A cracked tooth represents a structural compromise requiring prompt professional attention to prevent further damage or infection. Dental professionals use various restorative techniques to reinforce the tooth’s integrity and protect sensitive inner layers. Ignoring a fracture, even if minor, can lead to the crack spreading deeper, potentially resulting in tooth loss. Seeking a dentist’s evaluation immediately is the first step toward a successful long-term resolution.
Immediate Care and Temporary Protection
Before a dental appointment, individuals can manage discomfort and temporarily protect the compromised tooth. Rinsing the mouth gently with warm water helps clean the area and provides immediate relief. If swelling occurs near the affected tooth, applying a cold compress to the outside of the face can help reduce inflammation.
Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can be taken to manage pain until professional treatment is received. Avoid placing aspirin directly against the gums or the tooth, as the acidity can cause a chemical burn to the soft tissues. To prevent the crack from worsening, patients should avoid chewing food on the side of the injury.
If the cracked edge is sharp or jagged, it may irritate the tongue or the inside of the cheek. A small piece of dental wax or sugarless gum can be used to temporarily cover the sharp point. Since sensitivity often increases with a crack, avoid consuming foods or beverages that are very hot or very cold.
How Dentists Assess the Damage
Treatment depends entirely on the nature and depth of the fracture, requiring a thorough diagnostic process by a dentist. Dentists classify cracks into five main categories, ranging from superficial lines to severe fractures that extend into the root. Craze lines are fine, shallow cracks that only affect the outer enamel and often require only monitoring. A fractured cusp involves a piece of the chewing surface breaking off, typically from teeth with large fillings, and usually does not involve the pulp.
A cracked tooth begins on the chewing surface and extends vertically toward the root. The depth determines the prognosis, as it may or may not involve the pulp, which contains the nerve and blood vessels. Diagnostic tools like transillumination (shining a light through the tooth) and dental dye help illuminate the extent of the fracture.
If the fracture separates the tooth into two distinct segments, it is classified as a split tooth, a severe condition. The most serious type is a vertical root fracture, which begins in the root and moves toward the chewing surface, often leading to bone loss. X-rays check for signs of infection or bone damage around the root, indicating whether the crack has reached internal structures.
Permanent Solutions for Covering a Cracked Tooth
The permanent restoration selected is based directly on the crack classification and the amount of healthy tooth structure remaining. For minor cracks or chips, dental bonding may be used, which involves applying a tooth-colored composite resin to the surface and shaping it to repair the defect. Bonding is a quick procedure that works well for small defects but is not durable enough for deep or severe fractures.
When a crack is primarily aesthetic and affects the front surface of an anterior tooth, a dental veneer may be the preferred covering. A veneer is a thin, custom-made shell, often crafted from porcelain, bonded to the front of the tooth to conceal the crack. This solution requires minimal removal of the natural enamel compared to a full crown, making it a conservative option.
For most significant cracks, especially on back teeth that endure heavy chewing forces, a dental crown is the most robust solution. A crown completely encases the tooth above the gum line, acting as a protective cap to hold the fractured pieces together and absorb stress. Crowns can be made from various materials, including porcelain fused to metal, full ceramic, or metal alloys.
If the crack extends deep enough to involve the tooth’s pulp, the inner tissue may become inflamed or infected, requiring root canal therapy before the final covering is placed. Root canal treatment removes the damaged pulp tissue, cleans the internal chamber, and seals it to prevent infection. Afterward, a crown is almost always required to protect the now-brittle tooth structure from future breakage.
Post-Treatment Care and Longevity
The longevity of any permanent covering relies heavily on consistent post-treatment care. Maintaining excellent oral hygiene is necessary to protect the remaining natural tooth structure underneath the restoration from decay. This includes brushing twice daily with a non-abrasive toothpaste and flossing once a day to remove plaque buildup at the gum line surrounding the covering.
Patients should avoid placing excessive pressure on the repaired tooth by avoiding habits like chewing on ice, hard candies, or using teeth to open packages. These actions can chip the porcelain or cause the restoration to dislodge. If a patient grinds or clenches their teeth (bruxism), a custom-fitted night guard should be worn to protect the covering from destructive forces.
Regular professional checkups and cleanings, typically every six months, allow the dentist to monitor the condition of the restoration and the surrounding gum tissue. With proper care and maintenance, a permanent covering can function successfully for many years, helping to preserve the tooth and maintain oral health.