We have had several patients recently who have had problems related to cracked teeth. The symptoms of which these patients complain can be difficult for both the patient and the dentist. Both can become frustrated because the underlying cause of symptoms is frequently difficult to pinpoint. Often, patients will complain about pain which is caused by biting pressure and sometimes temperature. It is frustrating for both parties because the described symptoms are often difficult to duplicate in the dental office. It’s kind of like bringing your car to the dealer with a specific problem which suddenly vanishes as soon as you arrive at the dealership.
Cracked teeth generally occur for two reasons. First, silver or amalgam fillings expand and contract as we consume hot and cold foods and beverages. The expansion and contraction of the filling is slightly greater than the tooth itself. So, after years of such cycling in temperature-associated expansion and contraction, cracks frequently develop in the teeth. Second, cracks may occur while chewing foods. Commonly patients will describe a sharp pain in a tooth while they had been chewing, and the tooth will remain sensitive to biting pressure and/or temperature.
Cracked teeth are addressed in stages depending upon symptoms. First, a bonded filling may be placed in an attempt to prevent the cracks from propagating further. Depending on the depth and severity of the crack, an onlay or crown may be necessary to prevent the tooth from breaking. An onlay covers any thin walls of the tooth which may be at risk for fracture and is considered a conservative, aesthetic and long-term restoration. If the tooth has an extensive existing restoration or a more severe crack, then a crown which covers the entire tooth will be required to prevent the tooth from breaking.
In either case, the problem needs to be addressed as quickly as possible to prevent the crack from propagating further into the tooth leading to more severe dental problems. For example, if the crack reaches the pulp of the tooth, then root canal therapy will be required as well. The most severe complication would be the vertical tooth fracture which includes the root thereby making the tooth non-restorable. In such cases removal of the tooth and replacement in some fashion will be required.
The important points to remember are as follows:
1. Determine the exact source of discomfort first
2. Address the symptoms as quickly as possible
3. Begin with the most conservative treatment and progress as needed to eliminate all symptoms
Such teeth need to be followed on a regular basis to ensure that damage to the pulp has not occurred. Appropriate x-rays at routine intervals will be helpful for this. Keeping your dentist apprised of precise symptoms will also go a long way to help in diagnosis.
If you have any questions about cracked tooth syndrome please do not hesitate to contact our office by calling 908.359.6655 or on the web at www.DesignsForDentalHealth.com
