Cracked Tooth

Cracked and fractured teeth are common dental problems. As people retain their natural teeth longer (due to advances in dental technology), the likelihood of cracked teeth increases. There are many reasons why teeth may crack, for example, biting on hard objects, trauma, grinding and clenching of teeth. All of these behaviors place the teeth under extra strain and render them more susceptible to cracking.

When tooth enamel is cracked, pain can become momentarily debilitating. When no pressure is exerted on the crack there may be no discomfort. However, as the cracked tooth performs a biting action, the crack widens. The pulp and inner workings of the tooth then become exposed, and painful irritation occurs. As pressure is released again, the two parts of the crack fuse back together, and pain subsides. If left untreated, the pulp becomes irreversibly damaged and constantly painful. The resulting pulp infection can affect the bone and soft tissue surrounding the tooth.

Symptoms of a cracked tooth may include:

  • Unexplained pain when eating.
  • Sensitivity to warm and cold foods.
  • Pain with no obvious cause.
  • Difficulty pinpointing the location of the pain.

What kind of cracks can affect the teeth?

There are many ways in which a tooth can be cracked. The specific type of crack will determine what type of treatment is viable. In many cases, if the crack is not too deep, root canal therapy can be performed and the natural tooth can remain in the mouth. In other situations, the tooth is too badly damaged and requires extraction.

Here is a brief overview of some of the most common types of cracks:

Crazes – These are generally tiny vertical cracks that do not place the teeth in danger. These scratches on the surface of the teeth are considered by most dentists to be a normal part of the tooth anatomy. A craze rarely requires treatment for health reasons, but a wide variety of cosmetic treatments can be performed to reduce the negative aesthetic impact.

Oblique supragingival cracks – These cracks only affect the crown of the tooth and do not extend below the gum line. Usually, the affected part of the tooth will eventually break off. Little pain will result, because the tooth pulp (that contains the nerves and vessels) will remain unaffected.

Oblique subgingival cracks – These cracks extend beyond the gum line, and often beyond where the jawbone begins. When a piece breaks off, it will usually remain attached until the dentist removes it. Oblique subgingival cracks are painful and may require a combination of periodontal surgery (to expose the crown), and endodontic treatment to place a crown or other restorative device.

Vertical furcation cracks – These cracks occur when the roots of the tooth separate. This type of crack almost always affects the nerve of the tooth. Because the tooth will not generally separate completely, root canal therapy and a crown can usually save the tooth.

Oblique root cracks – These cracks tend not to affect the surface of the tooth at all. In fact, the damage is only apparent below the gum line and usually below the jawbone. Root canal therapy may be possible; depending on how close the fracture is to the tooth surface. However, extraction is almost always the only option after sustaining this classification of fracture.

Vertical apical root cracks – These cracks occur at the apex (tip of the root). Though the tooth does not require extraction from a dental perspective, many patients request an extraction because of the high degree of pain. Root canal therapy alleviates the discomfort for a while, but most often, teeth affected by such cracks are eventually extracted.

How are cracks in the teeth treated?

There are many different types of cracked teeth. Some can only be exposed using X-ray machines, while others are clearly visible to the naked eye. In cases where the tooth root is affected, root canal therapy is the most viable treatment option. The pulp, nerves and vessels of the tooth will be removed, and the resulting space will be filled with gutta-percha. A crown or filling will be added to stabilize the tooth and it will continue to function as normal.

When the crack is too severe for the tooth to be saved, the dentist will perform an extraction. There are a number of restorative options in this case, such as bridges, dental implants and partial dentures. All of these structures can restore biting, chewing and speaking functions.

If you have any questions or concerns about cracked teeth, please ask your dentist.

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Dr. Hekmat's chairside manner is something that should be cloned, and all young dentists and doctors should be able to see the tender insight that this man gives his patients. Dr. Hekmat is one of the nicest, most skillful, most dedicated men I have ever met. I can't believe I was so lucky to have found him in such a huge, busy metropolis as Los Angeles.

John Burbank, CA

Dr. Hekmat has been my trusted family dentist for many years, not only taking care of me--but my wife, sister, mother, brother-in-law and mother-in-law, too! From the warm smiles that greet me when I walk in the door to the compassionate, skillful and concerned care that Dr. Hekmat and his staff provide, my visits to his office are always like visiting a member of the family. ...And I don’t want to forget to mention that I appreciate the fact that in busy Westwood, Dr. Hekmat still provides completely free, validated parking. That’s no small feat in my part of town!

Louis Santa Monica, CA

Dr. Hekmat and his team are true professionals. He is kind and always has time to answer ALL of my questions and concerns. I began visiting him after a a friend referred to me several years ago and I have not visited any other dentists since getting work done with him because he continuously provides me and my family with excellent work. I have had a root canal, crowns, bonding, whitening and removal of amalgam fillings with him and I could not be happier with his work.

He is also totally available for emergencies, something other doctors shirk at. I was on my way to LAX when my front tooth (it was being prepped for a root canal) totally came off, I panicked, called him and drove myself to his office within a hour he had me all patched up.

He never tries to sell you anything, he and his staff know my name and always make me feel welcome and calm the anxiety that comes with getting dental work done.

Lizzie West Los Angeles, CA

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