Cracked Teeth

Types of Cracked Teeth

• Craze lines: Craze lines are extremely fine cracks affecting only the tooth’s outer enamel. They are usually superficial, painless, and do not require any treatment.
• Fractured cusp: This type of crack typically develops near a dental filling and does not extend into the tooth’s pulp (the part that contains blood vessels and nerves). Consequently, it causes little to no pain.
• Cracks spreading to the gum line: If a tooth crack extends vertically towards the gum line, prompt treatment is essential. On the other hand, tooth extraction may be necessary if the crack goes below the gum line. However, immediate dental treatment can increase the chances of saving and preserving the tooth.
• Vertical root fracture: These are cracks that originate at the root of the tooth and travel upward towards the chewing surface. Symptoms may be minimal unless the tooth becomes infected. Sometimes, the affected tooth needs to be extracted.
• Split tooth: This severe type occurs when the crack spreads from the surface of the tooth downwards below the gum line, dividing the tooth into two sections. While saving the entire tooth may sometimes be impossible, a dentist can salvage part of it.

Causes

• Excessive pressure from teeth grinding.
• Chewing or biting on hard foods like ice, sweets, or nuts.
• Sudden temperature changes in the mouth due to eating.
• A blow to the mouth caused by a car accident, fall, sports injury, or physical altercation.
• Large fillings that weaken the tooth’s structure.
• Age: The likelihood of tooth cracks increases in people over 50 years old.

Symptoms

• Swelling of the gum near the cracked tooth.
• Pain when biting or chewing.
• Sensitivity to hot or cold temperatures.
• Intermittent pain, though it is rarely persistent.

Diagnosis

The dentist usually follows these steps to diagnose a cracked tooth:

• Dental history assessment: Your dentist will ask about your dental history, as well as any habits such as teeth grinding or biting on hard foods, which could lead to tooth cracking.
• Visual examination: With the help of a magnifying lens, the dentist will closely inspect the tooth for any small cracks that might not be easily visible to the naked eye.
• Using a dental explorer: A dental explorer device is gently used to assess the tooth and adjacent areas. This helps dentists identify any cracks as the explorer catches on the edge of the fracture.
• Applying dental dye: A special dye may be applied to the tooth, making cracks more noticeable.
• Gum examination: Your dentist will examine the gums for inflammation, which can be a sign of vertical cracks irritating the gum tissue.
• Dental X-rays: Although X-rays might not show the crack at all times, they can reveal problems with the tooth’s pulp that indicate a crack.
• Bite test: You may be asked to bite on something to evaluate if releasing the bite triggers pain, a common indicator of a cracked tooth.

Treatment Options

• Bonding: With bonding, a plastic resin is used to cover the crack. This seals and repairs the fracture.
• Cosmetic contouring: This is a procedure to smooth and polish the uneven edges of a cracked tooth, improving its appearance.
• Dental crown: A ceramic or porcelain-made cap is placed over the tooth to shield and strengthen it. A dental crown is usually recommended when there isn’t enough natural tooth structure to accommodate a veneer.
• Extraction: If the root and nerves of the tooth are severely damaged, the entire tooth may need to be extracted.
• Root canal therapy: This procedure involves the removal of the damaged pulp from the tooth, especially when the crack extends into the pulp, to prevent further weakening and decay.
• Veneer: A thin cover composed of plastic or porcelain is placed over the front part of the tooth. Veneers are suitable when a significant portion of the natural tooth is intact.

Sometimes, the dentist may choose not to treat a cracked tooth. However, this decision is usually made if the crack:

• Does not significantly impact one’s appearance.
• Does not cause severe pain.
• Is reasonably minor (like a hairline fracture that does not extend deeper).

Complications

The main complication of a cracked tooth is the risk of developing an infection that could spread to nearby gum and bone tissue. Signs of a dental infection may include:

• Fever
• Bad breath
• Swollen gums
• Tender glands in the neck
• Pain when chewing
• Sensitivity to heat and cold

If an infection occurs, the dentist might need to perform surgery to drain pus from the area and prescribe antibiotics to kill the bacteria. It is essential to follow the provided instructions and complete the full course of prescribed antibiotics.

Prevention

It is impossible to fully treat a cracked tooth at home. However, you can take these steps to avoid one and control symptoms before seeing a dentist:

• Maintaining proper dental hygiene: Having strong teeth reduces the chances of developing a crack. It is therefore important to brush your teeth twice daily, floss regularly, and visit the dentist every six months for preventative care.
• Avoid chewing on hard foods: If you have a crack, it is essential to avoid chewing hard foods such as ice, nuts, or sweets until you see a dentist, as this could worsen the fracture.
• Using protective mouthguards: Wear a mouthguard when engaging in sports activities to avoid injury. You should also use a protective night guard if you grind your teeth during sleep.

If you develop a cracked tooth, do the following:

• Rinse with warm water: Gently rinse your mouth with warm water to clean the area and remove any food particles.
• Apply a cold compress: Reduce swelling by applying a cold compress to the external area of your cheek around the affected part.
• Take painkillers: Over-the-counter anti-inflammatory pain relievers, like ibuprofen (Advil, Motrin IB), can help reduce swelling and pain. Always adhere to the recommended dose and contact your dentist or physician if you have any concerns about medication.
• Seek a timely dental appointment: Make an immediate appointment with the dentist, as delayed treatment increases the possibility of complications.

It is important to note that these steps only provide temporary relief and management. Therefore, a dentist should assess any injuries or suspected fractured teeth to determine the appropriate treatment.

Takeaway

Many factors contribute to tooth fractures, including crunching on a popcorn kernel, biting a peppermint stick, chewing on crushed ice, or grinding teeth. However, the only way to prevent a cracked tooth from advancing into a serious health problem is by seeing a dentist for an examination of damage signs and recommendations for appropriate treatment. They can also provide guidance on how to avoid cracking your teeth.