A crack in a tooth is a fracture that can range from a tiny, surface-level line to a deep split extending below the gum line. Cracks are common, often causing symptoms like erratic pain when chewing or sensitivity to temperature changes. Signs can be subtle or immediately painful. Because the severity and necessary intervention are directly related to the crack’s characteristics, only a dental professional can accurately assess the damage and determine the appropriate course of action.
Identifying Different Types of Cracks
The classification of a tooth crack dictates the urgency and complexity of treatment. The most minor type is the craze line, a superficial fracture limited to the outer enamel layer. These lines are generally asymptomatic and are considered a cosmetic concern, typically not requiring dental intervention.
A fractured cusp involves a break in the pointed chewing surface, often occurring on teeth that have large existing fillings. This fracture usually causes localized, sharp pain when pressure is placed on the breaking piece, but it rarely extends into the tooth’s sensitive inner pulp. A more serious concern is the cracked tooth, an incomplete fracture that originates from the chewing surface and travels vertically toward the root. This progression often results in “cracked tooth syndrome,” characterized by pain upon release of biting pressure and sensitivity to cold.
If a cracked tooth is left untreated, it can advance into a split tooth, where the crack progresses completely through the structure, dividing it into two distinct segments. This damage usually extends below the gum line. The most challenging type to diagnose is the vertical root fracture, which begins in the root structure and moves upward toward the chewing surface. These fractures may not cause symptoms until a persistent infection develops in the surrounding bone and gum tissue.
Common Causes of Tooth Cracks
Teeth grinding and clenching, known as bruxism, exert immense, sustained pressure on the teeth that can cause hairline cracks to form and deepen. Many people perform this action unconsciously, particularly during sleep. This chronic stress gradually weakens the tooth structure, making it susceptible to fracture.
Trauma from a direct impact, such as a sports injury or a fall, can cause an immediate fracture. Cracks can also result from biting down suddenly on hard objects like ice cubes, popcorn kernels, or hard candy. Teeth restored with large fillings are at increased risk because the original tooth structure is compromised. The remaining walls are thinner and less able to withstand chewing forces, increasing the likelihood of a fracture around the restoration.
Rapid shifts in temperature can also stress the tooth structure, similar to how materials expand and contract with heat changes. For example, quickly drinking ice water after consuming hot coffee causes the enamel to rapidly change volume, creating internal tension that can initiate or worsen existing cracks. Furthermore, the natural aging process causes wear and tear, and studies show that people aged 50 and older are more prone to developing tooth cracks. This increased prevalence is due to the accumulation of decades of biting forces and previous dental work.
Professional Treatment Options
The treatment for a cracked tooth is entirely dependent on the crack’s depth, location, and severity, with the goal being to save the tooth whenever possible. For minor craze lines or small surface chips, dental bonding may be used. This technique involves applying a tooth-colored composite resin directly to the surface, which is then shaped, hardened with a special light, and polished to restore the tooth’s appearance.
When a crack involves a fractured cusp or is confined to the crown, a dental crown is typically the chosen treatment. The crown is fitted over the entire remaining tooth structure to hold the fragments together and prevent the crack from spreading. This restoration provides the necessary structural support and protects the tooth from future forces.
If the crack has extended deep enough to reach the pulp, a root canal treatment becomes necessary. The procedure involves removing the damaged or infected pulp tissue, cleaning and disinfecting the inner root canals, and then filling and sealing the space. A crown is almost always placed on the tooth afterward to protect the structure from future fracture.
In the most severe cases, such as a split tooth or a vertical root fracture that cannot be repaired, extraction is the only option. Once the tooth is removed, the patient can discuss replacement options, including a dental implant or a fixed bridge. Early diagnosis of a crack significantly increases the likelihood that a less invasive treatment can successfully save the tooth.