Cracked Tooth

The problem of a cracked tooth; the types, causes, symptoms and treatment. Advice is also given on how to reduce the chances of such a problem from developing in the first place.

What is a Cracked Tooth?

The problem of cracks in teeth and resultant pain is one that is becoming increasingly common. Cracks can form in a variety of ways and there are several possible causes. The problem may be obvious, for example when a piece breaks off, leaving a hole in the tooth. Alternatively it may be very hard to spot, as when a break forms but the tooth remains intact (like a line running down a pane of glass).

Some teeth will have fracture lines that are very difficult to find, and may lead to symptoms of cracked tooth syndrome's.

Teeth can develop different types of cracks:

Broken cusp: Where the pointy corner (or cusp) of a molar or premolar breaks away. A filling or crown will be needed.

Crazing:  Here the outer enamel surface has very shallow crack(s), often called craze lines. These type are very common and often visible on front teeth (incisors and canines). They do not usually require treatment.

Cracked tooth: This implies that the crack runs from the top downwards towards the root. It can run in different directions. For example, a crack can run towards the gum or straight down the middle. Although fractured, the tooth is still holds together (until the fracture spreads further). It is this type that can cause the most tooth pain and difficulty in diagnosis (it won't show up on dental X-rays, for example).

If untreated the fracture line may grow until you have a split tooth, where the two parts separate from each other. Tooth extraction is usually the only option with such a split- it is beyond fixing.

Contributing Causes

There are many different factors that can lead to this dental problem. The causes are generally due to weakening of teeth structure and/or excessive forces placed upon them. Common causes include:
 

• Prior weakening due to a cavity or a filling.
• Teeth that have been undermined after root canal treatment, in particular molars.
• Severe grinding and clenching. This can generate very large forces that can fracture even sound strong teeth!
• Problems with one's bite, for example having one out of line can put more pressure on this tooth.
• Biting down on something very hard, e.g. ice, toffees, nuts, meat bones etc. Likewise, using your teeth for opening a bottle can result in a chipped tooth. Avoid doing so!
• Trauma to the mouth. Direct trauma can lead to a broken tooth. Severe trauma can cause cracks indirectly; from sudden, severe closure of the teeth together.
• Periodontal disease. Here the bony support that usually protects and holds teeth may be stripped away. The teeth are more likely to fracture under the gum with this disease.
• Sudden changes in temperature inside the mouth.

Note that developing this dental problem at some stage in your life means you are statistically more likely to have a similar problem in the future.