If you’ve ever bitten down on a crusty piece of bread or an unpopped popcorn kernel or suffered a blow to the upper or lower jaw during an accident, you may have experienced part of a crown chipping off and falling out into your hand. In these kinds of cases, it is pretty obvious that a tooth is cracked. But many people do not realize that a tooth can be cracked without coming completely apart.
Causes of Tooth Cracking
If a tooth has had restorative work done such as a filling or root canal, or has untreated tooth decay where the structural integrity of the tooth has been compromised, there is a greater chance that this tooth will crack, either as a result of trauma or function.
Parafunctional habits such as grinding and clenching, where the molar teeth in particular are put under additional biting stress, can also increase the chances of a tooth cracking.
In many cases, the crack isn’t visible on an X-ray.
Symptoms of Cracked Teeth
So if your dentist can’t see these cracks or fractures on an X-ray, how do he or she know the crack is there? The presence of biting, percussion (light tapping or touch), or temperature and sweet sensitivity will alert your dentist that there is a potential problem.
The severity or acuteness of the discomfort is determined by the position, depth and direction of the crack. If the crack is below the gumline, an infection may develop in the gum tissue or inside the tooth root (if the crack is deep enough) resulting in a “fistula” (a blister) on the gum surface. A fistula drains pus from an infected site and is a definite sign to a dentist that something is wrong.
A dentist may not be able to diagnose a crack right away even with the presence of these symptoms. In fact, an examination by an endodontist may be required. If the source of the pain is still unknown, then a root canal might be suggested to address a suspected root issue, and it is often during this procedure that the crack is discovered. At this point, it is at the dentist’s discretion whether he or she believes the tooth can be saved, and the root canal procedure can continue with appropriate fracture management methods, or whether he or she should stop the treatment and consider other restorative options.