Cracked tooth syndrome is more than just mere obvious cracks on your teeth. These are microscopic cracks that are too small to show up on X-rays. In some cases, the fractures are under the gum line and could be more difficult to identify. They appear most often on lower molars which absorb most of the forces of chewing.
Grinding and clenching the teeth can make a person more susceptible to cracked tooth syndrome due to the constant forces they put on their teeth. Sometimes, a person’s normal bite causes certain molar cusps (the highest points of the tooth) to exert so much pressure on the opposing tooth that leads to cracks.
Teeth with large fillings or teeth that have undergone root canal treatment may be more likely to crack. This is because these teeth have become weaker. People with one cracked tooth are expected to have other cracks too, either at the same time or in the future.
Signs & Symptoms
When biting or chewing, you may feel a painful sensation from the affected tooth which is more sensitive to hot and cold temperatures. The sensitivity or pain can be mild or intense and may last for a brief moment. It may be painful only when you eat certain food or when you bite in a specific way. You will not feel a constant toothache, as you would if you had a cavity or abscess.
If the cracks expand, the tooth may become loose or a piece of the tooth may break off. This makes you vulnerable to infection. This can happen in the gum around the fractured tooth where a pimple-like bump may appear.
These symptoms may last for months. Cracked tooth syndrome is considered to be one of the most difficult dental problems to diagnose because the pain is unpredictable and the symptoms are inconsistent. In worst cases, your dentist may refer you to an endodontist (root canal specialist).
Your dentist may use special tools to test the tooth such as an “explorer” to feel the cracks or a toothbrush without bristles. It fits over one part of the tooth at a time as you bite down. If you feel pain, the tooth being tested most likely has a crack. Your dentist may also shine a fiber-optic light on the tooth or stain it with a special dye to search for a crack. If the tooth already has a filling or crown, your dentist may remove it in order to examine the tooth better.
After a series of tests focused on the suspected tooth, your dentist will recommend the best treatment. The treatment will depend on the severity, location, depth, and the size of the tooth fracture. Even then, treatments may not always completely relieve the symptoms.
Some Treatment Options Include:
Crowns – for one or more cusps (highest point of the tooth) affected
Root canal – for cracks affecting the pulp (center of the tooth)
Tooth removal – for severe cases of cracks
About 20% of teeth with cracked tooth syndrome need root canals to lessen the sensitivity to temperature. However, these teeth may still be painful when responding to pressure. If you felt pain before the root canal, you may still feel some pain afterward. However, it will no longer be as intense or as frequent.
Some people continue to have occasional symptoms even after treatment. This calls for a tooth removal. Some cracks affect the very root of the tooth in the jaw. There are no more ways to fix this type of crack. If your tooth is removed, you may have it replaced with an implant or a bridge.
However, treatment of cracked tooth syndrome is not always guaranteed. Your dentist should inform you about the prognosis.