Cracked Tooth Syndrome
Fractured teeth may be a commonly occurring problem in your mouth if your teeth have been subjected to any stresses beyond eating "normal foods".
Teeth may develop cracks when you routinely chew excessively hard foods like popcorn kernels, ice or hard candies. In addition, some large fillings tend to act like wedges inside the center of the tooth.
Often when a patient complains of symptoms consistent with "cracked tooth syndrome" there is a history of some major fall, a blow to the head or neck, a car accident or other major injury at sometime in life. The jaws may have crashed together and the teeth may have been injured without symptoms at the time. Fractures may be aggravated by habits like tooth clenching or tooth grinding that occurs unconsciously during sleep or deep concentration.
Some fractures in teeth can remain completely free of symptoms for many years following car or sporting accidents (or any bumps to the head or neck). Teeth with or without fillings can exhibit this problem, but teeth restored with typical silver fillings are the most susceptible.
Regardless of the cause, teeth do not have any natural ability to repair themselves. Fractures will not heal themselves and will eventually progress to a toothache of great severity and/or the tooth will weaken enough to split and fall apart.
Symptoms and Signs of Fractures are SOME or ALL of the Following :
- Sharp, shocking pain upon chewing.... Not necessarily all the time, just when you hit a certain spot. This type of pain will usually go away as soon as you take the biting pressure off the tooth. But sometimes the pain hurts most when you let up from biting on the tooth.
- Pain with cold air or water on the tooth that may linger for a few moments
- Pain with sweets
- Pain following meals, which persists as a dull ache for quite some time.
- Visually obvious brown or gray cracks running through the enamel surface of the tooth
- Gray or Brown darkening of the tooth, especially at or around the gumline.
Treatment for Fractured Teeth:
1. “Simple Fractures” – The majority of cracked teeth (90%) can be treated by placement of a simple crown (cap) which covers the entire tooth like a thimble fits over your finger, holding the tooth together firmly during future biting pressure. When the tooth is prepared for the crown, and a temporary crown is placed, the pain (if you had noticed biting pressure pain) usually leaves immediately. If this is the case with your tooth, we will place the permanent crown with a problem at your next appointment and the condition should be solved.
2. “Complex Fractures” – Occasionally (10%) the crack runs so deep into the tooth that the nerve chamber is violated. If biting pressure pain persists after the placement of the temporary crown, you may have a fracture involving the nerve chamber. This tooth may require a root canal treatment, but can eventually feel and functions just as any other tooth in your mouth.
3. “Terminal Fractures” – On a very rare occasion (less then 1% of the time) a tooth will be fractured all the way through the nerve and the roots. Treatment for this condition usually involves removing the tooth roots. Sadly, there is no way of knowing that this type of fracture exists until the tooth is removed and we can actually look at the roots. Often patients will have gone to great expense in an effort to save the tooth, through many dental procedures [ crowns, root canals, apicoectomies ] only to have the tooth extracted in the end. It is always an unavoidable and discouraging situation for both patient and dentist. Be assured that there is nothing the dentist may have done to prevent this situation. As in all medical procedures, it is impossible to guarantee a successful outcome 100% of the time.
Fractured teeth should be addressed as soon as possible following their detection and diagnosis. If you have a tooth that periodically gives you a sharp pain when you bite on it, then you have "cracked tooth syndrome" and you should have the tooth repaired immediately. It will not repair itself. The fracture can only deepen and become more unpredictable. Attempts to hold the tooth together with a "crown" is likely to help keep your experiences less complicated and minimize your expense. It can also help avoid the possibility of badly timed emergency situations and the possible loss of a tooth. In the unlikely event that you do lose a tooth to fracture, dental implants are a fabulous way to replace missing teeth using a technology that is very nearly 100% predictable and may last a lifetime.