CRACKED TEETH

What they are and why should you get them fixed today

The latest issue of Compendium¹, an in-depth research and treatment magazine for dental professionals, discusses Cracked Tooth Syndrome, or CTS. CTS usually affects the back teeth and may be caused by several factors, with the most common being the existence of cracked or loose metal fillings in the mouth. Metal filings are only designed to last five years, and because they are not glued in the same way white fillings are, the seams on the sides may open up, letting decay spread into the tooth, weakening it. If you crack the metal filling, which is not that difficult, the filling then may also act as a wedge and when you bite down, the pressure may contribute to cracking the entire tooth itself. Diagnosing and treating CTS is critical in avoiding root canals and loss of teeth - the sooner you see a dentist for proper treatment, the more likely you will be able to avoid these traumas.

A competent modern dentist will raise a red flag if an examination reveals cracked teeth. Cracked teeth are difficult to diagnose with a fogged-up mirror in the back of the mouth, so Printers Row Dental utilizes an intra-oral camera, which clearly reveals cracked teeth so that the patient can see them as well. Black shadows under the fillings or around the cracks indicate the presence of decay. Patients sometimes have a difficult time accepting that today is the day they need to fix these teeth - often there is no noticeable pain (though weird sensations in the tooth are common). Anyone who has known the pain that comes from a tooth in need of a root canal knows that they would certainly never want to experience it again - the process is very expensive and even traumatic. Plus, there is a chance that it may be too late to save the tooth, bringing into play the possibility of a gap in your mouth, which can only be fixed with pricey bridges, implants, or even dentures! By treating cracked teeth as soon as they are diagnosed, you greatly reduce your risk of needing a root canal or having the tooth pulled. Return to Articles>>>

An Overview of Cracked Teeth
Dentists are helping people keep their teeth longer thanks to a range of new sophisticated procedures. People are living longer and more stressful lives, consequently they are exposing their teeth to many more years of crack-inducing habits, such as clenching, grinding and chewing, all of which make teeth more susceptible to cracks

Why does a Cracked Tooth Hurt?
To understand why a cracked tooth hurts, it helps to know something about the anatomy of the tooth. Inside the tooth, under the white enamel and a hard layer called the dentin, is the inner soft tissue called the pulp. The pulp contains blood vessels, nerves and connective tissue. Return to Articles>>>

When the outer hard tissues of the tooth are cracked, chewing can cause movement of the pieces, and the pulp can become irritated. Biting causes pressure that widens the crack, and when this pressure is relieved, the crack can close quickly, resulting in a momentary, sharp pain. Irritation of the dental pulp can be repeated many times by chewing. Eventually, the pulp will become damaged to the point that it can no longer heal itself. The tooth will not only hurt when chewing, but it may also become sensitive to temperature extremes. In time, a cracked tooth may begin to hurt all by itself. Extensive cracks can lead to infection of the pulp tissue, which can spread to the bone and gum tissue surrounding the tooth. Return to Articles>>>

Will my tooth completely heal?
Unlike a broken bone, the fracture in a cracked tooth will never heal. In spite of treatment, some cracks may continue to progress and separate, resulting in loss of the tooth. Placement of a crown on a cracked tooth provides maximum protection but does not guarantee success in all cases.

The treatment you receive for your cracked tooth is important because it relieves pain and reduces the likelihood that the crack will worsen. Once treated, most cracked teeth continue to function and provide years of comfortable chewing. Talk to your dentist about your particular diagnosis and treatment recommendations. They will advise you on how to keep your natural teeth and achieve optimum dental health.  Return to Articles>>>

How is Cracked Tooth Syndrome treated?
Dr. Page has developed an extremely effective technology for treating cracked teeth that is typically less expensive than alternative procedures and that involves less grinding of the tooth than a metal crown. Printers Row Dental recommends that you see your dentist every 6 months.  Ask to have an exam by the dentist with a modern intra-oral camera.  Only a dentist can determine if your tooth is cracked, or if it is merely crazed. (Crazing is minor cracking that does not require treatment).

Types of Cracks
There are many different types of cracked teeth. The treatment and outcome for your tooth depends on the type, location, and severity of the crack.

Craze lines
Craze lines are tiny cracks that affect only the outer enamel. These cracks are common in adult teeth. Craze lines are very shallow, cause no pain, and are of no concern beyond appearances. Return to Articles>>>

Fractured Cusp

A fracture can happen when a cusp (the pointed part of the chewing surface) becomes weak. The weakened cusp may break off by itself, or it may have to be removed by the dentist. This standard treatment will usually relieve the pain. A fractured cusp rarely damages the pulp, so root canal treatment is seldom needed. Your dentist will likely restore such a tooth with a full crown. Return to Articles>>>

Cracked Tooth

This crack extends from the chewing surface of the tooth vertically toward the root. Sometimes the crack may extend below the gum line, and in severe instances, into the root. A cracked tooth is not completely separated into two distinct segments. Because of the position of the crack, damage to the pulp is common. Root canal treatment is frequently needed to treat the injured pulp. Your dentist will then restore your tooth with a full crown to bind and protect the cracked tooth.

Early diagnosis is important. Even with high magnification and special lighting, it is sometimes difficult to determine the extent of a crack. A cracked tooth that is not treated will progressively worsen, eventually resulting in the loss of the tooth. Early diagnosis and treatment are essential in saving these teeth. Return to Articles>>>

Split Tooth

A split tooth is often the result of the long-term progression of a cracked tooth. The split tooth is identified by a crack with distinct segments that can be separated. A split tooth can never be saved intact. The position and extent of the crack, however, will determine whether any portion of the tooth can be saved. In rare instances, endodontic treatment and a crown or other restoration by your dentist may be used to save a portion of the tooth. Return to Articles>>>

Vertical Root Fracture

Vertical root fractures are cracks that begin in the root of the tooth and extend toward the chewing surface. They often show minimal signs or symptoms, consequently they may go unnoticed for some time. Vertical root fractures are often discovered when the surrounding bone and gum become infected. Treatment usually involves extraction of the tooth. However, endodontic surgery is sometimes appropriate if a portion of the tooth can be saved by removal of the fractured root. Return to Articles>>>

Compendium magazine lists some characteristics of CTS:

• History of sharp pain when eating or biting

• Mild or intense non-lingering sensitivity to cold

• Absence of radiating, throbbing, or lingering pain

• Occasional pain when grinding teeth

The article also gives the mission statement in treating Cracked Tooth Syndrome:

"The goal of conservative treatment is to keep the cracked parts of the tooth from moving apart from each other and causing pain, while preserving as much natural tooth as possible."

The bottom line is this: cracked teeth are bad news, but they don't have to stay that way. Call Printers Row Dental today with your S.O.S. - Save Our Smiles! top>>> Return to Articles>>>

¹Griffin Jr., Jack D. DMD, FAGD "Efficient, Conservative Treatment of Symptomatic Cracked Teeth" Compendium magazine, February 2006