Cracked Tooth Syndrome: Symptoms, Diagnosis, and Treatment

Cracked tooth syndrome is a common dental problem that causes acute, sharp pain when biting or chewing, often accompanied by sensitivity to temperature changes. The challenge with cracked teeth is that the crack is not always obvious, either to you or initially to your dentist. Many cracks are microscopic or extend only partway through the tooth, making them difficult to see. However, a cracked tooth should never be ignored because untreated cracks can progress and eventually lead to tooth loss or require emergency treatment.

Understanding the symptoms of a cracked tooth and knowing when to seek treatment can help you address the problem early before it becomes severe.

Types of Tooth Cracks

Tooth cracks exist on a spectrum from minor to severe. A craze line is a small, superficial crack in the outer enamel layer of the tooth. Craze lines do not cause pain and rarely require treatment beyond monitoring. They are common and not a cause for concern.

A fractured cusp is a crack that affects one of the cusps (points) of a back tooth. The fractured cusp may cause pain when biting, but the crack does not usually extend into the pulp (nerve) of the tooth. These cracks are usually treatable with a crown or filling.

A cracked tooth is a split that extends vertically from the biting surface into the root. A cracked tooth may or may not involve the pulp. If caught early, before the crack reaches the nerve, it may be treatable with a crown. If the crack reaches the nerve or extends below the gum line, the tooth may be unrepairable and require extraction.

A split tooth is a vertical crack that completely divides the tooth into two pieces. A split tooth usually cannot be saved and will require extraction.

Symptoms and Diagnosis

The most common symptom of a cracked tooth is sharp pain when biting or chewing, especially on hard foods. The pain may be intermittent and occur only when biting in a certain way or on certain foods. Some patients also experience sensitivity to cold or hot foods.

You may notice that pain subsides once you stop applying pressure to the tooth. This is characteristic of cracked tooth syndrome and helps distinguish it from other dental problems like cavities or gum disease.

Some cracked teeth cause no symptoms initially. The crack may be discovered by your dentist during a routine examination, or it may not be discovered until the patient develops symptoms.

Diagnosing a cracked tooth can be challenging. Some cracks are visible on the tooth surface, but many are not. Dr. Bonin uses visual examination, X-rays, and sometimes special tests to identify cracks. He may use a device called a tooth slooth (a small instrument that applies pressure to suspect areas) to pinpoint a crack. Biting on a special tool can sometimes reproduce the pain and confirm the location of the crack.

Sometimes a crack is identified during examination but confirmed by a CT scan or specialized imaging. Other times, Dr. Bonin’s clinical suspicion based on your symptoms and the tooth’s appearance guides the diagnosis and treatment plan.

Why Cracks Happen

Cracks can develop for several reasons. Biting on something hard, like a nut shell, ice, or a bone, can cause an immediate crack. Accidents or trauma to the face or mouth can crack a tooth. An old, large filling that weakens the tooth structure can predispose the tooth to cracking.

Teeth that have undergone root canal treatment are more brittle and prone to cracking because they have lost their nerve and blood supply. These teeth should be crowned to protect them from fracture.

Grinding or clenching your teeth puts excessive stress on your teeth and significantly increases the risk of cracking. If you grind your teeth, a night guard can protect your teeth from stress-related cracks.

Temperature changes can also contribute to cracking. Drinking very hot beverages and then eating cold food or drinking cold water can cause a tooth to crack because the enamel and dentin expand and contract at different rates.

Treatment Options

Treatment of a cracked tooth depends on the severity and location of the crack and whether it involves the nerve of the tooth. Dr. Bonin will examine your tooth and discuss your options.

For a fractured cusp or a minor crack that does not extend deep into the tooth, a crown is the most common treatment. The crown covers the tooth and stabilizes the crack, preventing it from spreading further. A crown restores the tooth to full strength and allows you to use it normally.

For a crack that extends close to or into the nerve, root canal treatment followed by a crown is necessary. The root canal removes the infected or damaged nerve tissue, stopping any pain and infection. The crown then protects the tooth and allows it to function normally.

For a split tooth or a crack that extends too far into the root, extraction is necessary. Unfortunately, a tooth that is completely split cannot be reliably restored, no matter how good modern dentistry is. If you choose extraction, you will need to decide about replacement with a dental implant or bridge.

Some patients attempt to save a cracked tooth with just a filling, hoping to avoid the cost of a crown. However, fillings do not stabilize cracks. A filling may temporarily fill the crack, but the crack will continue to spread, and the tooth will likely fracture around the filling. Treating a cracked tooth with a crown is more expensive upfront, but it prevents long-term failure and the need for more expensive treatment down the road.

Prevention and Early Treatment

Preventing cracks is the best approach. Avoid chewing on hard objects like ice, hard candy, nuts in shells, or pens. Be cautious when eating foods with pits or bones. Do not use your teeth to open bottles or tear packages.

If you grind or clench your teeth, ask Dr. Bonin about a night guard. A guard protects your teeth from stress-related cracking while you sleep.

Avoid sudden temperature extremes. Try not to drink very hot beverages and then immediately consume cold foods or drinks.

Maintain good oral hygiene and visit your dentist regularly. Regular check-ups allow Dr. Bonin to identify cracks early, before they cause pain or progress to a point where the tooth cannot be saved.

If you suspect you have a cracked tooth, do not wait to seek treatment. Early treatment with a crown or bonded filling is less expensive and more likely to save the tooth than waiting until the crack becomes severe.

When to Seek Emergency Care

If you have severe, persistent pain from a cracked tooth, or if your tooth breaks or fractures, contact Bonin Dental Care immediately. Do not attempt to treat a broken tooth at home. If a piece of the tooth has broken off, save it if you can and bring it with you to your appointment.

Managing Pain Until You Can See Your Dentist

While you are waiting for an appointment, you can manage discomfort with over-the-counter pain relievers. Avoid chewing on the cracked tooth. Stick to soft foods on the other side of your mouth.

Avoid very cold or very hot foods and beverages, which can trigger sensitivity and pain. Room-temperature or warm foods and drinks are better tolerated.

If pain becomes severe or if you develop swelling or fever, seek emergency dental care immediately.

The Importance of Timely Treatment

The outcome for a cracked tooth depends largely on how quickly you seek treatment. A crack discovered and treated early can usually be managed with a crown, allowing you to keep your tooth. A crack that is ignored and spreads can eventually reach the nerve, requiring a root canal, or extend below the gum line, making the tooth irreparable.

In the worst case, a tooth that is untreated for an extended period may become so compromised that it must be extracted. This means you lose the tooth entirely and face the time and expense of replacing it with an implant or bridge.

Moving Forward

If you think you have a cracked tooth or if you have experienced sharp pain when chewing, contact Bonin Dental Care in Windsor to schedule an appointment with Dr. Bonin. Early diagnosis and treatment offer the best chance of saving your tooth and avoiding more extensive and expensive treatment later. We will evaluate your tooth thoroughly and explain your treatment options so you can make an informed decision about your care.