Cracked Tooth

Medically Reviewed By William C. Lloyd III, MD, FACS
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What is a cracked tooth?

A cracked tooth is a tooth that has been fractured or broken. Teeth consist of an outer white enamel, a hard dentin layer, and an inner soft tissue called pulp. The pulp is where the tooth’s nerves and blood vessels are located. A cracked tooth occurs when the outer hard layers—enamel and dentin—break. Cracks can just affect the enamel or go all the way through the dentin to the pulp.

There are several types of cracks that can happen to teeth including:

  • Craze lines are very small, shallow cracks in the enamel that don’t affect the dentin. These tiny cracks are very common in adults and usually don’t cause any symptoms.
  • Cracked cusp is a break of one of the pointed areas of a tooth’s chewing surface. This typically occurs around large fillings and usually doesn’t affect the pulp or cause much pain.
  • Cracked tooth is a vertical break in a tooth that extends from the chewing surface downward toward the root. The crack can extend to the gumline or continue below the gumline.
  • Split tooth is a cracked tooth that has progressed to the point that the tooth is in two pieces.
  • Vertical root fracture is a crack that begins in the root and extends upward toward the chewing surface. This type of crack rarely causes symptoms and may not show up until the surrounding bone and gums have problems.

Cracked tooth symptoms occur when the fracture affects the pulp, which becomes irritated. Craze lines, cracked cusps, and vertical root fractures typically have no symptoms. A cracked tooth or split tooth usually does cause symptoms. This includes pain when you chew, especially when you release biting pressure. Pain can also occur with hot, cold or sweet foods. Eventually, a cracked tooth can hurt on its own. However, the pain tends to come and go, making it challenging to locate the problem tooth.

A cracked tooth can happen due to wear and tear over time or from an acute injury, such as a blow to the jaw. Your risk of cracking a tooth is higher if you grind your teeth, chew on ice or other hard substances, or have advanced gum disease.

Unlike bones, teeth that are broken can’t heal themselves. Cracked tooth treatment depends on the type of break that has occurred. When possible, dentists will try to save the tooth. This may require simple bonding or a root canal and crown or veneers. If saving the tooth isn’t possible, it will need to be extracted.

Seek prompt dental care if you think you may have a cracked tooth. Early treatment may help save your tooth. Left untreated, a cracked tooth can completely split or develop an abscess, which can spread to the gums and bone.

What are the symptoms of a cracked tooth?

A cracked tooth causes symptoms when the fracture extends through the hard outer layers to the pulp. The pulp becomes irritated and can eventually become infected or damaged. This effect on the pulp is what causes cracked tooth symptoms.

Common symptoms of a cracked tooth

The most common symptom is sharp pain, which tends to come and go. This can make it hard to tell which tooth is causing the problem. Often, the pain occurs off and on when you chew, particularly when you ease up on the biting pressure. The pressure of biting down briefly opens the crack and the pain occurs when the crack quickly closes.

Cracked tooth pain can also be sudden with exposure to extreme hot or cold temperatures and with sweet foods. This can cause you to chew only on one side or avoid certain foods to prevent the pain. Eventually, the pain can be present without any of these triggers.

In addition to pain, the gums near the cracked tooth can become swollen and inflamed.

It’s best to seek dental care as soon as possible if you have tooth pain or find yourself changing the way you eat due to discomfort. In the case of a cracked tooth, early treatment can often save the tooth.

What causes a cracked tooth?

There are two main causes of a cracked tooth. The first is general wear and tear that happens with time. Several habits can worsen this deterioration, such as tooth grinding and chewing on ice. A tooth can also crack due to an acute injury to the mouth, such as blunt trauma.

What are the risk factors for a cracked tooth?

Several factors can increase the risk of cracking a tooth including:

  • Chewing on hard substances, such as ice, hard candy, popcorn kernels, or even pens
  • Chewing with uneven pressure on your teeth
  • Exposing your teeth to extreme temperature changes, such as drinking ice water right after eating something very hot
  • Grinding or clenching your teeth
  • Having advanced gum disease with bone loss
  • Having large fillings or a previous root canal, which weaken the tooth

Reducing your risk of a cracked tooth

You may be able to lower your risk of cracking a tooth by avoiding activities that can cause it. This includes:

  • Applying even pressure on both sides of your mouth when chewing
  • Avoiding exposure to drastic temperature changes
  • Not chewing on hard foods or objects
  • Practicing good dental hygiene to keep your teeth and gums healthy and treating gum disease early if it occurs
  • Using a retainer or mouthguard if you grind or clench your teeth
  • Wearing a mouthguard or mask if you play contact sports

Regular dental cleanings and exams can help keep your teeth and gums healthy. Spotting problems early is often the key to maintaining oral health and avoiding tooth loss.

How is a cracked tooth treated?

Treating a cracked tooth depends on the type and extent of the crack. Craze lines are generally harmless and don’t require treatment. Even though a cracked cusp usually doesn’t cause pain, dentists will treat it with a crown or filling to stabilize the tooth structure. And most people don’t realize they have a vertical root crack until more serious symptoms occur, such as infection. Treatment of all other cracks depends on the extent of the crack and the health of the pulp.

Whenever possible, dentists try to save a cracked tooth. Generally, this is possible if the crack does not extend below the gumline. For small cracks that don’t involve the pulp, it may be possible to bond the tooth. Bonding involves filling the crack with a plastic resin. If the crack extends to the pulp, treatment will entail a root canal and either a crown or veneer to protect the tooth. Crowns and veneers give extra support to the tooth.

If a crack extends below the gumline or the tooth is split, extraction is necessary.

What are the potential cracked tooth complications?

Early treatment offers the best chance of saving a cracked tooth. Left untreated, the crack will progress because fractured teeth don’t heal themselves the way bones do. This can lead to a crack that extends below the gumline, a split tooth, or an abscess that affects the surrounding bone and gums.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Dec 17
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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