Cracked/Damaged Tooth - New York, NY

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Experts at Diagnosing and Saving Cracked Teeth

Cracked teeth are the third leading cause of tooth loss, after decay and periodontal disease. A major factor in the rising incidence of cracked teeth is the ongoing increase in the average lifespan of people in the U.S. A 2013 study that analyzed more than 14,300 molars in nearly 2,000 patients showed 66.1% had at least one cracked molar and 46.2% had more than one. In some cases (for example, if you bite on something hard and part of your tooth around a filling breaks off), it will be obvious you have cracked a tooth. In other cases, a crack can be asymptomatic, or it may produce fleeting symptoms you might be attempted to ignore. If you suspect you have cracked a tooth, we recommend scheduling a visit at Advanced Endodontics of New York as soon as possible. Our endodontists specialize in diagnosing and saving cracked teeth in New York, NY, and will customize treatment to remedy the type, location and extent of your tooth crack.

Different Types of Cracked Teeth and Treatment

The American Association of Endodontics has identified five types of longitudinal tooth fractures: craze lines, fractured cusps, cracked teeth, split teeth and vertical root fractures.

Craze Lines

Craze lines (also called micro-fractures) are vertical lines that appear superficially on the front or back surface of your teeth. Translucent, yellow, gray or brown craze lines that look like hairline cracks are very common in adult teeth. Craze lines impact only the enamel and don’t penetrate the dentin layer. As such, they typically don’t predispose your teeth to deeper cracks that require functional treatment. However, if you’re concerned about the cosmetic appearance of craze lines in your front teeth, we suggest asking your dentist about porcelain veneers.

Fractured Cusps

A fractured cusp is a complete or incomplete fracture of the crown of the tooth that extends toward the gum line. This happens when a piece of the tooth’s chewing surface breaks off, often around a large filling. A fractured cusp rarely damages the pulp and usually doesn’t cause significant pain. If the extent of damage is minimal, a new filling or crown is typically the only treatment needed. But if the damage is more extensive, crown lengthening and/or a root canal procedure may be required.

Cracked Teeth

If you have a cracked tooth, the crack extends from the chewing surface of your tooth vertically toward the root. If the crack extends into the pulp, a root canal procedure and crown can prevent the crack from spreading further and restore functionality to the tooth. During root canal treatment, we’ll assess the crack’s internal depth microscopically. With proper management, cracked teeth have a favorable prognosis. A six-year study found periodontal issues in crowned cracked teeth occurred in only 4% of cases. Unfortunately, if the crack extends below the gum line, it’s no longer treatable and will require extraction, followed by getting a dental implant or bridge.

Split Teeth

A large-scale study found split teeth comprised 5% of extracted teeth and 61% were in patients from 40 to 50 years old. A split tooth is a complete fracture that starts in the crown and visually extends to the gum line. Although a split can occur suddenly, it results more commonly from long-term growth of an incomplete cracked tooth. A sudden and unusually high biting force on a hard, rigid object like a piece of bone can also cause a tooth to split. Additional causes are excessive removal of the tooth structure during cavity preparation and clenching or grinding your teeth (known as bruxism). Although a split tooth can never be saved intact, prognosis and treatment depend on the position and involvement of the tooth root. If the crack extends only to the middle part of the root, the smaller mobile segment can be removed and the remainder of the tooth can be restored. If the crack extends to the root end (known as the apex), extraction is the only solution.

Vertical Root Fractures

This type of fracture begins in the tooth root and extends toward the chewing surface, making diagnosis challenging. Because the crack doesn’t involve the chewing surface, symptoms can be minimal and as such, detection can take some time. Mild pain is the only symptom in the majority of cases, while spontaneous dull pain can occur when chewing. Some patients may experience slight tooth mobility. Vertical root fractures are often discovered when the surrounding bone and gum become infected. Clinically, a vertical root fracture may present with similar symptoms as periodontal disease or failed root canal treatment. A periodontal-type abscess may be present as a result of chronic inflammation at the fracture line. While extraction is usually necessary, endodontic surgery may be appropriate if removal of the fractured portion can save the tooth.

What Are the Causes of Cracked Teeth?

Years of wear and tear from normal chewing can potentially lead to craze lines. Cracked teeth are often a result of repetitive stress injury, which increases with age. Different sports can be major causes of all types of dental injuries, including cracks and avulsed teeth. Other causes include:

Bruxism
Misaligned teeth
Biting your nails
Using teeth to open containers
Biting frozen foods
Chewing ice cubes
Eating hot drinks or food immediately followed by cold drinks
Extensive tooth restoration including root canals

What are Symptoms of a Cracked Tooth?

The symptoms of cracked teeth vary considerably depending on the depth of the crack and the severity of pulp inflammation. When tooth enamel and dentin are cracked, this impacts the soft dental pulp inside your tooth, which can be irritating and produce symptoms. Extensive cracks can cause infection of the pulp tissue, which can spread to the bone and gum tissue surrounding the tooth. The most common symptom of cracked teeth is discomfort while chewing, although sensitivity to cold also occurs frequently. In many cases, the pain may be intermittent, making pinpointing the cause of discomfort somewhat challenging.

How is a Cracked Tooth Diagnosed?

Studies show early diagnosis of cracked teeth decreases the risk of pulp damage, which requires endodontic treatment. Cracks located in the marginal ridges and anatomic grooves of crowns are easy to detect and diagnose because they’re usually superficial and visible to the naked eye. Other cracks are not as easily detectable because they can travel deep inside the crown structure and either outward into the periodontal ligament space or inward into the pulp chamber. Hidden cracks frequently impact these areas:

An accurate endodontic evaluation is the first critical step in the proper management of cracked teeth. At Advanced Endodontics of New York, our endodontists will assess your symptoms, the orientation and depth of the crack, and pulpal and periodontal involvement to determine the most appropriate course of treatment. The following tests may be used to guide accurate diagnosis and optimal treatment of a cracked tooth in New York, NY:

cone-beam computed tomography (CBCT) scan
Digital periapical X-rays
Pulp and periapical testing
Periodontal probing
Microscopic exam
Methylene blue dye
Transillumination
Isolated bite pressure testing

Prevention of Cracked Teeth

Although cracked teeth aren’t completely preventable, taking the following steps can decrease your susceptibility:

Avoid chewing on hard objects (e.g., ice, pens, unpopped popcorn kernels, and whole almonds)
Don’t clench your jaw or grind your teeth; if you do habitually, get fitted for a nightguard to protect against bruxism
Wear a mouthguard or face mask when participating in contact sports
Follow a healthy diet and oral hygiene habits to help mitigate the risk of decay because fillings can weaken the structure of a tooth and make it vulnerable to cracks

We have the right training to diagnose and save your tooth!

Schedule a visit with Advanced Endodontics of New York to treat your cracked tooth and protect your smile.

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