A cracked tooth is a common dental issue ranging from a cosmetic imperfection to a significant structural failure, often causing discomfort or sensitivity. A fracture compromises the tooth’s integrity, allowing external stimuli to affect the sensitive inner layers. Addressing this damage is necessary to relieve symptoms and prevent further deterioration. Treatment depends entirely on the location and depth of the fracture. This article explores the restorative options, from simple surface repairs to extensive surgical procedures.
Categorizing Tooth Fractures
Understanding the specific type of fracture is the first step in determining if a tooth can be sealed or requires a more comprehensive approach. Dental professionals classify these injuries into five main categories based on severity and extent.
The most minor classification involves craze lines, which are extremely small, thin cracks confined solely to the outer enamel layer and usually cause no pain. A fractured cusp occurs when a piece of the chewing surface breaks off, often near an existing filling. A true cracked tooth is a vertical fracture starting on the chewing surface and extending toward the root.
More severe are split teeth, where the crack separates the tooth into two distinct segments. The most challenging type is the vertical root fracture, which starts below the gum line in the root and progresses upward, often remaining asymptomatic until the pulp becomes infected.
Simple sealing is generally limited to the least severe fractures, such as craze lines or superficial enamel-dentin fractures. Once a crack extends deeper, involving the inner dentin or the pulp, treatment shifts to a more involved restorative or endodontic procedure.
Restoring Minor Cracks with Bonding and Sealants
For minor, superficial damage that does not penetrate deep into the tooth, a crack can often be sealed using dental bonding or sealants. These conservative treatments are appropriate for craze lines or small chips confined to the outer enamel that do not expose the sensitive pulp tissue. The goal is to prevent the crack from spreading and eliminate sensitivity caused by exposed dentin.
Dental bonding involves applying a tooth-colored composite resin directly onto the prepared tooth surface. The dentist may slightly roughen the area with a mild acid solution to help the material adhere effectively. The composite resin is then shaped to fill the fracture and restore the tooth’s natural contour. A specialized light is used to rapidly harden, or cure, the material, creating a durable bond.
This method is quick, often completed in a single appointment, and requires minimal removal of the original tooth structure. The finished restoration is trimmed and polished to blend seamlessly. Dental sealants are a similar application, sometimes used to coat the chewing surfaces of molars, effectively covering and protecting a shallow crack from bacteria and mechanical stress.
Comprehensive Repair for Deeper Fractures
When a fracture progresses through the dentin and compromises the tooth’s structural integrity, simple bonding is no longer sufficient, and comprehensive treatments are required. A full coverage crown is a common solution when the crack threatens the entire tooth. The crown acts like a cap, holding the remaining structure together. The tooth is first reshaped, and then a custom-made crown, often porcelain or ceramic, is cemented over the natural tooth to stabilize it and restore function.
If the crack involves the dental pulp—the inner core containing nerves and blood vessels—bacteria can enter, causing inflammation and infection. Root canal therapy is performed in this situation to remove the infected pulp tissue. After cleaning and disinfection, the space is sealed with a rubber-like material, and the tooth is typically protected with a crown to prevent re-fracture.
Extraction is the final option for the most severe fractures, such as a split tooth or a vertical root fracture extending far below the gum line. These deep fractures are often impossible to repair because the damage prevents a stable, long-term restoration. Removing the tooth eliminates the source of pain and infection, allowing replacement with a bridge or a dental implant.
Recognizing Signs of a Cracked Tooth
Awareness of common symptoms is important because early intervention significantly increases the chances of saving the tooth. One telling sign of a cracked tooth is intermittent pain that occurs specifically when chewing. This pain is often felt sharply when biting down or, more distinctly, when the biting pressure is released.
Sensitivity to extreme temperatures, such as hot coffee or cold air, frequently indicates that a fracture has exposed the underlying dentin or pulp. Unlike the constant throbbing associated with a cavity, the discomfort from a crack often comes and goes, making it difficult to pinpoint the exact tooth involved. Localized gum swelling or tenderness may also signal a crack extending toward the root, potentially leading to infection. A prompt dental consultation is necessary if any of these symptoms are noticed.