Cracked Tooth Syndrome

Cracked tooth syndrome relates to 21 variety of symptoms and signs caused by a crack in a tooth. To improve the chances of saving a cracked tooth, early diagnosis and treatment are important. Most cracked teeth can be saved. If a crack is located and treated early, your dentist may be able to prevent the crack from progressing through the tooth. The dentist may use different terms to describe the crack, including craze, fracture, crack or split. Sometimes dentists use these terms interchangeably and sometimes to describe a specific type of crack. Cracked tooth syndrome usually occurs in a molar or premolar but may
affect any tooth. The syndrome may involve:

Cracks may start in the top of the tooth and run downwards. These cracks may propagate and involve the pulp, nerve and root.


 

Symptoms and Sings of a Cracked Tooth

 

Causes of Cracked Tooth Syndrome

 

Diagnosis of Cracked Tooth Syndrome

Diagnosis can be difficult because symptoms are not consistent. Also, cracks can vary greatly in length and location. Often, cracks are not disco erred until a variety of symptoms are present. If a cracked tooth is suspected, your dentist will take your dental history and ask you questions about the sensitive tooth. Diagnosis may involve the following issues.

The examination

Your dentist may check for:

Bite tests

Bite tests are helpful in locating the pain. As pinpointing the pain is often difficult, your dentist may ask you to bite on a hard object that is focussed on one cusp. This will allow the dentist to localise your bite pressure to one tooth or part of the tooth. X/Hen you bite down on the part of the tooth that is cracked, or release the biting pressure, you are likely to feel pain.

Probing of the gums

Your dentist may probe the gums all around the suspect tooth. This some times helps to assess the extent of the crack.

Radiographic exam (X-rays)

The dentist may want to take an X—ray film to rule out other causes of tooth discomfort, such as decay. Cracks in teeth rarely show up on X-ray films. Cracks in the root may show up as a loss of bone around the cracked root or give the appearance of an abscess.

Removal of a filling

If the suspect tooth has a filling, your dentist may remove the filling. This will allow the dentist to determine if a crack is present and, if so, the extent and direction of the crack. Some dentists use a magnifying device or an operating microscope to inspect the tooth.

Staining

To test for the presence of a crack, your dentist may apply a coloured dye to the:

Transillumination

Your dentist may place a special light directly on the tooth surface. If a crack is presented will block the light. Teeth without cracks allow the light to shine through.

Temperature change

Your dentist may also use ice or hot or cold water to test which tooth is sensitive.

 

Untreated Cracked Teeth

The longer a simple cracked tooth is left untreated, the more likely it will become a complex crack. The pulp inside the tooth may die, and infection in the tooth may occur. It will then be necessary to perform root canal treatment or, in some cases, extract the tooth.

In severe cases, the tooth may split in half. In this case, the tooth usually has to be extracted. A bridge, denture or dental implant may then be needed.

 

Prevention

Even with these precautions, teeth can still develop cracks.

 

Treatment for a Cracked Tooth

Early treatment is important. Propagating cracks may be stopped or slowed down, increasing the chances that the tooth can be saved. Treatment depends on the extent and position of the crack.

SIMPLE CRACK:

The treatment for most cracked teeth involves removing the weakened cusp and placing a large fill ing or crown (cap) on the tooth (see the Australian Dental Association patient education pamphlet Crowns and Bridges). If more than one cusp is fractured or if the tooth is heavily restored, a crown is an effective treatment.

The crown protects the tooth and often prevents the crack from progress ing. When the tooth is prepared for the crown and a temporary crown put in place, the pain usually subsides quickly.

Sometimes, before a crown or filling is placed, a stainless steel band is put in place with a sedative dressing to see if the tooth pain can be stopped. If discomfort stops, a filling or crown will then be placed. If the discomfort does not stop, the dentist may suggest the need for root canal treatment (see the Australian Dental Association patient education pamphlet Root Canal Treatment)

COMPLEX CRACK:

If the crack has progressed to the pulp or has caused inflammation of the pulp, root canal treatment may be needed before the crown or filling is put in place. Root canal treatment requires two or three additional appointments.

If your dentist feels that your case is complicated and requires specialist treatment, the dentist may refer you to an endodontist or prosthodontist. If you have any further questions or con kerns about treatment, your dentist will be pleased to discuss them with you.