Introduction
Teeth are fracturing today in record numbers and are now reputed to be the third leading cause of tooth loss. This increase is due to several factors including longer life spans (older, brittle adult teeth tend to crack more) and higher stress levels that may lead to increased teeth clenching and grinding. Additionally, teeth can crack due to consistent exposure to temperature changes, trauma, or habits like grinding. Grinding your teeth at night (bruxism) can lead to teeth cracking and fractures, making it important to address this habit early. Using a night guard can help protect your teeth from the damage caused by grinding your teeth at night.
Early diagnosis is critical — if your dentist can detect a crack while it’s small, treatment can usually save a tooth. Untreated cracked teeth, however, can lead to tooth decay, infection, and potentially require tooth extraction.
What Is Cracked Tooth Syndrome?
Yes, Cracked Tooth Syndrome is a real problem that’s often quite difficult to diagnose. The term “syndrome” refers to the association of several clinical signs (discovered by the dentist) and symptoms (reported by the patient), which often occur together. Because the signs and symptoms vary in cracked tooth syndrome, diagnosis, actually pinpointing the problem tooth (or teeth), can be difficult. Cracked tooth syndrome can also cause sensitivity and self-consciousness if it affects front teeth. Dentists attach thin layers called dental veneers to the front surface of a tooth to enhance its appearance after damage.
Stages & Types of Crack Development
It presents itself in many phases: craze lines, cracks, fractures, fractured cusp, and sometimes vertical splits. A cracked tooth starts at the top of the tooth and extends down but not below the gumline. A fractured cusp is a break or chip on the chewing surface, often seen in molars, and may cause sensitivity. The chewing surface is important for bite force, and fractures often occur there.
Craze lines are mini cracks in just the outer surface of the tooth (enamel). These are common in adult teeth and are harmless, as they only affect the outer enamel. Although not an immediate danger to the tooth, craze lines can lead to true cracks in the enamel that actually penetrate into the dentin layer (the body of the tooth). This in turn can lead to a very serious condition called a fracture/split where the crack may extend deep into the root of the tooth. Remediation options depend on the severity and type of the crack.
It goes without saying that the deeper the crack extends, the worse the symptoms. A fracture that exposes the nerve of the tooth is the most serious condition; dentists must assess and treat it as soon as possible to have any chance of saving the tooth. Severe damage may require advanced treatments, and treatment depends on the extent of the crack. After treatment, a crack in a tooth will not heal completely but most cracked teeth can function normally for many years.
A vertical split in a tooth is not salvageable.
Why Diagnosis Is Challenging
Cracks or impending fractures in teeth are usually too small to be seen on x-rays, so dentists must use other methods. Vertical root fracture can be difficult to detect and may be associated with vertical bone loss near the root.
Sometimes crack detection requires high magnification instruments. Most endodontists (root canal specialists) use microscopes as a routine part of their practice and are very good at detecting cracks and fractures. Endodontists assess whether a crack has reached the nerve inside a tooth and determine if root canal treatment is needed to relieve pain and symptoms. Dentists perform root canals when a crack extends into the tooth pulp, removing the damaged tissue. If the tooth is infected, they must eliminate the infection before placing a crown..
Symptoms will vary depending on the location of the crack in a tooth and what other structures are involved. If a crack involves the outside of the tooth (periodontal structures, gums, periodontal ligament and bone) a different set of symptoms will occur than if a crack involves the inside of the tooth (the pulp chamber containing the nerve). Vertical root fracture or vertical root fractures can cause vague symptoms and may require special imaging or dyes for detection.
A sharp, intense pain of short duration during chewing and upon release of food usually indicates a crack in a “vital” tooth, in which the nerve has not been affected. If a crack reaches the nerve it will become an avenue for infection. The pulp tissue housing the nerve then becomes inflamed and sensitive to temperature changes.
Importance of Early Detection
The earlier a crack is detected and the more superficial it is, the simpler it will be to repair.
Cracks in teeth without a living nerve give vague symptoms and the origin of the pain is often difficult to locate until the tissues around the teeth are affected. If a crack involves the periodontal structures (the gum, periodontal ligament and bone), symptoms may include tenderness around the tooth, easily identifying what tooth is hurting.
When a crack increases and becomes a true fracture, the symptoms intensify. If located in the crown of the tooth, a piece of the tooth may cleave off and be quite sensitive to temperature change and sweet foods. If the crack is located in the root, the patient will experience pain of increasing intensity and feel it particularly if infection sets in.
Detecting a crack early—while it’s still superficial—makes it much simpler for dentists to repair. Treatment is always based on a proper diagnosis. It could be as simple as replacing the lost tooth structure with a simple filling, or covering the crack or fracture with appropriate restorative materials. Dental bonding involves filling a small crack with a tooth-colored resin to restore its shape. If the nerve is involved, dentists may need to perform root canal treatment and protect the tooth with a dental crown (ceramic cap). A ceramic cap is a type of dental crown used to cover and protect a damaged tooth. Crowns permanently cover damaged teeth, protecting them from further damage. The discomfort of a root canal is often similar to a simple filling. Another suggestion your dentist may have, is that you consider wearing an occlusal (bite) guard or night guard to protect your teeth from clenching and/or grinding (bruxism) which may very well be occurring subconsciously. At worst, if the tooth is not salvageable it will mean tooth extraction and replacement.
This is an overview of a complex problem. Please talk to us and come and see your dentist as soon as possible. It may mean saving a tooth. Wearing a mouthguard during contact sports can protect your teeth from injury. Additionally, avoiding hard foods can reduce the risk of cracking your teeth. You should avoid chewing on the affected side and avoid chewing hard objects like ice or fingernails to prevent further break or damage.
Pain relief can be achieved with over-the-counter medications such as paracetamol or ibuprofen as a temporary measure until you see your dentist.
Treating cracked teeth involves a range of treatment options and treatment recommendations, depending on the type and severity of the tooth fracture. Your dentist will treat the tooth based on the specific condition, and treatments may include fillings, crowns, root canals, or tooth extraction if the tooth cannot be saved.
Most cracked teeth can function for years after treatment, but cracks do not heal completely. Preventing teeth cracking is important—do not grind your teeth, and use a night guard if necessary.
Introduction to Cracked Tooth Syndrome
Cracked tooth syndrome is a dental condition that occurs when a tooth develops a small crack that may not be immediately visible but can cause significant discomfort. This syndrome often results from biting into hard food, grinding your teeth, or experiencing trauma to the mouth. People with cracked tooth syndrome may notice pain or sensitivity when biting or chewing, especially if the crack worsens over time. If left untreated, a cracked tooth can lead to more serious dental issues, such as tooth decay, infection, or even tooth loss. Because the symptoms can be subtle at first, it’s important to see a dentist as soon as possible if you experience any pain or discomfort in your teeth. Early treatment can prevent the crack from spreading and help preserve your oral health.
Types of Tooth Damage
Tooth damage can present in several forms, each requiring a different treatment option. Chipped teeth are the most minor, usually involving a small piece of the tooth breaking off and leaving a rough edge. While a chipped tooth may not always cause pain, it can still affect the appearance and function of your teeth. Cracked teeth are more serious, with a crack that extends from the biting surface down toward the root. This type of damage can cause pain when biting and may require more extensive treatment. The most severe form is a split tooth, where a deep crack causes the tooth to separate into distinct segments. In these cases, the crack extends through the tooth, often making it impossible to save the affected tooth. Understanding whether you have a chipped tooth, cracked tooth, or split tooth is essential for determining the best treatment option and restoring your dental health.
Causes of Tooth Fractures
There are several common causes of tooth fractures that can compromise your oral health. Biting into hard food, such as ice, hard candy, or unpopped popcorn kernels, can put excessive pressure on your teeth and lead to cracks. Grinding your teeth, especially at night, is another major factor that can wear down tooth enamel and cause tiny cracks to form. Trauma to the mouth, such as a fall or sports injury, can also result in fractured teeth. Other contributing factors include large fillings that weaken the tooth structure, gum recession that exposes the root, and habits like chewing on hard objects (pens, fingernails). Being mindful of these risks and taking steps to prevent accidents—such as wearing a mouthguard during contact sports and avoiding hard foods—can help protect your teeth from cracking and maintain your oral health.
Symptoms of a Broken Tooth
The symptoms of a broken tooth can vary depending on the extent and location of the crack. Many people experience sharp pain when biting or chewing, especially if the crack extends toward the gum line. Sensitivity to hot, cold, or sweet foods is also common, as is discomfort when releasing biting pressure. Sometimes, a broken tooth may have rough edges that irritate the tongue or cheek. If the crack extends below the gum line, it can cause severe pain and increase the risk of infection in the surrounding gum tissue. In some cases, the pain may come and go, making it difficult to pinpoint the affected tooth. If you notice any of these symptoms, it’s important to seek dental care immediately to prevent further damage and avoid complications.
Diagnosing Tooth Problems
Diagnosing tooth problems like cracks and fractures requires a careful dental examination. Your dentist will look for visible signs of damage, such as wear on the tooth enamel, cracks, or changes in the tooth’s appearance. Specialized tools, including magnifying glasses and dental x-rays, may be used to detect tiny cracks that aren’t visible to the naked eye. In some cases, your dentist might apply a cold compress or use a topical anesthetic to make the examination more comfortable, especially if the tooth is sensitive. Early diagnosis is crucial, as it allows for prompt treatment and can prevent the crack from worsening. If you suspect you have a cracked or damaged tooth, don’t wait—schedule a visit with your dentist as soon as possible to protect your oral health.