Not all cracks are healthy!
Any dental problem is scary to explain, bear, and even think of sometimes. A cracked or fractured tooth is one such scary experience. Many sufferers are wondering if they can recover the fractured tooth or not. With my experience of treating many dental patients, I felt that teaching people about the treatment choices available, and the home care techniques would help.
Table of Contents
- What is a Fractured Tooth?
- How to prevent tooth fracture?
- Types of tooth fractures
- Cracked tooth repair solutions
- FAQs
What is a Fractured Tooth?
Everyday rituals contribute to tooth cracks.
Few reasons for tooth fracture:
- Opening bottles
- Tearing open packages
- Removing staples
- Chewing ice
- Getting knocked in the face by a variety of objects (including first)
A fractured tooth is not a subtle issue. Even if unnoticed or untreated for a long time, it will cause minor to major discomforts. But, the only problem with this is, it requires medical support to heal. If left untreated, the discomfort grows until the tooth gets restored. Dentistry advances have given the scope of treating them and restoring the tooth.
A cracked tooth is a broken or damaged tooth due to injury or poor dental and oral hygiene. There may be other reasons for fractures in teeth like trauma, injury, general wear, and tear accidents, or biting the hard materials. Luckily, we can treat all kinds of fractures unless they grew deeper and more severe through the enamel.
Why teeth cracks or breaks?
The hardest tissue in our body is the enamel which is the top layer of the tooth. This enamel protects the tooth from damage due to acidic foods and medicine or beverages. But enamel is still breakable. Some of the most common daily activities that cause teeth fracture are:
- Opening bottles
- Tearing open packages
- Removing staples
- Chewing ice
- Getting knocked in the face by a variety of objects (including first)
Sometimes chewing foods also fractures the teeth, and not just nut shells. If the enamel on the tooth layer got dissolved, some of the soft foods also cause tooth cracks.
Diagnosing Fractured Tooth
In most cases, there will be no noticeable symptoms of tooth fractures. If the condition worsens deep in the tooth, there will be these common symptoms:
- Sensitivity to heat, cold, or sweetness.
- Discomfort while biting and chewing. Especially when the pressure on a tooth is being released.
- Intermittent Pain that may be severe or slight.
- Swelling and inflammation around the infected tooth.
How to prevent Tooth Fractures?
In general, fractures in teeth cannot be completely prevented. But there are a few simple precautions that help you be less prone to tooth fractures.
- Avoid frequent intake of crunchy or hard foods.
- Do not chew on hard objects like pens and pencils.
- Avoid cracking nuts or shells, or opening the hard caps and even packets.
- Do not clench or grind your teeth.
- Take necessary precautions while playing sports.
Read about Tooth Clenching and Grinding.
Types of Tooth Fractures
- Craze lines
- Fractured cusp
- Cracked tooth
- Split root
- Vertical root fracture
Not all teeth can fracture in the same way. Some of the fractures are severe and require emergency medication and dental attention while others are minor and require no treatment at all. There are different degrees of cracks. A tooth gets cracked or fractured if there form lines on the tooth surface. Some of the fractures mean, the breaking or splitting of a tooth into several pieces. Depending upon this range of tooth fractures, results may be catastrophic.
While these tooth fractures are common in people, diagnosing and treatment planning for the longevity of the tooth are critical factors for patients. One of the primary challenges we, as dentists have, is, When to intervene in the fractured tooth? I would say that it is very simple if we identify and classify the cracks. This will provide some guidance for suitable treatment planning and ultimately better results. From my experience, I found that fractured tooth conditions are treatable if detected early and treated properly.
The American Association of endodontists has identified five types of tooth cracks. They are:
- Craze lines
- Fractured cusp
- Cracked tooth
- Split root
- Vertical root fracture
So, understanding these types of cracks or fractures helps in accurate diagnosis and treatment.
- Craze Lines
These are the microfractures at the enamel layer only. So, they are also called enamel infractions. The fractures do not penetrate the dentin layer of the tooth. All teeth have craze lines. They are visible in anterior teeth as vertical striations within the enamel. One of the major causes of craze lines is tooth trauma. Tooth trauma may be due to blunt force or recurrent functional forces like bruxism and parafunction.
Craze lines have no symptoms and are easily detected. So, we recommend preventing these recurrent functional forces. These are more cosmetic issues. If the size of craze lines is more, they may collect plaque and stain. We cannot remove Craze lines and hence a porcelain veneer is used to cover the front of the tooth.
Read about how to handle tooth trauma.
This is one of the most common types of tooth fractures. Usually, it is pain-free as it appears on the tongue side of the lower back teeth or the teeth side of the upper back teeth. The symptoms of this fracture are temperature sensitivity, irritation in gums, sharp edges on the teeth, and pain while chewing. If the patient experiences any traumatic event, the fractured cusp may break and separate.
A fractured cusp gets identified on transmitting the Transilluminated light beyond the fracture segment. We will determine the prognosis for tooth retaining depending upon the degree of fracture. For this type of fracture root canal therapy or capsule, coverage procedures are suggestible.
A cracked tooth is an incomplete fracture. These cracks may form on the crown of the tooth or may extend vertically into the root portion of the tooth. There are major chances of pulpal and periapical pathosis as the fracture in the cracked tooth progress apically. This makes it difficult to know the location and extent of the crack.
To detect these cracks, some are seen with magnification and some with a dental explorer because they have caused enamel separation. Patient symptoms also vary from temperature or biting pain to zero pains, all depending on the individual’s degree of cracks. There are no proper or dedicated procedures to treat cracked tooth than removing old restorations. Hence, I always suggest proper diagnosis and preventive strategies to avoid.
A split tooth is a full fracture that starts from the crown extending subgingivally. It often extends to the proximal root through both the proximal surfaces and the marginal ridges. The outcome of a fractured tooth is a split tooth (evolution)! The tooth parts have been completely split apart. Although the split could happen rapidly, it usually develops over time from an unfinished crack.
Once more, bad behaviors like bruxism, parafunction, eating ice, etc., contribute to the spread of cracks and, eventually, a fractured tooth. Mastication can sometimes cause pre-existing pain, but not always.
The divided portions may be “wedged” apart, but the prognosis for the tooth is typically dismal. When a split occurs, sometimes only a single root gets affected (e.g., an upper molar root). The “split root” may be able to be removed in those circumstances, saving the remaining tooth. The dentist suggests replacement procedures after the tooth has been extracted.
The chewing surface gets affected by a vertical root fracture that starts in the tooth’s root. Moving from the cheek to the tongue side, the fracture may threaten a portion of the root or its entire length. When the bone and surrounding tissue get infected, this fracture is frequently found.
A radiograph can be used to identify this fracture. Usually, the dentist or dental hygienist will find a deep, narrow pocket along the root.
Since root fractures have a terrible prognosis, extraction is the only option for treatment. In some circumstances, a dentist may attempt a root resection, which involves removing the fractured root.
Cracked tooth repair solutions
- Dental Bonding
- Filling
- Dental crown or cap
- Porcelain veneer
- Dental sealants
- Root Canals
Cracked or fractured teeth if grown for a long extent cause discomfort and pain. Hence mostly we suggest immediate consultation. However, until then the patient is first advised to rinse the mouth with warm salt water. This will clean the infections and prevents further spreading. It is also suggestible to avoid chewing on the same side of the mouth.
There are different solutions for a fractured tooth. They are:
This is the least preferred procedure to repair a broken or cracked or fractured tooth. Dental bonding is for minor issues that make the teeth and smile look unpleasant. In this procedure, the dentist will apply a small amount of bonding on the tooth surface. This bonding gets hardened by sending a blue light. This is the ultimate solution to cosmetic issues. It is quickly adjustable allowing one to gain the lost aesthetics.
One of the best solutions for mending a cracked or fractured tooth is a dental filling. The restorative filling material is frequently used by dentists to temporarily restore teeth that have decayed, fractured, or require repair. For basic tooth restoration, dental fillings are a painless and economical choice.
A dental crown is a replica of your teeth and hence it looks naturally like all other teeth. In the restoration procedure of a fractured tooth, a dental crown is placed over a tooth to prevent further infection or cracks & breaks in the tooth.
You might not need to encase the tooth in a dental crown if your fracture is not serious. We use the porcelain veneer to fix some cracks and fractures that are only aesthetic. A porcelain veneer is a paper-thin shell that resembles the front surface of a sound, natural tooth. With the use of a veneer, your tooth may be able to be fixed while still retaining most of its healthy structure.
Sealants are a filling material used to fill the holes in the teeth. These sealants protect the infected tooth by acting as a barrier against cavity-causing bacteria.
A root canal may be necessary if the crack in your tooth has reached the tooth’s nerve. This is because if the nerve gets left exposed to bacteria in your mouth, it could become infected and end up dying or becoming painful. We need to clean the nerve and remove it during a root canal treatment. The reputation of this technique as being painful is poor. However, if it is done correctly, you should experience no pain or very little discomfort. After a root canal, a crown is frequently and especially highly advised on a rear tooth. This will prevent the tooth from splitting once more.
Read More about Root Canal and its uses