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Cracked (Fractured) Tooth

Overview

A cracked tooth is associated with tooth damage caused by an external force; this damage causes a small fracture or crack in the tooth. Sometimes, the crack is minor and does not affect tooth function. However, in other cases, the tooth may split or break into pieces, which can be a dental emergency. While any tooth is susceptible to cracking, the upper front teeth and the back teeth in the lower jaw (mandibular molars) are the most prone to fracture. Cracked Tooth Syndrome (CTS) is the clinical term used to describe this condition. 

Tooth fracture is not always associated with noticeable symptoms; however, when present, the symptoms include:

  • Sharp toothache associated with chewing or biting
  • Heightened sensitivity to hot, cold, or sweet foods.
  • Swelling or inflammation in areas surrounding the tooth.
  • Untreated cases may progress to infections (tooth abscesses), which may spread and cause serious health issues. 

If the patients experience any of the aforementioned symptoms or suspect that they have a cracked tooth, they are advised to schedule a dental appointment.

Teeth cracking is commonly attributed to one or more of the following causes:

  • Age: Teeth naturally weaken with age. Cracks are more common in individuals aged 50 years or above.
  • Dental trauma: Accidents, falls or direct blows to the mouth could cause tooth cracking.
  • Biting hard foods: Chewing hard food items, such as candy, popcorn kernels, nuts, or ice, can cause tooth cracks.
  • Dental treatments: Large fillings or root canal treatments without crown placement may weaken the teeth, increasing the chances of developing tooth cracks.
  • Bruxism (teeth grinding): Psychological stress and other mental issues may result in tooth grinding, which, over time, increases the chances of tooth cracking.

A dentist may use several methods to confirm a cracked tooth:

  • History taking: A complete, comprehensive medical history, including details regarding possible causes/exposure to risk factors and symptoms, is collected.
  • Oral examination: The following steps may be performed by the dentists:
    • Bite test: Checking for pain by requesting the patient to bite down on a stick.
    • Probing: Checking the tooth for signs of cracks/fractures using a periodontal probe.
    • Gum evaluation: Checking for signs of inflammation (vertical fractures may cause gum irritation).
    • Transillumination: Passing light through the tooth to illuminate and visualise the crack.
    • Staining: Administration of a staining dye on the tooth for a clear view of the tooth crack.
  • Dental X-ray: X-ray imaging is performed to detect and view fractures and related issues (bone malformations or bone loss). 
  • A 3D scanning technique called cone beam computed tomography (CBCT), which can pinpoint bone loss that may be indicative of a fracture, may also be performed.

A cracked tooth cannot heal by itself. The extent and severity of the fracture determine the course of treatment. Treatment may not be required for mild cracks, which do not cause infection or pain. Common treatment methods include:

  • Dental bonding: The cracks are filled with a tooth-coloured composite resin.
  • Dental contouring: The rough edges may be smoothened out and polished after ascertaining the areas where the affected tooth makes excessive contact with the opposite teeth.
  • Dental crown: A ceramic/porcelain/resin-based cap is fitted over the cracked tooth for protection.
  • Dental veneers: Custom-made porcelain or resin shells are fitted, usually permanently, over the front surface of the tooth.
  • Root canal treatment: For cases in which tooth cracks extend into the dental pulp and lead to infections, a root canal treatment may be performed for the removal of the infected pulp tissues.
  • Tooth extraction: For cases in which tooth cracks severely damage the root and nerves, causing pain and sensitivity, tooth removal is recommended. A dental bridge or implant can then be given as a replacement for the extracted tooth.

With timely diagnosis and treatment, repaired teeth can last for years without any complications. However, in some cases, even after treatment, tooth cracks may split or widen, resulting in tooth loss.

Patients are advised to seek dental care if they notice pain on chewing, sensitivity, visible cracks, or swelling near the affected tooth. Early intervention improves the chances of saving the tooth.

Although not all tooth cracks can be avoided, certain steps reduce the risk:

  • Avoid chewing very hard foods.
  • Wear a mouthguard during sports.
  • Use a night guard if you grind your teeth.
  • Maintain regular dental check-ups for early detection of wear and tear.

For diagnosis and treatment of a cracked tooth, consult a General Dentist or Endodontist.

Disclaimer:

The information in this Health Library is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional with any questions about a medical condition or before starting any treatment. Use of this site and its content does not establish a doctor–patient relationship. In case of a medical emergency, call your local emergency number or visit the nearest emergency facility immediately.