A toothache that arises specifically when biting down can be a perplexing and uncomfortable experience. This sensation often indicates a cracked tooth, a fracture in the tooth’s hard structure. Cracked teeth are a common dental issue that can compromise the tooth’s integrity. This article provides general information about cracked teeth and their management, but it is not a substitute for professional dental advice.
Why Biting Down Hurts
Pain when biting down on a cracked tooth stems from the biomechanical response of the tooth under pressure. A cracked tooth contains a fracture line within its hard layers of enamel and dentin. When pressure is applied during biting, the two segments of the cracked tooth can flex or separate slightly. This movement irritates the sensitive pulp, the innermost part of the tooth containing nerves and blood vessels, leading to a sharp, often sudden, pain.
The pain is frequently most noticeable when releasing the bite, as the pressure changes rapidly and the crack segments spring back into place. This distinct pain pattern helps differentiate a cracked tooth from other dental issues, which may cause a constant ache.
Other Indicators of a Cracked Tooth
While pain upon biting is a primary symptom, a cracked tooth can manifest through several other indicators. Many individuals experience sensitivity to extreme temperatures, such as hot or cold foods and beverages. This sensitivity occurs because the crack can expose the underlying dentin, which contains microscopic tubules leading to the sensitive pulp. Sweet foods can also trigger discomfort due to similar exposure.
The pain associated with a cracked tooth is often intermittent, meaning it comes and goes rather than being a constant ache. This erratic nature can make it challenging to pinpoint the exact tooth causing the problem. Some individuals might also notice general discomfort around the affected tooth or localized gum swelling, which could indicate irritation or infection if the crack has extended deeper.
What to Do Next
If you suspect you have a cracked tooth, seeking professional dental evaluation promptly is important. An untreated crack can worsen over time, potentially leading to more extensive damage or infection. While waiting for your dental appointment, you can take temporary measures to manage discomfort. Over-the-counter pain relievers, such as NSAIDs, can help reduce pain and swelling.
It is advisable to avoid chewing on the affected side of your mouth and stick to a soft diet to minimize pressure on the tooth. Diagnosing a cracked tooth can be challenging for dentists, as cracks are not always visible to the naked eye or on standard X-rays. Dentists might use various techniques, including:
- Visual inspection with magnification
- Biting on a specific instrument like a “tooth sleuth” to pinpoint pain
- Transillumination (shining a light through the tooth) to reveal the crack line
- Applying dental dyes to make the crack more apparent
Pathways to Repair
The approach to repairing a cracked tooth depends significantly on the type, location, and severity of the fracture. Early treatment is important for preserving the tooth and preventing more severe complications. Minor cracks, often called craze lines, affecting only the outer enamel and causing no pain, may only require monitoring.
If the crack is small and superficial, dental bonding may be an option. This procedure involves applying a tooth-colored composite resin material to fill the crack, restoring the tooth’s appearance and providing some structural integrity. For more significant cracks that extend deeper but have not reached the pulp, a dental crown is often recommended. A crown is a custom-made cap that covers the entire tooth, holding the cracked segments together and preventing the crack from spreading further. If the crack has extended into the pulp, causing irreversible damage or infection, root canal treatment becomes necessary to remove the damaged pulp and save the tooth. As a last resort, if the crack extends too far below the gum line or splits the tooth beyond repair, extraction may be the only viable solution, followed by options like a dental implant or bridge to replace the missing tooth.
Keeping Your Teeth Crack-Free
Preventing cracked teeth involves adopting habits that protect your dental structures from excessive stress and trauma. A common cause of cracks is biting on hard objects, such as ice, popcorn kernels, or hard candies; avoiding these can significantly reduce risk. Using your teeth as tools, for instance, to open packages, should also be avoided.
Wearing a mouthguard during sports or any activity with a risk of facial impact can protect your teeth from accidental cracks. If you grind or clench your teeth, a condition known as bruxism, especially during sleep, wearing a nightguard can help absorb the forces that contribute to tooth fractures. Maintaining good oral hygiene through regular brushing and flossing strengthens your teeth and contributes to overall dental health, making them less prone to damage. Regular dental check-ups allow dentists to identify and address any signs of weakness or minor cracks early on.