People are walking around every day completely unaware that there is a cracked tooth in his/her mouth. Why? This is because cracked teeth do not necessarily hurt. We see cracked teeth in our practice every single day. Sometimes it’s during routine hygiene appointments, because the tooth has broken, and other times it’s because it hurts when the patient chews or eats crunchy things. This phenomena is known as “cracked tooth syndrome”.
According to the publication Dental Economics, problems related to cracked and fractured teeth are the third leading cause of tooth loss after caries (cavities) and periodontal (gum) disease. As the population ages, it is likely that cracked teeth will become more prevalent (due to normal wear and tear).
The standard of care for a cracked tooth BEFORE it breaks is a crown (cap). In essence, it’s like putting a ring around a barrel. It is inevitable that if a cracked tooth is not crowned, one of three things will happen. It will break; it will need root canal treatment; or it will break in such a way where there is not enough tooth structure to support a crown and it will have to be extracted. If the latter situation occurs, the patient will be faced with the decision of how to replace the missing tooth, either with an implant, or with a bridge. This can become very costly.
Patients ask us, “how did my tooth get cracked”, and “it’s not bothering me now, so what happens if I don’t get it fixed?” Early diagnosis and treatment of a tooth that is cracked provides the best, and most economical, outcome for the tooth.
Some patients will exhibit temperature and/or biting pain. Others will not exhibit any symptoms. If the tooth is symptomatic, meaning that the patient is experiencing discomfort, it is usually an indication that the tooth needs more than just a crown to fix it.
Here at Dr. King’s Family & Cosmetic Dentistry, we believe identifying and diagnosing cracked teeth is an important preventative measure. Cracked teeth are generally diagnosed by visually observing if a tooth is cracked. Our team uses intraoral cameras and high magnification glasses (loupes) to more easily identify cracks. We educate our patients by sharing these photos with them during regular hygiene appointments. Another means of identifying cracks in teeth is with a state-of-the-art surgical operating microscope that Dr. King regularly uses while performing root canal treatment.
Causes of Cracked Teeth
There are many ways that a tooth may become cracked. The most common cause is due to large fillings that take up a significant part of the tooth, in part because a tooth may have been restored multiple times. Whenever a dentist drills into a tooth, it forever changes the integrity of that tooth. It will never be a strong as it was before.
With normal day-to-day activities and eating, teeth undergo thermocycling. Thermocycling is when the tooth experiences a broad range of temperatures throughout its lifetime. With hot and cold, fillings expand and contract as the temperature increases and decreases. As the filling expands and contracts, it stresses the tooth and causes tiny little fractures in it. Microleakage then occurs as bacteria leaks in via tiny cracks surrounding these large silver and tooth-colored fillings. Once the bacteria is inside the tooth, it cannot get out. The bacteria then causes decay which will continue to spread inside the tooth. The decay inside the tooth causes it to weaken and eventually break.
The less common, yet still prevalent, causes of cracked teeth include bruxism (clenching and grinding), chewing hard foods, and chewing ice. Another cause is malocclusion. This is when a patient’s teeth don’t line up the way that they should and certain teeth suffer from excessive wear and sheer force as a result.
Ways to Prevent Cracked Teeth
- Occlusal guard (night guard)
- Avoiding chewing hard foods such as ice
How to treat
- Crown (before the tooth actually breaks)
- Root canal and a crown (if the tooth breaks into the nerve)
- Extraction (if the tooth breaks into the bone)
Early detection by Dr. King and his team of hygienists followed by treatment of a fractured or cracked tooth is critical to the viability of the tooth. There are many ways to help prevent a tooth from becoming cracked to begin with, and Dr. King offers these services in his office through options such as orthodontics or by having a night guard that is custom-made to the patient’s mouth. Over-the-counter night guards can often make matters worse by leading to problems in the jaw, so this option is highly discouraged. If the tooth breaks prior to it being crowned, Dr. King can the perform the necessary root canal or extraction followed by the placement of a bridge or an implant. Please contact us at (757) 464-6228 so that we may provide you with the best treatment options available.