The Cracked Tooth

By Catherine M. Fascilla, D.D.S.

Have you ever bitten into something and experienced a sharp pain that quickly disappears? It may not happen all the time and you may not even be able to determine which tooth it is. You may also experience sensitivity to sweets and to hot or cold. Have you found yourself avoiding certain foods and chewing on one side of your mouth? It is possible that you have a cracked tooth.

The pain you experience is caused by the crack opening and closing as pressure is exerted on the tooth. The crack may appear as a hairline fracture or may not be visible at all. It is often not detectable by x-ray.

There are many possible causes for a cracked tooth. If you like chewing on hard objects like pens or pencils or on foods such as ice, hard pretzels, hard candy or nuts , you are likely to develop a crack. Your risk is increased if the tooth has large fillings or has undergone root canal treatment or if you are in the habit of clenching or grinding your teeth. An accident causing a blow to the mouth or any unusual stress or trauma to a tooth may cause a fracture. Exposure of tooth enamel to extremes in temperature such as eating something very hot followed by drinking an ice-cold beverage may also lead to cracks.

Treatment varies from a simple filling if the cracked portion is small to an extraction or complete removal of the tooth if the fracture is extensive or splits the tooth in half. Most teeth that develop cracks do not involve the dental pulp. The pulp is the soft tissue within the tooth that contains the nerve and blood vessels. If the pulp is not irritated, root canal treatment is not necessary. However, since large fillings are found in many cracked teeth, the restoration of choice is often a crown (cap).

If you do experience pain on chewing, avoid chewing on that side and see your dentist as soon as possible. Regular dental checkups are very important. While tiny cracks are very common and usually cause no problems, seeing your dentist regularly will allow your dentist to treat a problem in its earliest stage.

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