Although teeth are tough and durable, it’s possible for them to be cracked or fractured from a fall, an impact, a blow to the face, or another type of stress or trauma. Teeth that have suffered previous injury, have deep, untreated tooth decay, or are structurally compromised by old silver (amalgam) fillings may be more prone to cracking than undamaged teeth. There is even some evidence that more people are developing cracked teeth today due to longer life spans (leading to teeth becoming more brittle) and increased stress (leading to tooth grinding and clenching)—a condition dentists call “cracked tooth syndrome.”
Cracked teeth can be minor problems or serious issues. Tiny cracks in the tooth’s enamel (also called “craze lines”) don’t cause any discomfort, and don’t generally need to be treated. Most of the time, however, when you suffer from a cracked tooth you will know it right away—and you will need to seek treatment promptly.
In some cases, the affected tooth may produce immediate, sharp pain; in other cases, the discomfort may come and go in response to consuming hot or cold foods and beverages, or to biting and chewing. Either type of pain indicates that the tooth’s nerve has been damaged or exposed. In this situation, the tooth should be examined by a dentist and treated immediately.
Cracks can begin at the chewing surface or the root surface of teeth; they can extend only a slight distance, or can split the tooth into two or more parts. What kind of treatment is needed depends on how severely the tooth is damaged.
These minor cracks involve only the outer enamel surface of the tooth, and don’t cause any symptoms. Common in adults, they are rarely serious and generally don’t need treatment (unless they get larger). However, they are sometimes polished away or sealed with dental materials for a better appearance.
Small Crack at Chewing Surface
Small cracks that don’t go below the gum line and don’t involve the pulp can often cause discomfort—but they are among the less serious types. They may be treatable with a filling, dental bonding, or a crown restoration, depending on the extent of the damage. Root canal treatment is usually not needed for minor cracks.
Frequently seen in molars (back teeth), this condition occurs when a part of the tooth’s chewing surface becomes weakened, and begins to crack. This type of crack may cause minor discomfort, which can usually be relieved immediately by having a dentist carefully remove the cracked cusp. A dental crown or an onlay restoration, which is similar to a filling, is often recommended to restore the tooth to its full function and appearance. In many cases, a root canal is not necessary.
Large Cracks or Fractures
Cracks in the tooth can extend from the chewing surface all the way to the tooth’s roots. When the crack extends below the gum line, or if the pulp is involved, treatment becomes more complicated. Generally, if the root is in good condition, it is best to try and save the tooth via root canal treatment. However, in some cases—for example, a tooth that is split vertically or fractured into two parts—extraction will be necessary. Immediate evaluation is critical before the damage gets worse.
These cracks begin at the tooth’s roots and extend toward the chewing surfaces. They are usually painful, and are often associated with infection in the tissues surrounding the tooth. When a tooth is fractured below the jawbone, it usually can’t be saved. If that’s the case, there are a number of tooth replacement methods, including dental implants and natural-tooth-supported bridges, which can give your smile back its pleasing appearance and full functionality.