Did you know that the third leading cause of tooth loss is a cracked tooth? Why are they so common? Cracked teeth are one of the main reasons people have a dental emergency. No fun! Because teeth are lasting longer, there has been an increase in the incidence of cracked teeth in the last decade. Let’s learn a little bit about this common bugaboo.


What is Cracked Tooth Syndrome?

Cracked Tooth Syndrome (CTS) was first discovered in 1964. By definition, it is an incomplete fracture of a back tooth. Remember the parts of the tooth? There is the hard outer layer called enamel, under which the dentin, a softer layer lies. The inside of the tooth contains the nerve and blood supply or pulp within the pulp chamber or root canal space.


Affecting mostly the lower molars and upper premolars (two teeth in front of the molars), the crack usually just involves the enamel and the dentin, but it can move into the pulp. Ouch!


What Causes a Cracked Tooth?

Cracked teeth can be caused by many things. Sometimes, the tooth shape itself contributes to the crack. Did you know that if you have one cracked tooth that you are more likely to have another?  Some more common causes:

  • Clenching
  • Grinding
  • Habits
    • Chewing ice or Pens
  • Large fillings – especially amalgams due to the forces they put on the cusps
  • Trauma – biting on a nut or olive pit


When Should I See My Dentist?

The symptoms can vary a great deal with a cracked tooth, which can make it difficult to diagnose, but don’t wait! Cracks spread and what could have been easily treated with a crown could soon require an extraction! Suspect a crack if you have any of the following:

  • Hot sensitivity
  • Cold sensitivity
  • Pain on biting – especially certain foods.
  • Pain on releasing


cracked tooth syndrome


How is a Cracked Tooth Diagnosed?

Finding a cracked tooth can be very tricky! They usually occur in lower molars and upper premolars.The symptoms are varied and can mimic other conditions. Some people complain of a “zing” when they eat things like seeds or nuts. Other people may describe symptoms that sound like a sinus infection or jaw pain. What makes it even more difficult is that cracks can’t be seen by an x-ray until they are very large, and the pain can be hard to pinpoint.  Your dentist will rely on what you tell them to help sleuth out a cracked tooth.


Many teeth can have small cracks without being symptomatic, so looking at the tooth isn’t enough. Some other tools your dentist may use to find a crack are

  • Explorer – sharp instrument to feel for the crack
  • Light – a light held to the tooth can show fractures
  • Dye – sometimes a dye is applied
  • Bite Stick  or device to find sensitive spot
  • Microscope or magnification with camera
  • Periodontal probe – look for fracture of root


Once your dentist has a suspect, they will try to reproduce the sensation of pain you had in order to make sure they have found the culprit! Diagnosis may take more than one visit.


How is a Cracked Tooth Treated?

Recent studies have shown that even small cracks are readily invaded by bacteria. Your dentist wants to remove the bacteria, stop the spread of the crack and splint the tooth together. The best treatment for most cracked teeth is a crown. A crown can do all three! Treatment for a crack will vary based on the size and location of the crack:

  • Crown – to prevent spread of crack
  • Root Canal – if nerve is affected
  • Extraction – if crack spreads to root


What Happens if it’s Left Untreated?

Cracks spread. That’s what they do. Left untreated, a cracked tooth can become infected and the tooth can eventually be lost. Possible outcomes include

  • Cusp fracture
  • Root Fracture
  • Infection
  • Tooth Loss


What to Remember About Cracked Teeth

Finding and treating cracked teeth early is of utmost importance. Don’t wait to report your symptoms! Your dentist is well-trained to spot cracks early and can offer you the best treatment for your situation. Have questions?