As people keep their natural teeth longer, cracked teeth are becoming more common. Biting hard objects, injuries, and grinding or clenching all strain teeth and make them more likely to crack.
A cracked tooth may not hurt at rest, but when you bite, the crack opens and irritates the pulp inside, causing sharp pain that stops when you release. Left untreated, the pulp becomes permanently damaged and constantly painful, and infection can spread to the surrounding bone and gums.
Symptoms
- Unexplained pain when eating
- Sensitivity to hot and cold
- Pain with no obvious cause
- Pain that’s hard to pinpoint
Types of cracks
| Type | What happens | Usual outcome |
|---|---|---|
| Crazes | Tiny surface lines, a normal part of tooth anatomy | Rarely need treatment; cosmetic options can reduce their look |
| Oblique supragingival | Affects only the crown, above the gum line | The piece usually breaks off with little pain |
| Oblique subgingival | Extends below the gum line, sometimes past the bone | Painful; may need gum surgery plus root canal and a crown |
| Vertical furcation | The roots separate, almost always affecting the nerve | Root canal and a crown can usually save the tooth |
| Oblique root | Below the gum line and usually below the bone | Extraction is almost always needed |
| Vertical apical root | At the tip of the root | Root canal relieves pain for a while, but these teeth are usually extracted eventually |
Treatment
Some cracks only show up on x-rays; others are easy to see. When the root is involved, root canal therapy removes the pulp, nerves and vessels, the space is filled with gutta-percha, and a crown or filling stabilizes the tooth so it works normally.
If the crack is too severe to save the tooth, we’ll remove it and talk about replacing it with a bridge, implant or partial denture.