Tooth Cracks and Fractures

Cracked Tooth Syndrome

Patients often report a history of pain of varying intensity and long duration, the source of which is difficult to determine. This pain may be accompanied by cold sensitivity. The source of this sharp pain, especially felt during chewing of foods that create a vacuum effect during chewing, is often unidentifiable. This condition is known as “cracked tooth syndrome.” Symptoms may vary depending on the depth of the crack, the direction of progression, and the tissue involved in the crack line.

What are the causes of tooth cracks?

The main cause of tooth cracks is physical forces, especially bruxism, which is the habit of grinding and clenching teeth, trauma, expansion and contraction in amalgam fillings due to temperature changes, suddenly biting a hard food, parafunctional habits, early and unbalanced contacts on the teeth, and the existing fillings or coatings not having the correct closing relationship. However, the cause of tooth cracks may not always be determined.

Is It Possible to Treat Tooth Cracks?

Early diagnosis is important for successful treatment. In addition to radiographic and clinical examination, a number of bite tests, vitality tests, thermal tests, and examination with halogen light if the crack is superficial are very useful. In order to make a visual diagnosis, it may sometimes be necessary to remove the restoration on the relevant tooth or to surgically open the suspicious area. If the cause is not eliminated and the crack is not treated, tooth fractures are possible.

The treatment method of cracked teeth is determined by the location, depth and direction of the crack. If the crack or fracture is at the enamel layer level, follow-up can be done or support can be obtained from composite fillings depending on the size of the complaint. Filling or coating is preferred according to the depth of the crack at the dentin layer level. However, if the crack has affected the vascular nerve bundle of the tooth, root canal treatment should be performed. Then, coating will be appropriate in terms of supporting the remaining tooth tissues.

Unfortunately, the chance of treatment for root cracks and fractures is gradually decreasing. The risk of infection in the gum at the level of the broken root also increases. The tooth is likely to be extracted.

After treatment, a night plate should be used to balance chewing forces. Early contacts should be arranged. A balanced bite should be provided. The condition of the teeth should be monitored in periodic checks.