What kinds of cracks are there, and how is each treated?
The American Association of Endodontists (endodontists are dentists trained in root canal treatment) describes five kinds:
- Craze lines. Hairline marks in the enamel, common on adult front teeth. They need no treatment; if they bother you, polishing, bonding (tooth-colored resin built onto the tooth) or a veneer (a thin ceramic facing bonded to the front of the tooth) can hide them.
- Fractured cusp. A cusp (one of the raised points on the chewing surface) of a back tooth breaks, often around a large filling. The crack may reach the dentin (the softer layer under the enamel) but usually spares the pulp. An onlay (a lab-made partial crown) or a crown (a cap that covers the whole tooth) holds the tooth together so the crack is less likely to spread; see crowns.
- Cracked tooth. A crack runs from the chewing surface toward the root, and the pulp may become irritated or infected. Above the gumline, root canal treatment (cleaning and sealing the space inside the tooth) and a crown can often save the tooth; see root canals. Below the gumline, the tooth often has to come out.
- Split tooth. A cracked tooth left too long, now in two parts that move separately. It rarely survives; removal and a replacement, such as an implant (an artificial root placed in the jaw) or a bridge (a fixed replacement anchored to the neighboring teeth), is the usual path.
- Vertical root fracture. A crack that starts in the root, most often after root canal treatment, and is often found only when the bone around it becomes infected. Removal is usual; in a tooth with several roots, removing only the cracked one is occasionally possible.
Why do teeth crack?
Cracks come from load: grinding and clenching (bruxism), chewing ice, pits or hard candy, an uneven bite, or a blow to the mouth. Teeth with large fillings or root canal treatment have thinner walls and crack more easily, and age adds up.
What does a cracked tooth feel like?
- A sharp pain when you bite, especially when you let go.
- Sensitivity to cold, sweet or heat that comes and goes.
- Pain you cannot place on one tooth.
- Later: a darkening tooth, a bad taste, a loose piece, a swollen gum, or a pimple on the gum that drains pus.
Small cracks are invisible to the naked eye. Dr. Tetri looks for them with magnification and strong light, a bite test (biting on a small plastic tool one cusp at a time), a cold test and X-rays, and a CBCT (a three-dimensional dental scan) when it would change the plan.
What should I do until I can see you?
- Chew on the other side and eat soft, room-temperature food.
- Take an over-the-counter pain reliever if you normally tolerate it, following the label.
- Rinse gently with warm salt water after meals.
- Call us. A cracked tooth is usually easier to save this week than next month.
How do I prevent cracks?
Keep ice, pits, nails and pens away from your teeth, and wear a night guard (a thin custom guard worn during sleep) if you grind and a sports guard for contact sports. Ask about a crown for a back tooth with a very large filling or a root canal treatment. Keep your check-ups at the interval we set for you, often every six months and more often after gum disease, so a crack is caught while it is still a line.
When to call us
Call 786-320-5445 the same day if a tooth hurts when you bite or release, aches for a while after cold, feels loose, or has a swollen gum beside it.