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Cracked Tooth

Cracked Teeth: What is it, Symptoms, Causes and Risk | National Dental Centre Singapore

Cracked Tooth - What it is

Teeth can crack in several different ways. Cracks may affect the crown, root or both parts of the tooth.

Cracks may differ in depth (how deeply it penetrates the tooth structure) and length (how extensive it is), and where it starts. Cracks can be:

  • Craze lines – superficial tiny cracks which occur within the enamel, which do not cause symptoms and need no treatment
  • Fracture of a cusp – when part of the chewing surface of a tooth breaks off completely
  • Cracked tooth – where a crack extends from the biting surfaces to varying depths down the tooth. The crack does not separate the tooth into two segments
  • Split tooth – the tooth is separated by the crack into two distinct segments
  • Vertical root fracture – a crack which originates from the root and extends to varying lengths towards the crown


A cracked tooth may be painful upon biting because the pressure of biting causes the crack to be forced open. When you stop biting, the pressure is released and a sharp pain results as the crack quickly closes.


Even though the crack may be microscopic, bacteria can harbour in the crack lines, resulting in irritation to the pulp inside the tooth. The dental pulp contains connective tissues, blood vessels and nerves. When the dental pulp is irritated, the tooth may be sensitive to changes in temperatures. Root canal treatment may be necessary to save the tooth if the pulp is damaged or diseased as a result of the crack.

Cracked Tooth - Symptoms

​Cracked teeth demonstrate many types of symptoms ranging from discomfort to pain when chewing, pain on release of biting pressure and sensitivity to hot and cold temperatures. However, these symptoms are often inconsistent, making diagnosis of cracked teeth challenging.

Cracked Tooth - How to prevent?

​While cracked teeth are not completely preventable, there are some steps to take to minimize your risk:

  • Avoid chewing on hard food or objects such as ice, hard nuts, bones, pens etc.

to-avoid-crack-teeth-do-not-chew-on-hard-objects-by-national-dental-centre-singapore 

  • Avoid habits such as clenching or grinding your teeth.
  • Speak to your dentist about getting a night guard if you notice that you clench or grind your teeth at night.
  • Wear a mouth guard when playing contact sports.

Cracked Tooth - Causes and Risk Factors

​A tooth may crack due to a variety of factors:

  • Parafunctional habits such as clenching and grinding of teeth
  • Habits like chewing on hard objects or foods such as ice, nuts or hard candy
  • Uneven chewing pressure placing excessive stress on a tooth
  • Loss of a significant portion of tooth structure through wear, large fillings or other restorations

Cracked Tooth - Diagnosis

​It can be difficult to diagnose a cracked tooth. You may not even be able to tell which tooth hurts or whether the pain is from an upper or lower tooth. A crack may appear as a hairline fracture, running vertically along the tooth. It is often invisible to the eye and may not show up on an x-ray.


You can help your dentist determine which tooth is causing the problem by noting when and where you have sensitivity to heat or cold, as well as approximately where the pain is when you are chewing.


Superficial cracks are common and usually do not require any further treatment. Regular visits to the dentist will allow your dentist to diagnose and treat cracks in the early stage. If you have persistent dental pain, avoiding chewing on that side and contact your dentist.

Cracked Tooth - Treatments

The treatment and outcome for a cracked tooth depends on the type, location and extent of the crack. Not all teeth are amendable to treatment. Split teeth are almost always doomed for failure. Your endodontist is the best person to advise you on the appropriate treatment.

Usually, there will be a need to stabilize or splint the tooth with a band to prevent further progression of the cracks. Endodontic or root canal treatment is often necessary if there is pulpal involvement arising from the crack.

 molar-band-placement-by-national-dental-centre-singapore

     Molar band placement


Endodontic treatment will relieve pain and resolve pulpal inflammation and infection, but it will not cure cracks, as these are physical defects on the tooth surfaces. During endodontic treatment, the tooth may be stained with a special dye to facilitate the assessment of the number, location and extent of the cracks within the tooth under a microscope.

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      Tooth stained with special dyes

 
When the cracked tooth becomes asymptomatic and has stabilized, a crown will be placed. Placement of a crown provides maximum protection and helps to reduce progression of cracks.
It is important to note that in spite of treatment, some cracks may continue to progress and result in loss of the tooth.

Cracked Tooth - Preparing for surgery

Cracked Tooth - Post-surgery care

Cracked Tooth - Other Information

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