Cracked Tooth
Cracked and fractured teeth are common dental problems. As people retain their natural teeth longer (due to advances in dental technology), the likelihood of cracked teeth increases. There are many reasons why teeth may crack, for example, biting on hard objects, trauma, grinding and clenching of teeth. All of these behaviors place the teeth under extra strain and render them more susceptible to cracking.
When tooth enamel is cracked, pain can become momentarily debilitating. In the absence of pressure on the crack, there may be no discomfort. However, as the cracked tooth performs a biting action, the crack widens. The pulp and inner workings of the tooth then become exposed, and painful irritation occurs. As pressure is released again, the two parts of the crack join back together, and pain subsides. If left untreated, the pulp becomes irreversibly damaged and constantly painful. The resulting pulp infection can affect the bone and soft tissue surrounding the tooth.
Symptoms of a cracked tooth may include:
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Unexplained pain when eating.
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Sensitivity to warm and cold foods.
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Pain with no obvious cause.
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Difficulty pinpointing the location of the pain.
What kind of cracks can affect the teeth?
There are many ways in which a tooth can be cracked. The specific type of crack will determine what type of treatment is viable. In cases where the crack is not too deep, root canal therapy and a crown can be performed, and the natural tooth can remain in the mouth. In other situations, the tooth is too badly damaged and requires extraction.
Here is a brief overview of some of the most common types of cracks:
Craze Lines – These are generally tiny vertical cracks that do not place the teeth in danger. These scratches on the surface of the teeth are considered by most dentists to be a normal part of the tooth anatomy. A craze line rarely requires treatment for health reasons, but a wide variety of cosmetic treatments can be performed to reduce the negative aesthetic impact.
Supragingival cracks – These cracks only affect the crown of the tooth and do not extend below the gum line. Usually, the affected part of the tooth will eventually break off. Little pain will result, because the tooth pulp (that contains the nerves and vessels) will remain unaffected. Oftentimes a restoration such as a composite filling or a crown is indicated.
Subgingival cracks – These cracks extend beyond the gum line and often beyond where the jawbone begins. When a piece breaks off, it will usually remain attached until the dentist removes it. Oblique subgingival cracks are painful and may require a combination of periodontal surgery (crown lengthening surgery to expose the tooth more) and endodontic treatment followed by a crown.
Root cracks – These cracks tend not to affect the visible surface of the tooth at all. In fact, the damage is only apparent below the gum line and usually below the jawbone. Root canal therapy may be possible, depending on how close the fracture is to the tooth surface. However, extraction is almost always the only option after sustaining this severe type of fracture.
Vertical root fractures– These cracks start at the apex (tip of the root). Root canal therapy alleviates the discomfort for a while, but most often, teeth affected by such catastrophic fractures are eventually extracted.
How are cracks in the teeth treated?
There are many different types of cracked teeth. Some can only be diagnosed using X-ray machines and CBCT scans, while others are clearly visible to the naked eye. In cases where the tooth root is affected, root canal therapy is the most viable treatment option. The pulp, nerves, and vessels of the tooth will be removed, and the resulting space will be filled with gutta-percha. A crown or filling will be added to stabilize the tooth, and it will continue to function as normal.
When the crack is too severe for the tooth to be saved, the dentist will perform an extraction. There are a number of restorative options in this case, such as bridges, dental implants and partial dentures. All of these structures can restore biting, chewing, and speaking functions.
If you have any questions or concerns about cracked teeth, please contact our office.
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