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Split Tooth

What is a cracked tooth?

A cracked tooth is a tooth that has become broken.

Do all teeth crack in the same way?

No. Teeth can crack in several different ways:

  • Cracked tooth – this is when a crack runs from the biting surface of the tooth down towards the root. Sometimes it goes below the gum line and into the root. A cracked tooth is not split into two parts but the soft, inner tissue of the tooth is usually damaged.
  • Craze lines – these are tiny cracks that affect only the outer enamel of the tooth. They are common in all adult teeth and cause no pain. Craze lines need no treatment.
  • Cracked cusp – the cusp is the pointed part of the biting surface of the tooth. If a cusp becomes damaged, the tooth may break. You will usually get a sharp pain in that tooth when biting.
  • Split tooth – this is often the result of an untreated cracked tooth. The tooth splits into two parts. Vertical root fractures are cracks that begin in the root and go up towards the biting surface.

Why do teeth crack?

Many things can cause teeth to crack; such as:

  • Extreme tooth grinding, which can put the teeth under enormous pressure
  • Large fillings that weaken the tooth
  • Chewing or biting on something hard, for example, ice, boiled sweets, fruit stones, meat bones, muesli or granary bread
  • A blow to the chin or lower jaw
  • Gum disease, where there has been bone loss that could make the teeth more likely to suffer from root fractures
  • Sudden changes in mouth temperature
  • Teeth become more brittle as we get older

How can I tell if I have a cracked tooth?

The signs can be difficult to spot and the symptoms varied. You may get pain from time to time when you are chewing, especially when you release the biting pressure. Extreme temperatures, especially cold, may cause discomfort, or you may be sensitive to sweetness, but with no signs of decay. Swelling may be limited to a small area near to the affected tooth.

If the pain is severe, take pain relief. Always check with your doctor or pharmacist if you are taking any other medication.

Why don’t cracks show up on a dental x-ray?

Unfortunately, dental x-rays sometimes don’t show up the cracked tooth. This is because the x-ray beam must be parallel to the crack before it can penetrate it. However, sometimes other signs of a crack may show up. With a vertical root fracture, if the crack has been there long enough, vertical bone loss near to the root can be seen. Your dentist may use a bright light or a magnifying glass to find the crack. They may also use a special dye to follow the course of the crack.

Will I need to have treatment?

Yes. It is important to get advice as soon as possible to help the treatment be more effective. If they are not treated, cracked teeth can lead to the death of the nerve, and an abscess might grow that could need root canal treatment or extraction. In severe cases the tooth can actually split in two. If this happens your dentist will not be able to save the tooth and it will need to be taken out.

Will I lose my tooth?

In some cases, the tooth may need to be taken out, but not always. In the upper jaw the crack is often right through the middle of the tooth and extraction is the only option. It is important therefore to get advice as soon as possible.

How are cracked teeth fixed?

The choice of treatment depends on the amount of damage to the tooth. You should ask your dentist what the best treatment for you is.

bonding – this is when a plastic resin is used to fill the crack and it can easily repair a small chip off the biting edge of the tooth. Bonding can restore the shape of the tooth.

cosmetic contouring – this is done when the chip is very small. The rough edges of the tooth are rounded and polished to blend away the crack.

veneers – these are ideal for a tooth that still has a fair amount of structure remaining, as they are long lasting and need the least amount of tooth removing first. A veneer is a thin layer of porcelain or plastic material made to fit over the front surface of the tooth.

crowns – these are used as a last resort for a tooth that is not suitable for a veneer. A crown fits right over what is left of the tooth, making it strong and giving it the appearance of a natural tooth. If the nerve has been damaged and becomes infected you may need to have root canal treatment first. This involves removing all infection from the root canal. The root is then cleaned and filled to prevent any further infections. The tooth would then be fitted with a crown to give it extra support.

replacement – the replacement of a tooth may be possible and your dentist will advise you.

After treatment for a cracked tooth, will my tooth completely heal?

Unlike broken bones, the crack in a tooth will never heal completely. After treatment, a crack may get worse and you could still lose the tooth. It is still important that you get treatment because most cracked teeth can work normally for years after treatment. Your dentist will be able to tell you more about your particular problem and recommended treatment.

Can I stop my teeth cracking?

Not altogether, patients with one cracked tooth will frequently return with the same problem in another tooth, but there are some precautions you can take:

wear a mouthguard – if you grind your teeth at night, have a night guard made to protect the teeth. If you play sports, wear a custom-made mouthguard.

avoid biting or chewing on hard objects.

How much will my treatment cost?

The cost will vary depending on what treatment you need. There may be extra costs if there are complications and you need more treatment. Ask your dentist for a treatment plan and a written estimate before you start treatment.

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