Cracked Teeth - With more sophisticated procedures, dentists are helping people keep their teeth longer. Because people are living longer and more stressful lives, they are exposing their teeth to many more years of crack-inducing habits, such as clenching, grinding, and chewing on hard objects. These habits make our teeth more susceptible to cracks.
Cracked teeth show a variety of symptoms, including erratic pain when chewing, possibly with release of biting pressure, or pain when your tooth is exposed to temperature extremes. In many cases, the pain may come and go, and dentists may have difficulty locating which tooth is causing the discomfort.
Why have I been referred to an endodontist?
All dentists are trained in the diagnosis and treatment of cracked teeth in dental school. Some cracked teeth, however, can be especially difficult to diagnose, and treatment may involve root canal treatment. That is why you have been referred to an endodontist.
Endodontists are dentists with at least two additional years of training that include the diagnosis and treatment of unusual dental pain. Cracked tooth pain often comes from damage to the inner soft tissue of the tooth, the pulp. Root canal treatment can relieve that pain.
Early diagnosis is extremely important. Like cracks in a windshield, cracks in teeth often start small and progress over time. The sooner a crack is detected and treated, the better the chance of saving your tooth. An endodontist's special training can be valuable when a crack tooth is suspected.
Why does a cracked tooth hurt?
When the outer hard tissues of the tooth is cracked, chewing can cause movement of the pieces, and the underlying pulp (inner soft tissue of the tooth including nerves) can become irritated. When biting pressure is released, the crack can close quickly, resulting in a momentary, sharp pain. Irritation of the dental pulp can be repeated many times by chewing. Eventually, the pulp will become damaged to the point that it can no longer heal. The tooth will not only hurt when chewing but may also become sensitive to temperature. In time, a cracked tooth may begin to hurt all by itself. Extensive cracks can lead to infection of the pulp tissue, which can then spread to the surrounding bone and gums.
Types of cracks - There are many different types of cracked teeth. The treatment and prognosis for your tooth depends on the type, location, and severity of the crack.
Craze lines are tiny superficial cracks that affect only the outer enamel of the tooth. These cracks are extremely common, cause no pain, and usually require no treatment.
When a cusp (the pointed part of the chewing surface) becomes weakened a fracture may result. The weakened cusp may break off by itself or may have to be removed by the dentist. When this happens, the pain will usually be relieved. A fractured cusp rarely damages the pulp, so root canal treatment is often not required. The tooth will usually be restored by your dentist with a crown.
This type of crack extends from the chewing surface of the tooth vertically towards the root. The crack may extend below the gumline and possibly even into the root. Because of the position of the crack, damage to the pulp is common. Root canal treatment is frequently needed to treat the injured pulp. Your dentist will then restore the tooth with a crown to bind and protect the cracked tooth.
Early diagnosis and treatment is extremely important. A cracked tooth that is goes untreated will progressively worsen and may eventually result in the loss of the tooth.
A split tooth is often the result of the long term progression of a cracked tooth. The crack has split the tooth into distinct segments that can be separated. A split tooth can never be saved intact. The position and extent of the crack, however, will determine whether any portion of the tooth can be saved. Occasionally, root canal treatment and a crown or other restoration may still be able to save a portion of the tooth.
Vertical root fracture
Vertical root fractures are cracks that begin in the root of the tooth and extend toward the chewing surface. The often show minimal signs and symptoms and may go unnoticed for some time. Vertical root fractures are often discovered when the surrounding bone and gum become infected. Treatment usually involves extraction of the tooth, however, occasionally endodontic surgery may save a portion of the tooth by removing the fractured root.
Will my tooth completely heal?
Unlike a broken bone, the fracture in a cracked tooth will never heal. In spite of treatment, some cracks may continue to progress and separate, resulting in loss of the tooth. Placement of a crown provides maximum protection but does not guarantee success in all cases.
The treatment you receive for your cracked tooth will relieve pain and reduce the likelihood that the crack will worsen. Once treated, most cracked teeth continue to function and provide years of comfortable chewing.