When we talk about the "cracked tooth craze," we're not referring to a fad; we're referring to a type of crack. (The image to the right shows a craze.)

You may have cracked a tooth because of an accident or injury, uneven biting or chewing, or stress. Also, over time you may have worn down or lost some of the tooth structure because of grinding and clenching your teeth, getting large fillings or other restorations, or having root canal treatment. Depending on the severity of damage to your cracked tooth, different treatments may be required.

Types of cracks

At first a crack may be small and unobtrusive. But if it is left untreated, the crack may progress further across the tooth or deeper into the tooth. For example:

• A craze is a surface crack that shows as a line on the tooth enamel. Although it may not look very attractive, a craze usually does not need treatment.
• A fracture is a crack, usually through the pointed part of the tooth (cusp) that causes part of the tooth to grow weaker and even break off. A fractured cusp usually can be restored with a crown or an onlay.
• A vertical crack is one that extends from the chewing surface down the tooth. We may be able to restore your tooth with bonding or a veneer. However, if the crack extends as far as the root and damages the pulp, root canal treatment may be needed. We may then be able to protect the remaining tooth with a crown. But if the crack extends too far, we may need to remove the tooth. That's why it's critical that we investigate these cracks to stop them from extending deeper.
• A split is a vertical crack that extends so deeply into the tooth that it can separate into pieces. Depending on the location and severity of the split, we may be able to save the tooth, or we may need to remove it.
• A root fracture is a crack that begins in the root of the tooth and slowly extends upward. This type of crack may not be noticed until the surrounding gum and bone show signs of infection. In this situation, we may need to remove the tooth.

Sometimes our instruments and tests do not reveal that a tooth is definitely cracked, even though symptoms indicate that a crack exists. For example, tooth sensitivity or pain may be intermittent. This condition typically is called cracked tooth syndrome, and it often occurs when a fracture is incomplete, especially in molars. Cracked tooth syndrome is most common among adults between the ages of 30 and 50.

A cracked tooth will not heal on its own. Therefore, the sooner we can identify, treat, and monitor the crack, the more likely we may be able to save the tooth.

Symptoms of a cracked tooth

Symptoms of a cracked tooth may include:

• Pain when you bite down
• Sensitivity to hot or cold foods and beverages
• Discomfort when the tooth is exposed to air
• Toothache for no apparent reason

Sometimes there are no symptoms at all, only visual evidence of a crack. Other times a crack may be more difficult to identify, even with examinations or x-rays.

Also, sometimes the pain or sensitivity may be intermittent (a sign of cracked tooth syndrome). If you are experiencing any of these symptoms, even if they are sporadic, be sure to let us know.

Prevention

To avoid cracking a tooth:

• Do not chew on hard items (ice, unpopped popcorn kernels, pens, pipes, etc.).
• Do not clench or grind your teeth.
• Use a bite splint or nightguard to help alleviate bruxism (clenching and grinding your teeth).
• Use a mouthguard to protect your mouth when participating in sports.

By following these prevention tips and having regular checkups to monitor any emerging cracks, together we can help to preserve your healthy teeth.