A split tooth is a severe dental fracture characterized by a crack that begins on the chewing surface and extends vertically deep into the root, separating the tooth into two distinct pieces. Because the fracture line often exposes the sensitive inner pulp and may reach below the gum line, a split tooth is considered a dental emergency. Immediate professional dental attention is required to assess the damage and determine the necessary intervention.
Defining the Types of Tooth Fractures
The term “split tooth” specifically refers to the most advanced stage of a vertical fracture, where the tooth has completely separated into two mobile segments. This differs significantly from less severe forms of tooth damage.
Craze lines are superficial cracks found only in the outer enamel, which are common in adult teeth and cause no pain or functional issues. A fractured cusp occurs when a piece of the chewing surface breaks off, often around an existing filling. This type of fracture rarely involves the inner pulp tissue and usually results in sharp pain only when biting down.
The progression typically starts as a cracked tooth, which is an incomplete fracture running vertically from the top surface toward the root. If left untreated, this crack can propagate to become a true split tooth. Another distinct fracture type is a vertical root fracture, which originates in the root structure below the gum line and moves upward toward the chewing surface.
Symptoms of a split tooth include sharp pain when chewing, particularly when releasing biting pressure on the affected side. Sensitivity to temperature changes, especially cold, is also a frequent complaint, along with localized swelling in the adjacent gum tissue. An isolated deep pocket around the tooth, detected during a dental examination, often points toward a split tooth and indicates a poor prognosis.
Why Teeth Split: Key Causes
A split tooth is typically the result of excessive force applied to a tooth that has already been weakened by other factors. These causes are broadly categorized into sudden external forces and long-term structural compromises.
Sudden trauma, such as a blow to the mouth or jaw during a fall or sports injury, can generate enough force to cause an immediate split. Habits that involve biting down on unyielding objects, like chewing ice, hard candies, or popcorn kernels, also create extreme, localized pressure that can lead to fracture.
Structural weakness is often the underlying factor that makes a tooth susceptible to splitting under normal forces. Teeth with large, aged dental restorations, especially silver amalgam fillings, are significantly weaker because a greater proportion of the natural tooth structure has been removed. The remaining tooth walls are less resilient and more prone to fracture propagation.
Chronic tooth grinding and clenching (bruxism) places constant, excessive stress on the teeth, gradually creating micro-cracks that deepen over time. This repetitive force increases the risk of a crack extending into a full split. Deep tooth decay that has extensively compromised the dentin layer also reduces the tooth’s internal strength, making it more vulnerable to failure under normal chewing forces.
Required Dental Interventions
Treatment for a split tooth depends entirely on the extent and precise location of the fracture line. Before professional treatment, immediate steps include avoiding chewing on the affected side and rinsing the mouth with warm salt water to keep the area clean and reduce swelling. A dentist will determine if the fracture extends below the bone line, which is the primary factor dictating the treatment path.
If the split has not extended vertically too far below the gum line and the segments are not fully separated, a procedure may be attempted to save the tooth. This typically involves a root canal treatment, which removes the infected or irritated pulp tissue from the tooth’s interior. The root canals are cleaned, disinfected, filled, and sealed to prevent further infection.
Following the root canal, a full-coverage dental crown is placed over the remaining tooth structure. The crown acts like a protective cap, holding the two segments together and preventing the crack from spreading further. This approach preserves the natural tooth and maintains the patient’s normal bite function.
However, if the fracture extends deep into the root, particularly below the bone level, the tooth cannot be salvaged and extraction is mandatory. Once the tooth is removed, replacing the missing tooth is necessary to prevent shifting of adjacent teeth and bone loss. Replacement options include a dental implant or a fixed bridge, which anchors an artificial tooth to the adjacent healthy teeth.