The Challenge of Cracked Teeth

Because we are living longer and more stressful lives, we sometimes expose our teeth to clenching, grinding, chewing on hard objects, and other habits that make our teeth more susceptible to cracks.

Cracked teeth demonstrate many types of symptoms, including pain when chewing, perhaps with the release of biting pressure, or pain when teeth are exposed to temperature variations. It is also common for tooth pain to come and go, making it difficult to diagnose the location of discomfort.  Cracks in teeth often start small and progress slowly, meaning early detection is very important.

When a crack allows movement of the cracked pieces of your tooth below the gumline, chewing down, then releasing the pressure on the mobile piece stretches the ligament that wraps around your tooth.  This not only causes momentary, sharp pain, but over time, the influx of bacteria into the crack near the dental pulp can cause irreversible damage, and tooth may spontaneously hurt, even when you are not chewing. Ultimately, cracks can lead to infection of the pulp tissue, which can spread to the bone and gum surrounding the problematic tooth.

Dr. Odum and Dr. O’Connor will look for clues to predict tooth prognosis from a clinical exam, 2-D images, and 3-D CBCT images.  Only teeth with a favorable prognosis will be recommended for treatment.  Specialized techniques are required to save teeth with cracked teeth, which may include root canal therapy and surgery below the gumline to expose healthy tooth structure for protective crown support.



Cracked teeth types and locations with a favorable prognosis that are restorable.

  • Craze Lines. These are tiny cracks that affect only the outer enamel, are very common, cause no pain and are usually of no concern.
  • Fractured Cusp. The cusp is the pointed part of the chewing surface, and can cleave from the main body of the tooth.  This type of fracture requires removal of the weakened cusp, and protection of the tooth with a crown from your family dentist. If the cusp fracture exposes the dental pulp, root canal therapy is indicated.
  • Treatable Cracked Tooth. This type of fracture propagates from the chewing surface of the tooth vertically towards the root.  A treatable cracked tooth is limited to the crown of the tooth can be treated with a crown from your family dentist.

Cracked teeth types and locations with an unfavorable prognosis requiring extraction.

  • Non-Treatable Cracked tooth. Our endodontists will inspect the tooth internally with a microscope to differentiate between a treatable and a non-treatable cracked tooth.  A non-treatable cracked tooth extends below the gumline and the crest of bone surrounding the root.
  • Split Tooth. Given enough time, a cracked tooth will progress so far, that the tooth splits into distinct segments that can be separated, allowing salivary bacteria to travel deep between the segments.
  • Vertical Root Fracture. Initially discovered when the surrounding bone and gum become inflamed and infected; these cracks may go unnoticed over time. Most commonly located at hidden curved or thin areas of the root, our doctors will study the patterns of resulting bone loss with a 3-D CBCT image to ascertain tooth prognosis.