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 your dentist may have difficulty locating which tooth is causing the discomfort.
To understand why a cracked tooth hurts, it helps to know something about the anatomy of the tooth. Inside the tooth, under the white enamel and a hard layer called the dentin, is the inner soft tissue called the pulp. The pulp contains the tooth’s nerves and blood vessels.
When the outer hard tissues of the tooth are cracked, chewing can cause movement of the pieces, and the pulp can become irritated. Eventually, the pulp will become damaged to the point that it can no longer heal itself. The tooth will not only hurt when chewing but may also become sensitive to temperature extremes. In time, a cracked tooth may begin to hurt all by itself. Extensive cracks can lead to infection of the pulp tissue, which can spread to the bone and gum surrounding the tooth.
Chipped teeth account for the majority of dental injuries. Most chipped teeth can be repaired either by reattaching the broken piece of tooth enamel or by bonding a tooth-colored filling or crown in place. See your dentist as soon as possible after the injury to treat your chipped tooth and keep it from worsening.
There are many different types of cracked teeth. The treatment and outcome for your tooth depends on the type, location and extent of the crack.
Craze lines are tiny cracks that affect only the outer enamel. These cracks are extremely common in adult teeth. Craze lines are very shallow, cause no pain, and are of no concern beyond appearances.
When a piece of a tooth’s chewing surface breaks off, often around a filling, it’s called a fractured cusp. A fractured cusp rarely damages the pulp, and usually doesn’t cause much pain. Your dentist can place a new filling or crown over the damaged tooth to protect it.
If you’ve cracked a tooth and breathing through your mouth or drinking cold fluids is painful, bite on clean, moist gauze or cloth to help relieve symptoms until reaching your dentist’s office. Never use topical oral pain medications (such as Anbesol®) or ointments, or place aspirin on the affected areas to eliminate pain symptoms.
A cracked tooth means a crack extends from the chewing surface of your tooth vertically toward the root. The tooth is not yet separated into pieces, though the crack may gradually spread. Early diagnosis is important in order to save the tooth. If the crack has extended into the pulp, the tooth can be treated with a root canal procedure and a crown to protect the crack from spreading.
However, if the crack extends below the gum line, it is no longer treatable, and the tooth cannot be saved and will need to be extracted. That’s why early treatment is so important. A cracked tooth that is not treated will progressively worsen, eventually resulting in the loss of the tooth. Early diagnosis and treatment are essential in saving these teeth.
A split tooth is often the result of the long term progression of a cracked tooth. The split tooth is identified by a crack with distinct segments that can be separated. A split tooth cannot be saved intact. The position and extent of the crack, however, will determine whether any portion of the tooth can be saved. In some cases, endodontic treatment may be performed 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. They often show minimal signs and symptoms and may therefore go unnoticed for some time. Vertical root fractures are often discovered when the surrounding bone and gum become infected. Treatment may involve extraction of the tooth. However, endodontic surgery is sometimes appropriate if a tooth can be saved by removal of the fractured portion.