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Cracked Tooth: Things To Know

Updated: Feb 6

A cracked tooth is an oral condition where the tooth (crown or root) becomes damaged due to disease or traumatic mishaps. When it happens, patients will often present saying that they've a fractured tooth, chipped tooth, or broken tooth, all of which describe the same condition.


tooth split in half vertically
tooth split in half vertically

Depending on the extent and severity of the crack in your tooth, professional dental treatment may be required. However, you will not know what you'll need until you have it evaluated by your dentist.


Table of content:


Overview


What is a cracked tooth?

A cracked tooth or fractured tooth, is when your tooth becomes damaged, broken, or missing pieces of itself. Essentially it is no longer whole nor is it fully intact.


What it can look like:


fractured off crown
fractured off crown

This precarious condition can be excruciatingly painful but there are also odd situations where it can be asymptomatic, such as in broken root canal teeth. Nonetheless, we highly recommend seeing a dentist if you have it.


Fracture extent & severity

Teeth can completely crack or develop partial fractures because this condition occurs on a spectrum. How bad it is would depend on the severity and the extent of it.


Fracture type

Extent

Severity

Enamel only

Small

Mild

Dentin involvement

Medium

Moderate

Pulp involvement

Large

Severe

Fractured off crown

Very large

Very severe

Root fracture

Catastrophic

Catastrophic

The extent and severity of the fracture will ultimately determine if the tooth can be saved and restored or it would need to be extracted. It doesn't always have to involve the entire tooth, it can be a part of it such as one layer or multiple layers.


 

Symptoms

For cracked teeth, the symptoms or how it feels will be largely proportional to the severity of the fracture. That means the bigger the crack the more pain, sensitivity, and discomfort you should expect to experience.


Broken tooth signs & symptoms:

  • Tooth pain when chewing or eating.

  • Spontaneous toothache that comes and goes.

  • Sensitivity to cold, hot, & acidic foods.

  • Gum swelling around the tooth.

  • Tooth feels sore and tender.

  • Piece of tooth looks missing.

  • Retained root tip.


Fractured tooth separating from silver filling
Fractured tooth separating from silver filling

Cracked tooth syndrome

Cracked tooth syndrome is a condition where a tooth is fractured but the crack line is not clinically visible to the naked eye. In other words, the tooth visually appears intact/normal but it exhibits a lot of symptoms that are similar to a broken tooth.


This syndrome is incredibly difficult for dentists to diagnose and treat because if it is truly fractured beyond repair, an extraction will be required. It is hard to make that decision because the tooth appears intact visually.


Both the patient and the dentist will need to make a leap of faith and move forward with it.


 

Causes

Teeth can become fractured due to many reasons, which includes:

  • Eating hard foods. Ice cubes, crab legs, nuts, olive pits, candy, popcorn kernels, etc.

  • Lifestyle habits. Nail biting, pen biting, etc.

  • Tooth decay. Very large cavities can cause the tooth to crumble under biting pressure.

  • Trauma. Trip & fall, sports injuries, motor vehicle collisions, altercations, etc.

  • Bruxism. Teeth grinding in the middle of the night or day.

  • Root canal tooth with no crown. An endodontically treated tooth with no crown on it.

  • Large cavity fillings. Extremely large fillings may not provide enough structural support and it can fracture the tooth. Crowns are recommended for very large tooth fillings.


Teeth most likely to fracture

Statistically, children are the most likely to sustain trauma resulting in a tooth fracture. The tooth that is most likely to crack is the upper front tooth since it is in the most precarious and prominent position in the mouth.


  • Incidence of dental trauma in 2011-2013 for children ages 8-10 were compared to the incidence rates in 1989-1990.

  • Roughly 2.2% of children in both time periods had some form of oral trauma, which implies that the rates have stayed consistent.


  • Most common type of trauma was enamel fracture and enamel-dentin fracture.

  • Most affected tooth was the maxillary central incisor (upper front tooth).


In summary, children are most prone to cracked teeth and it is the upper front tooth that fractures most commonly. Of course, that doesn't mean that adults can't get it, but children tend to be clumsier during play and that is when it usually happens.


 

Diagnosis & Tests

There are multiple ways that your dentist can diagnose a cracked tooth. Most of the time it is obvious and can be seen visually during a clinical exam. Other times it may require more diagnostic tests to determine such as in the case of cracked tooth syndrome.


Tooth slooth - tooth fracture diagnostic tool front of package

Diagnostic tests:

  • Visual clinical oral evaluation - Inspecting for crack lines or missing pieces of tooth.

  • Bite test using tooth slooth to pinpoint fractures.

  • Examine your gums for inflammation.

  • Transillumination - Pass a light through your tooth to illuminate the crack.

  • Tooth dye - Put a staining dye on your tooth to stain the tooth crack.

  • Dental x-ray - Severe fractures can be detected with bitewings and periapical x-rays but mild ones will require a CBCT.

  • Periodontal probing - A vertical fracture will present with DEEP probing depths in one spot of the gums.


Tooth slooth - fracture diagnostic tool back label with instructions

Types of tooth fractures

  • Cracked tooth. Damaged, broken, chipped or missing pieces of a tooth.

  • Fractured cusp. When one of the cusps of the tooth gets sheared off.

  • Tooth split in half. Literally your tooth is now in two pieces.

  • Vertical root fracture. Also known as VRF, this is when the fracture extends down the root of the tooth and below the gum line.


Non-fractures that resemble a cracked tooth:

  • Craze lines (hairline cracks). These are small thin crack lines on the exterior surface of the enamel. These do not require any treatment and they usually do not get worse.


Treatment

The treatment that is needed for a fractured tooth will depend on the extent and severity of the damage. The mild cases will only require basics dental work while the severe cases will require major dental work.


Potential dental treatment:

  • Cosmetic contouring. A tiny chip on the enamel can be smoothed down with a fine diamond bur. This is called recontouring the enamel or enameloplasty.

  • Dental bonding. Fractures involving the enamel only can be restored with dental bonding using composite resin, a tooth colored filling material.

  • Veneer. A broken tooth that involves the dentin can be conservatively repaired with a veneer. This is a thin piece of porcelain that is placed over the tooth.

  • Crown. A porcelain or ceramic cap can be placed over the cracked tooth to protect it.

  • Root canal. Fractures involving the pulp will need a root canal, meaning the affected nerve will need to be removed. Afterwards you can get a crown on it.

  • Extraction. Catastrophic fractures are typically non-restorable, which means the entire tooth needs to be removed. Dentists cannot defy the laws of physics and save it.

  • Implant. If you get an extraction, you can replace the missing tooth with a titanium screw called a dental implant.


Which treatment will I need?

Below is a decision tree for what treatment you might need for a cracked tooth. It's just meant to give you an idea of what you may expect after your dentist consultation.


Cracked tooth treatment decision tree
Decision tree

Management at home

The only way to permanently fix a cracked tooth is by seeing a dentist. However, while you're waiting for your appointment there are things you can do at home to manage your condition and perhaps temporarily alleviate some of the pain.


  • Keep area clean. Brush, floss, and rinse with salt water after every meal so that you can keep your mouth and broken tooth clean. Plaque and food will cause irritation.

  • Cold compress. If there is swelling, using on a cold compress on that side of the face can help control the swelling and relieve some of the discomfort.

  • Pain medication. Breaking a tooth can be painful but taking pain medication can relieve it. The best toothache medicine is advil dual action.

  • Avoid triggers. If chewing on that tooth hurts, stop doing it. If certain foods irritate it, stop eating that food!


The above are standard recommendations by dentists for what you can do for it at home. If you want to try alternative home remedies, you are doing so at your own risk.


Prevention

Complete prevention of a tooth fracture may be impossible but you can at least minimize or reduce the risk of it occurring with smarter lifestyle choices.


Tips to reduce the chances of tooth cracking:

  • Avoid chewing hard foods.

  • Practice good oral hygiene.

  • Wear a night guard for teeth grinding and a mouth guard for sports.

  • Regular dental check ups.


Prognosis


Can a cracked tooth heal?

A tooth that has cracked cannot heal on its own nor will it go away on its own. This event is very physical in nature and thus will require a physical solution. Leaving it alone will only get progressively worse and potentially more painful.


How long will my broken tooth repair take?

Depending on how severe the fracture is and what treatment your broken tooth will need, it could be a single appointment visit or it could span months.


How long each treatment takes:

  • Bonding can be completed the same day.

  • Crowns or veneers will take two visits spanning over 2 weeks total.

  • If it needs a root canal, it'll also need a crown and that may take 3-4 weeks.

  • For catastrophic tooth fractures, the extraction and implant may take 8-12 months.


Ultimately, it depends on what type of dental treatment that your damaged tooth needs.


What is the outlook for a fractured tooth?

With prompt treatment, repaired teeth can last for years and hopefully they won't cause issues later on. However, there is always the chance that something can happen to it again but that isn't something that you can predict. You can get unlucky and crack it again shortly afterwards.


When to see a dentist

If you chip, break, crack, or fracture your tooth, you should see your dentist immediately because there is no permanent at home fix for it. Home remedies may help temporarily alleviate the pain but they will not be able to repair the damaged tooth.


Those are all the tips by our emergency dentists in Long Island City in regards to a tooth that may have cracked!

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About the author: Dr David Chen, DDS

Hello, I'm Dr Chen and I'm an actively practicing dentist in Long Island City, NY. I graduated from Columbia University College of Dental Medicine in 2016 but prior to going to dental school I was already working in the dental field. It's been more than a decade since I first got to know dentistry and let me tell you, time flies by quickly. Since then I've developed a fondness for writing, which is how this all got started!

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Medical Disclaimer:

This blog is purely meant for information purposes and should not be used as medical advice. Each situation in your mouth is unique and complex. It is not possible to give advice nor diagnose any oral conditions based on text nor virtual consultations. The best thing to do is to go in person to see your dentist for an examination and consultation so that you can receive the best care possible.

The purpose of all of this oral health information is to encourage you to see your dentist and to inform you of what you may expect during your visit. Due to the unfortunate nature of dentistry, there isn't really any true home remedies that will get rid of dental problems. Roughly 99.99% of them require in-person intervention by a healthcare professional.

Hint: That is the reason why you can't eliminate seeing dentists in your life!

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