Cracked teeth are partial fractures that appear on the crowns of teeth and may extend under the gums. Some tooth cracks may cause little to no pain. However, most fractures cause acute pain before or after mastication (biting down), which is known as cracked tooth syndrome.
Tooth cracks commonly form on the surfaces of teeth facing the front of the mouth and the surfaces of teeth facing the back of the mouth. They occasionally appear on the front teeth due to injuries or weakened dental restorations.
Cracks also commonly develop on the chewing surfaces of back teeth, including the premolars and molars. These cracks are caused by constant biting pressure and/or chewing on hard objects. Premolars in the lower jaw rarely fracture.
There are five types of tooth fractures, including:
Craze lines appear as very small, vertical cracks on tooth enamel. These tiny cracks are harmless and commonly develop with age. They do not cause pain or require treatment.
Fractured cusps are relatively easy to diagnose, treat, and have a good prognosis. These fractures can develop in teeth with deep cavities or large dental fillings.
Fractured cusps do not extend to the pulp of teeth, which is the soft center that contains a tooth's connective tissues, nerves, and blood vessels. They do not cause pain but can cause tooth sensitivity because the dentin is exposed.
Tooth cracks that extend subgingivally (below the gumline) need to be extracted. If a crack hasn’t reached the gum line, it can be saved with another restorative dental treatment, such as a crown or dental bond. These fractures typically cause acute pain before or after biting down and tooth sensitivity.
If left untreated, a severely cracked tooth will lead to a split tooth, which is a complete fracture.
A split extends to every surface of a tooth. Causes of split teeth include persistent and destructive forces to dental restorations or traumatic injuries. It’s impossible to save a tooth that has a complete split.
Vertical root fractures travel upward from below the gum line. These fractures occur most commonly in root canal treated teeth. Dentists always extract teeth with vertical root fractures.
Frequent and repetitive forces damage tooth structure, which results in a minor fracture and continued growth of that fracture over time.
People over 50 years of age are most commonly affected by cracked teeth. Although, adults can experience them at any age, depending on their lifestyle habits.
The primary causes of cracked teeth include:
Common symptoms of a cracked tooth include:
If you have craze lines, which are small (superficial) teeth cracks, treatment is not necessary. If you have a fractured cusp, crack below the gum line, a split tooth, or a vertical root fracture, treatment is necessary.
Common restorative treatment options for cracked teeth include:
Dental crowns are fake teeth (caps) that fit over damaged, decayed, or weak teeth. They consist of metals, ceramics, or composite resin.
If a tooth crack is severe, but the tooth does not have to be removed completely, crowns are the ideal option. Crowns hold together the cracked parts of teeth and restore their natural shape, function, and look.
During a dental bonding procedure, a high-intensity curing light and special adhesive are used in combination with tooth-colored composite resins. The material bonds to the teeth and fills any noticeable cracks.
Bonding is one of the most popular restorative treatment options among adults because it is painless and completed within one office visit.
Often times, cracks in teeth reach the dental pulp. In these cases, root canal treatment is necessary. Root canals, also known as endodontic treatment, are effectively used to restore infected or inflamed roots.
If the tooth is unsavable due to an infection or a deep crack, it will have to be extracted instead.
Dentists usually extract teeth due to extreme decay, trauma, injury, or damage. If a tooth crack extends below the gum line, removing the entire tooth and root pieces is necessary.
After extraction, your dentist will examine the tooth socket and remove any remaining fragments. Most patients opt for a dental implant after the tooth is removed.
Very minor cracks that develop on the outer layers of teeth can repair themselves. This process is known as remineralization.
If a tooth fracture is severe and extends below the gum line, it cannot be repaired with treatment and will need to be extracted. Cracks that spread to the pulp can be repaired with a root canal and dental crown.
If a tooth fracture causes pain or leaves behind sharp fragments in your mouth, it is considered a dental emergency. You should visit an emergency dental clinic as soon as possible for treatment. If the fracture is not causing pain, it is not considered a dental emergency. You should still make an appointment with your dentist, but it isn't urgent.
A broken tooth can lead to a serious infection or dental abscess. A dental abscess is a collection of pus that forms below an infected tooth. If left untreated, a dental abscess can result in tooth loss, infections, septicemia, and in extreme cases, a deadly brain abscess.
“Cracked Teeth.” American Association of Endodontists, www.aae.org/patients/dental-symptoms/cracked-teeth/.
Hollins, Carole. Basic Guide to Dental Procedures. John Wiley & Sons, Inc., 2015.
Torabinejad, Mahmoud, and Richard E. Walton. Endodontia: princípios e prática. ELSEVIER, 2010.