Cracked Tooth: Symptoms, Treatment, Causes

A cracked tooth is a common dental issue involving various types of fractures affecting the tooth structure. The cracks range from minor craze lines to severe splits requiring extraction. Patients with cracked teeth must know the symptoms, treatment, and causes of a cracked tooth by researching them or consulting a board-certified dentist to engage in preventive and restorative procedures.

The symptoms of a cracked tooth vary depending on the type and severity of the crack. Common symptoms include pain while chewing, resulting from pressure on the crack, leading to discomfort during chewing. Swollen gums surrounding the shattered tooth suggest that germs have entered and caused a localized infection. Pain when ingesting particular meals and beverages is caused by the exposure of the underlying dentin, which leads to sensitivity to sweetness and temperature fluctuations. Intermittent pain and overall discomfort in the teeth and gums are signs of a cracked tooth caused by the movement of broken pieces that influence the tooth's nearby structures.

The remedy for a fractured tooth varies based on the form and seriousness of the crack, including bonding, which adds resin to a broken tooth to revive its shape and functionality. Crowns serve as a safeguarding cover that enhances the overall strength of the tooth, preventing any additional harm. Root canals eliminate damaged pulp, sanitize the tooth, and seal it to avoid infection and stop the advancement of cracks. Teeth replacement methods such as dental implants or bridges are required in extreme circumstances, after which tooth extraction. Dental veneers are an appropriate treatment for extensive fissures in the front teeth, providing a long-lasting solution tailored to fit perfectly.

Cracked teeth occur for varied reasons, and hard foods like candies or un-popped popcorn kernels exert excessive force on teeth, resulting in fractures. Extreme temperature changes cause enamel to expand and contract rapidly, resulting in hairline cracks. Accidental blows to the mouth from sports injuries, falls, or auto accidents cause immediate physical damage. Age-related enamel weakening makes teeth more susceptible to cracks over time. Teeth grinding, or bruxism, places repetitive stress on teeth, creating minor stress fractures that worsen over time.

Recent research on cracked teeth has focused on improving diagnostic techniques and treatment recommendations. Diagnosis of cracked teeth using cone-beam computed tomography: literature review and clinical experience written by Gao and Lin explored the usefulness of cone-beam computed tomography (CBCT) in diagnosing vertical root fractures. Hilton, et al. authored Recommended treatment of cracked teeth: Results from the National Dental Practice-Based Research Network, which aims to know the prevalence of cracked teeth that require restoration and treatment. The research entitled Diagnosis of cracked tooth: Clinical status and research progress by Yu, et al. tackled the struggles in assessing dental cracks, including the extent of damage. Treatment of cracked teeth: A comprehensive narrative review written by Kakka, Gavriil, and Whitworth aimed at evaluating the effectiveness of tooth restoration procedures via several research studies.

What are the Types of Cracked Tooth?

The types of cracked tooth are listed below.

Craze Lines: Craze lines are prevalent dental fissures that are less severe and predominantly occur in adults. Craze lines are minute, hairline fractures in the enamel, manifesting as slender vertical lines and seldom causing discomfort or necessitating intervention unless they exacerbate.

Fractured Cusps: Fractured cusps occur when a segment of a tooth's chewing surface detaches. The condition arises in teeth with substantial fillings. The fissures extend to the gumline but do not damage the dental pulp. Fractured cusps are remedied with the placement of a new filling or crown; however, in some instances, a root canal procedure is imperative.

Cracked Teeth: Cracked teeth exhibit vertical fissures that extend from the chewing surface toward the root without causing the tooth to bifurcate. These fissures potentially jeopardize the dental pulp, necessitating procedures such as root canal therapy or tooth extraction in more severe cases.

Split Tooth: A split tooth is a condition where a crack extends from the tooth's surface to the root, bifurcating the tooth into two parts. Extraction is imperative for a split tooth, although recovering a portion in specific molars with multiple roots is feasible.

Vertical Tooth: Vertical tooth fractures originate from the root and propagate upwards, presenting mild symptoms and remaining undetected for an extended duration. The fractures necessitate extraction unless a dentist excises the broken root and preserves the remaining portion of the tooth.

What are the Symptoms of Cracked Tooth?

The symptoms of a cracked tooth are listed below.

Pain during Mastication: Eating-related pain is discomfort experienced while chewing or biting food. The phenomenon arises from pressure when eating, intensifying the crack, displacing the broken segments, and irritating the tooth's pulp and nerves.

Swollen Gums: Swollen gums are the evident inflammation in the gums surrounding a fractured tooth. They occur due to a crack, which enables bacteria to infiltrate the gum tissue, resulting in irritation and a localized infection.

Sweetness Sensitivity: Sweetness sensitivity is the experience of sudden and intense pain when ingesting sweet foods or beverages. The sensitivity arises due to the split that exposes the underlying dentin, which is highly permeable, enabling sweet foods to access and irritate the tooth's pulp.

Temperature Sensitivity: Temperature sensitivity is pain after ingesting hot or cold meals and beverages. The event arises because fluctuations in temperature induce the fracture to enlarge or shrink, impacting the nerves located within the tooth.

Intermittent Pain: Intermittent pain occurs sporadically and without a discernible pattern. It occurs due to the displacement of the fractured fragments, which sporadically impact the nerves, resulting in episodic discomfort.

Discomfort Around Teeth and Gums: Oral discomfort is a vague and difficult-to-identify feeling of uneasiness in the teeth and gums. The event arises due to the dispersed nature of the crack and its influence on adjacent tissues, resulting in extensive and indistinct pain.

What are the Causes Cracked Tooth?

The causes of a cracked tooth are listed below.

Hard Foods: Consuming hard foods like candies, ice, or un-popped popcorn kernels causes teeth to crack. Biting down on hard items at the wrong angle exerts excessive force on the teeth, leading to fractures.

Extreme Temperature Changes: Rapid exposure to extreme temperature changes, such as biting into cold food after consuming a hot item, causes hairline cracks. It happens because the enamel expands and contracts quickly, leading to fractures.

Accidental Blows to the Mouth: Direct trauma to the mouth from sports injuries, falls, or auto accidents results in cracked teeth. The incidents cause immediate physical damage to the tooth structure, necessitating prompt dental care.

Age: People's teeth become more prone to cracking because their enamel weakens as they age. The cumulative wear and tear over a lifetime weaken the tooth structure, increasing the likelihood of fractures.

Weak Teeth: Teeth weakened by long-term wear, erosion of enamel, or large fillings are more susceptible to cracking. It occurs because the compromised tooth structure is unable to withstand regular biting forces, making it easier for cracks to form and extend.

Teeth Grinding: Chronic teeth grinding, or bruxism, leads to cracked teeth due to repetitive stress and friction. The constant pressure creates minor stress fractures that worsen over time if the grinding occurs during sleep without the individual's awareness.

What are the Treatments of Cracked Tooth?

The treatments of cracked tooth are listed below.

Bonding: Bonding involves applying a resin to a fractured tooth and hardening it using a specific light to permanently glue the material to the tooth. It restores the tooth's appearance and function, preventing additional harm.

Crown: A crown is a custom-made cap that protects and strengthens the entire tooth. A dental crown encases the damaged tooth, stopping further damage and restoring its normal shape and function.

Root Canal: A root canal involves removing the injured pulp inside the tooth, cleaning it, and sealing it. The procedure protects the tooth by removing the infection and preventing the break from spreading further.

Tooth Extraction: Tooth extraction is the removal of the entire tooth from its socket when the crack is too severe to be repaired. It avoids infection spread and relieves discomfort but necessitates a replacement device such as an implant or bridge.

Dental Veneers: Dental veneers are thin porcelain layers that a dentist install on the tooth to hide a break. Dental veneers are long-lasting and last for more than 10 years with careful care, making them excellent for more severe cracks in front teeth; however, the application process is longer because the veneer is customized in a laboratory for an optimal fit.

Tooth Replacement: Tooth replacement replaces a severely broken or knocked-out tooth that is unable to be restored with existing therapies. Dentists propose a fixed dental bridge, implant, or partial denture to restore function and beauty.

Can Cracked Tooth Be Treated At Home?

No, a cracked tooth cannot be treated at home. Over-the-counter painkillers, avoiding hard meals, and maintaining proper mouth hygiene provide brief relief from symptoms through home treatments. Correct identification and healing of the fracture requires professional dental work, whether bonding, crowns, root canal therapy, or extraction. Delaying expert treatment causes more problems, including an infection or aggravation of the crack.

Professional dental care is necessary, given the complexity and possible severity of broken teeth. Dentists employ specialist instruments and imaging modalities like X-rays and cone-beam computed tomography (CBCT) to identify the degree and kind of crack precisely. There is no degree of accuracy available for cures at home.

Professional cleaning and sealing are crucial when the fracture has progressed to the pulp to prevent bacterial infection, which causes more severe problems, including systemic health problems or abscesses. Expert treatments include veneers or crowns that offer long-lasting, durable answers that guard the tooth and restore its function.

What are the Researches about Cracked Tooth?

The research about cracked teeth talks about the materials and tools utilized for diagnosis and evaluating the treatment provided to the patients.

The research entitled, Diagnosis of cracked teeth using cone-beam computed tomography: literature review and clinical experience by Gao and Lin highlights CBCT's role in diagnosing vertical root fractures (VRFs), a specific type of cracked tooth classified by the American Association of Endodontists (AAE). The study discusses CBCT's effectiveness in detecting various cracks despite some limitations in identifying narrow fractures on roots. Factors influencing diagnostic accuracy, such as device-related, patient-related, and evaluator-related factors, are examined, along with strategies to improve clinical practice.

Recommended treatment of cracked teeth: Results from the National Dental Practice-Based Research Network focus on the characteristics of cracks in posterior teeth and the associated treatment recommendations. The study by Hilton, et al., involving 209 dentists and 2858 patients, found that approximately one-third of cracked teeth were recommended for restoration. Strong predictors for recommending restoration included caries, biting pain, and visible cracks on radiographs. The comprehensive study provides valuable data on the treatment choices made by network dentists and highlights the factors influencing these decisions.

The research Diagnosis of cracked tooth: Clinical status and research progress authored by Yu, et al., reviews current clinical detection methods and the challenges in accurately assessing the extent of cracks. The study emphasizes the need for early, quantitative, and non-destructive detection methods to determine the involvement of cracks in affected teeth. It provides a detailed overview of existing detection techniques and calls for further research to develop more precise diagnostic tools.

Treatment of cracked teeth: A comprehensive narrative review by Kakka, Gavriil, and Whitworth examines the latest research on cracked teeth' restorative and endodontic management. The review, based on an extensive literature search including MEDLINE, Embase, Scopus, and Web of Science, and several "Grey literature" sources, concludes that cracked teeth with normal pulp or reversible pulpitis have high survival rates with composite restorations. The review suggests that monitoring asymptomatic cases is viable and that endodontic intervention outcomes for cracked teeth are comparable to the non-cracked teeth when proper restorative management is applied.

What are the Differences between Cracked Tooth and Crooked Teeth?

The differences between a cracked tooth and crooked teeth are found in their causes and treatments. A cracked tooth results from trauma, such as a blow to the mouth, biting on hard objects, or grinding teeth. Symptoms of a cracked tooth include pain when chewing, sensitivity to temperature changes, and general discomfort. Treatments include dental bonding to fill the crack, crowns to protect the tooth, root canals if the crack has affected the pulp, or extraction if the tooth is beyond repair.

Crooked teeth are caused by genetic factors, early loss of baby teeth, or habits such as thumb sucking. Crooked teeth lead to difficulty cleaning teeth properly, resulting in a higher risk of tooth decay and gum disease. The condition affects bite alignment and causes wear on teeth and jaw pain. Treatments for crooked teeth often involve orthodontic solutions like braces, clear aligners, such as Invisalign, or, in more complex cases, surgery to correct jaw alignment.

Cracked and crooked teeth share similarities in their impact on oral health and aesthetics. Proper dental care, including regular brushing, flossing, and routine dental check-ups, is essential in managing and preventing complications associated with cracked and crooked teeth. The two conditions require timely intervention to avoid further damage and ensure optimal oral health. Early detection and personalized treatment plans are key to addressing these dental issues effectively.

Dentist Dr. Dt. Erdem CETIN

He started his professional career in a private practice in Antalya in 2005 and served there until 2012. Between 2012 and 2016, he continued his work as a partner at the institution named KlinikAntalya. In 2016, he founded Myra Dental Centre Turkey and continues his professional activities there. Additionally, he has strengthened his expertise in the field with his membership in the International Congress of Oral Implantology (ICOI).

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