While our teeth are remarkably strong, they are not invincible. Cracks can develop in them for many different reasons, and often cause discomfort, pain, tooth decay, and premature tooth loss. Surprisingly, even cracks which appear in plain sight can go unnoticed for a very long time, until they become unignorable major causes for concern.

In this blog, we will discuss the causes of cracked teeth, identify the signs to be aware of, discuss when it is necessary to seek professional assistance, outline the appropriate steps to take if you suspect a cracked tooth, explore the process of diagnosis, examine available treatment options, and provide preventive measures to avoid future occurrences.

What is cracked tooth?

A cracked tooth refers to a condition where a tooth has a visible or invisible crack that extends either partially or completely through the tooth’s structure. Cracked teeth can occur in different ways, including a single crack, multiple cracks, or a fracture that extends vertically or horizontally.

Cracked tooth syndrome

Cracked tooth syndrome (CTS) is a term used to describe a condition in which a tooth has an invisible or difficult-to-detect crack. The crack in the tooth may be so small that it is difficult to detect on X-rays or during a dental exam. Due to the elusiveness of cracked tooth syndrome, diagnosis can be challenging at times.

Types of cracks

Different types of cracked teeth can be identified depending on the extent and location of the cracks, including:

• Craze lines: These are tiny, superficial cracks that affect only the tooth’s outer enamel. Typically, they are harmless and do not cause serious symptoms.
• Fractured cusp: This type of crack occurs when a portion of the tooth’s chewing surface (cusp) breaks off. It usually does not extend deeper into the tooth and is treatable with a dental restoration.
• Cracked tooth: A cracked tooth is characterised by a crack extending from the chewing surface to the tooth’s root. The crack may or may not extend through the entire tooth, and symptoms range from moderate sensitivity to severe pain.
• Split tooth: A split tooth develops when an untreated cracked tooth progresses to a more advanced stage, resulting in a visible split with distinct segments. Options for treatment may include extraction or a combination of root canal therapy and tooth restoration.
• Vertical root fracture: The crack begins at the tooth’s root and extends upward. Vertical root fractures can be difficult to detect and may necessitate tooth extraction if they are severe.

What causes teeth to fracture?

Understanding the factors that can contribute to a cracked tooth is crucial for prevention. Some common causes include:

• Age-related factors, as teeth become more susceptible to cracks over time due to wear and changes in tooth structure
• Stress-related habits like teeth grinding or jaw clenching (bruxism)
• Biting down or chewing ice, pens, hard candies, pencils or fingernails

• Trauma or injury to the mouth or face
• Weakened tooth structure due to large fillings or root canals
• Uneven biting pressure

How can you tell if your tooth is cracked?

Identifying the signs of a cracked tooth can be challenging, as they may not always be obvious. However, some common indicators include:

• Sensitivity to hot or cold foods and beverages
• Discomfort or pain while chewing or biting down
• Inconsistent pain that comes and goes
• Swelling of the gums around the affected tooth
• Discolouration or visible cracks on the tooth surface
• A sharp or dull ache in the affected area

Which measures should you take?

To properly address the symptoms of a cracked tooth, you must visit your dentist as soon as possible. In the meantime, follow these essential steps:

• Rinse your mouth with warm saltwater to help reduce swelling and alleviate discomfort.
• Avoid chewing on the affected side to prevent further damage.
• If you can’t see your dentist on the same day, use dental wax or temporary dental cement to cover sharp edges and protect your tongue and cheeks.
• Over-the-counter pain relievers can help manage pain, but consult your dentist before taking any medication.

When to call a professional

If you suspect you have a cracked tooth, you should consult your dentist immediately. They have the knowledge to accurately diagnose the issue and administer the proper treatment. Consult your dentist if any of the following symptoms occur:

• Persistent pain or discomfort in a tooth: If you experience persistent or recurring tooth pain, it could be a sign of a cracked tooth.
• Visible cracks or damage to a tooth: If you can see cracks or damage on a tooth, you should consult a dentist to determine the severity of the issue and the best course of action.
• Sensitivity to hot or cold that lasts for more than a few seconds: Sensitivity to hot or cold foods and beverages that lingers for an extended period can indicate a cracked tooth. A dentist must assess this symptom as soon as possible.
• Swelling or inflammation in the gums: Inflammation or swelling around a tooth or its surrounding gums may indicate an underlying problem, such as a cracked tooth. It is best to seek professional assistance to determine the cause and proper treatment.

Some dental clinics offer dental emergency services, providing the convenience of a dedicated helpline where you can call to receive pain relief prescriptions, first aid assistance, and a prompt appointment to address urgent dental issues.

Remember that any suspicion of a cracked tooth must be considered carefully. It is always smart to consult your dentist to receive an accurate diagnosis and timely treatment.

Diagnosis

During your dental appointment, your dentist will conduct a comprehensive examination to determine the presence and extent of the crack. They may use different methods, including:

Visual inspection: Your dentist visually inspects the tooth’s surface for cracks, chips, and other damage. Some cracks are visible, but not all. Thus, further diagnostic approaches may be needed to detect hidden or light structural flaws in teeth.

Physical examination: A sharp explorer may be used by your dentist to gently scratch the surface of the tooth. If there is a crack present, the tip of the explorer may catch or get stuck in the crack, indicating its presence.

X-rays: Cracks that are not visible to the naked eye can be detected using X-rays. Traditional dental X-rays may detect certain types of cracks, but CBCT scans provide a more comprehensive evaluation. CBCT provides a three-dimensional image of the tooth and adjacent structures, allowing a more thorough assessment of the crack.

Biting and sensitivity tests: When testing a tooth’s sensitivity and pain level, the dentist may ask you to bite down on different objects or apply pressure to the tooth. These tests can be used to pinpoint the crack’s location and degree of severity.

Transillumination: With this method, a strong light is shone through the tooth to reveal flaws that might not otherwise be evident. Certain kinds of cracks, especially those that are difficult to see visually, can be diagnosed with the help of transillumination.

Dental staining: Your dentist may apply a coloured dye or staining solution to the tooth surface in order to highlight and identify cracks or other imperfections in the teeth. This can aid in improving the crack’s visibility and ease of diagnosis.

Treatment

The appropriate treatment for a cracked tooth depends on the severity and location of the crack. Possible treatment options may include:

• Dental bonding: This procedure is used to repair minor cracks and restore the tooth’s structure. A tooth-coloured resin material is applied to the cracked area, shaped, and hardened to bond with the tooth, improving its appearance and strength.
• Dental crowns: When a crack is more severe, dental crowns can be utilised to provide strength and protection to the tooth. A crown is a custom-made cap that covers the entire visible portion of the tooth, restoring its shape, function, and aesthetics.
• Root canal therapy: Root canal therapy may be necessary if the crack has reached the tooth’s pulp, causing pain and infection. This procedure involves removing the infected pulp, cleaning the root canal, and sealing it to prevent further damage or infection.
• Dental veneers: In cases where the cracks are primarily cosmetic and do not affect the tooth’s structural integrity, veneers can be an option. Veneers are usually made of porcelain or composite material and are bonded to the front surface of the teeth, enhancing their appearance and covering minor cracks.
• Tooth extraction: In cases where the crack is irreparable or poses a threat to oral health, tooth extraction may be recommended. This involves removing the cracked tooth from its socket, and options for tooth replacement are typically next.
• Dental implants or bridges: After tooth extraction, dental implants or bridges can be considered as tooth replacement options. Dental implants involve surgically placing an artificial tooth root into the jawbone and attaching a prosthetic tooth, whereas bridges use neighbouring teeth as support to fill the gap created by a missing tooth.

Prevention

Preventing cracked teeth is always better than dealing with the consequences. Here are some preventive measures to keep your teeth healthy and intact:

• Avoid chewing or biting on hard objects or foods.
• Wear a mouthguard during sports or physical activities to protect your teeth from trauma.
• Practise good oral hygiene by brushing and flossing regularly.
• Visit your dentist for routine checkups and dental cleanings.
• Treat bruxism by using a custom-fitted night guard or seeking appropriate treatment.
• Maintain a well-balanced diet and limit sugary and acidic foods and drinks.

Preserving your smile

Cracked teeth can be deceptive, frequently concealing themselves in plain sight and causing pain when least expected. Recognising the symptoms and taking proactive measures are essential for maintaining oral health.

If you suspect that you have a cracked tooth, seek professional dental care immediately. Regular dental exams, preventative care, and diligent oral hygiene practices are the keys to maintaining a healthy smile and preventing cracked teeth. Early detection and treatment are the keys to saving you from future discomfort and potentially extensive dental procedures.