Cracked Tooth Syndrome is a common problem. Unfortunately, unlike teeth with obvious fractures, teeth with cracked tooth syndrome usually have fractures that are difficult to see on X-rays or with the naked eye. Sometimes the fracture is below the gum line, making it even more difficult to identify. Cracked tooth syndrome more often occurs in molars, usually lower molars, which absorb most of the forces of chewing. People who grind or clench their teeth may be more susceptible to cracked tooth syndrome because of the constant forces put on their teeth. Teeth with large fillings or teeth that have undergone root canal treatment are weaker than other teeth and more likely to crack.

The first symptom of a cracked tooth is often intermittent pain in the tooth when you bite or chew. The tooth may be painful only when you eat certain foods or when you bite in a specific way. It may be worse when you eat sugary foods as the sugar leaks into the tooth crack causing pain. You will not feel a constant ache, as you would if you had a cavity or abscess, but the tooth may be more sensitive to cold temperatures. Many people with cracked tooth syndrome have symptoms for months, but it is often difficult to diagnose because the symptoms are not consistent.

To make the diagnosis we will start with a thorough examination of your mouth and teeth, focusing on the tooth in question. We also may take X-rays, although X-rays often do not show the crack. We may use special instruments to test the tooth for fractures. One instrument looks like a toothbrush without bristles that fits over one part of the tooth at a time as you bite down. If you feel pain, the cusp being tested most likely has a crack affecting it. Treatment depends on where the crack is, how deep it is and how large it is.

Sometimes a crack affects one or more cusps of a tooth. These are the highest points of the tooth. In this case, the tooth may be fixed with a crown. Some cracks affect the pulp: the center of the tooth, where the nerves and blood vessels are. In that case, the tooth will need root canal treatment. About 20% of teeth with cracked tooth syndrome will need root canals. After a root canal, the tooth will no longer be sensitive to temperature, but it still will respond to pressure. If you felt pain before the root canal, you may still feel some pain afterward. It probably will not be as intense or as frequent, but it may still occur.

In some cases, the tooth may need to be removed. Some cracks affect the root of the tooth in the jaw. There’s no way to fix this type of crack. If your tooth is removed, you can have it replaced with an implant or a bridge.

People with one cracked tooth are more likely to have others, either at the same time or in the future. We can make an occlusal splint/ night guard for you, to prevent you from grinding or clenching your teeth. This will reduce the chances of you cracking another tooth. An occlusal splint is usually worn while sleeping. It also can be worn at other times if clenching or grinding happens during waking hours as well.

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