Because people are living longer and lead more stressful lives, teeth are being exposed to many years of crack inducing habits such as clenching, grinding, and chewing hard things. These habits make teeth more susceptible to cracks.
Typically teeth with cracks/fractures are undetectable on radiographs (x-rays). Hence, cracked and fractured teeth can especially be difficult to locate. When the outer hard tissues of a tooth are fractured or cracked, chewing can cause movement of the pieces, and the pulp becomes irritated. Often this results in a momentary, sharp pain which eventually progresses to include thermal sensitivity. In time the cracked or fractured tooth, similar to other teeth with pulp degeneration, can begin to hurt on its own.
Does your tooth feel like it “zaps” you when bite on it? Cracked or fractured teeth exhibit a variety of symptoms. If your tooth is cracked/fractured, you might feel occasional pain when chewing, particularly between bites as you release the pressure on your teeth. You might also feel pain when you eat or drink something hot or cold. In many cases, the pain may come and go, and the dentist may have difficulty locating which tooth is causing the discomfort.
Not all cracked and fractured teeth hurt. It really depends on the severity of the crack and the pulps’ response. A crack/fracture can make the tooth sensitive due to movement of the fractured tooth pieces and/or leaking irritants into the pulp and even allow bacteria to come right in causing eventual infection of the tooth.
Inside the tooth, under the white enamel is a hard layer called the dentin, and there is the soft inner tissue called the pulp. The pulp contains blood vessels, nerves, and connective tissue. The pulp is a vestige of what originally formed your tooth when you were a child.
Chewing can cause movement of this crack in the enamel and/or dentin. The pulp can become irritated by the movement of the crack. When biting pressure is released, the crack can close quickly, resulting in a momentary, sharp pain. Eventually, the pulp will become damaged to the point that it can no longer heal itself. The tooth will not only hurt when chewing but may also become sensitive to temperature change. In time, a cracked tooth may begin to hurt all by itself. Extensive cracks can lead to infection of the pulp tissue, which can spread to the bone and gum tissue surrounding the tooth.
That depends on if the crack/fracture is caught early enough, often times only a restoration that holds the tooth together will be needed. Once the pulp begins to degenerate and/or becomes infected, it must be treated endodontically if the tooth is going to be maintained. Like cracks in a windshield, cracks in teeth can often remain small or progress slowly over time. I believe that the sooner a crack or fracture is detected and appropriate treatment delivered, the better the chance of maintaining your tooth.
The treatment of your cracked tooth depends on the type, location, and severity of the crack.
Unlike a broken bone, the fracture in a cracked tooth does not heal. In fact, even after treatment, it is possible that a crack may continue to worsen and separate, resulting in the loss of the tooth.
The treatment you receive for your cracked tooth is important because it will relieve pain and reduce the likelihood that the crack will worsen. Once treated, most cracked teeth continue to function and provide years of comfortable chewing. Talk to your dentist and/or endodontist about your particular diagnosis and treatment recommendations. They will advise you on how to keep your natural teeth and achieve optimum dental health.
Unfortunately, there is not a definitive answer. The prognosis is related to the extent of the crack/fracture. Prognosis becomes poor when the crack extends below the gum line. The problem is “like a crack in a windshield; it can stay the same or spread”. It is difficult to predict how long a fractured/cracked tooth will be maintained in your mouth.
While cracked teeth are not completely preventable, you can take some steps to make your teeth less susceptible to cracks.
If you experience symptoms of a fractured or cracked tooth, see your dentist immediately. If detected early enough, a cracked/fractured tooth can often be more likely to be maintained.
All of the common cracks and fractures of the crown region start on the surface and work their way into the tooth toward the end of the root.