A cracked tooth is a fracture in the hard structure of the tooth that warrants immediate professional attention. This damage involves a break in the outer enamel layer, which may extend into the deeper dentin or even the inner pulp tissue. Unlike a broken bone, a cracked tooth cannot heal itself, and ignoring the damage allows bacteria to seep into the inner layers. Intervention is required to prevent the crack from progressing, which could lead to infection, severe pain, or eventual tooth loss.
Identifying the Severity of the Crack
Determining the severity of a crack dictates the urgency of treatment and the long-term prognosis for the tooth. Cracks are classified into categories. The least severe are craze lines, which are very small, shallow vertical cracks that affect only the enamel and typically cause no pain, requiring only cosmetic consideration.
A fractured cusp involves a break in the pointed chewing surface, often occurring around a large existing filling. While this can cause sharp pain, it rarely extends into the pulp, meaning it is usually an urgent rather than an emergency concern. A true cracked tooth extends vertically from the chewing surface toward the root. If this fracture reaches the pulp, it becomes a time-sensitive issue, causing erratic pain, sensitivity to temperature changes, or discomfort upon the release of biting pressure.
The most severe cracks are a split tooth and a vertical root fracture. A split tooth is a long-term cracked tooth where the fracture has fully separated the tooth into two segments. A vertical root fracture begins in the root and moves upward toward the chewing surface, often causing gum inflammation and infection near the root. These types of cracks generally have the poorest prognosis, as the tooth structure is compromised beyond salvageable repair.
Immediate Steps for Pain Management
While a cracked tooth requires professional care, you can take immediate steps to manage discomfort and protect the tooth. Begin by gently rinsing your mouth with warm salt water. This warm rinse helps to keep the area clean and can provide a temporary soothing effect on the surrounding gum tissue.
For pain and external swelling, apply a cold compress or a wrapped ice pack to the outside of your cheek near the affected area. Hold the compress for 15-minute intervals to help reduce inflammation and numb the local nerve endings. Over-the-counter pain relievers, such as acetaminophen or ibuprofen, can also be taken to manage the discomfort.
If the cracked tooth feels sharp or is irritating your tongue or cheek, cover it with dental wax or a piece of sugar-free gum. Dry the tooth gently, then press the material over the sharp edge to create a smooth barrier. Avoid chewing on the side of the cracked tooth to prevent the fracture from spreading deeper.
Professional Dental Treatment Options
Once a dentist examines the cracked tooth, the recommended treatment is matched to the depth and location of the fracture. For minor damage, such as superficial craze lines or small chips, the tooth may be repaired with dental bonding. This involves applying a tooth-colored resin material to fill the crack and restore the tooth’s natural shape.
If the crack is deeper, involving a fractured cusp or a vertical fracture that has not yet reached the pulp, the dentist will likely recommend a dental crown. A crown is a cap that fully covers the tooth, holding the fractured segments together and preventing the crack from spreading under the force of chewing. This restoration provides long-term stability and function to the compromised tooth.
A root canal procedure is necessary when the fracture is deep enough to have damaged the inner pulp tissue. During this procedure, the inflamed or infected pulp is removed, the inner chamber is cleaned, and it is sealed. Following a root canal, the tooth is then typically protected with a crown to reduce the risk of future breakage.
If the crack has progressed to a split tooth or a vertical root fracture, the tooth is often unsalvageable, and extraction is required. These severe fractures compromise the integrity of the tooth structure deep below the gum line, preserving the tooth risks chronic infection and damage to the jawbone. Following extraction, the missing tooth can be replaced with an implant or a bridge.