often causes pain. The tooth may also become sensitive to temperature extremes. In time, the pulp may become so irritated that your tooth may hurt by itself, even when you are not chewing, or eating or drinking something hot or cold. When the pulp becomes irritated, it needs to be treated in order to save the tooth.

How will my cracked tooth be treated?
The treatment of your cracked tooth depends on the type and severity of the crack. There are five common types of cracks.

Craze lines 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 need no treatment.

The second type of crack involves the cusp. The cusp is the pointed part of the chewing surface of your tooth. If a cusp becomes weakened, a fracture can result. Part of the cusp may break off or may need to be removed by your dentist. But this type of crack, a fractured cusp, rarely affects the pulp. Because the pulp is not affected, it is very unlikely that you would need root canal treatment. Your tooth can usually be restored by your dentist with a crown or other restoration.

If your crack is diagnosed as a cracked tooth, then the crack probably extends from the chewing surface of the tooth vertically towards the root. Sometimes it extends below the gum line and into the root. A cracked tooth is not separated into two distinct segments, but the soft inner tissue of the tooth is usually damaged anyway. If this happens, you will probably need root canal treatment to remove the damaged tissues and save the tooth. It is particularly important to diagnose this type of crack early. In its earlier stages, a cracked tooth can still be saved.

If you have a split tooth, on the other hand, it can never be saved intact. A split tooth is often the result of an untreated cracked tooth that splits into two distinct segments. With endodontic (root canal) treatment, however, a portion of the tooth can sometimes be saved.

Vertical root fractures are cracks that begin in the root and extend toward the chewing surface. They show very few signs and symptoms and therefore may go unnoticed for some time. You may discover that you have a vertical root fracture when the bone and gum surrounding the root become inflamed and infected. Treatment usually involves extraction of the tooth, but sometimes endodontic surgery can save a portion of the tooth.

After treatment for a cracked tooth, will my tooth completely heal?
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.

Despite the possibility for the tooth to worsen, the treatment you receive is important. It will relieve your pain and reduce the chances that the crack will worsen. Most cracked teeth continue to function for years after treatment. Your dentist or endodontist will be able to tell you more about your particular diagnosis and treatment recommendations.

What can I do to prevent my teeth from cracking?
While cracked teeth are not completely preventable, you can take some steps to make your teeth less susceptible to cracks.
  • Don't chew on hard objects such as ice, unpopped popcorn kernels or pens.
  • Don't clench or grind your teeth.
  • If you clench or grind your teeth while you sleep, talk to your dentist about getting a splint or nightguard to protect your teeth.

Wear a mouthguard or a mask when playing contact sports. And if you experience symptoms of a cracked tooth, see your dentist immediately. If detected early, a cracked tooth can often be saved.