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Cracked Tooth Syndrome

Why do teeth crack?

Cracks are a common problem that most often affect teeth with multiple fillings. Decay and the subsequent weakening of the tooth structure can occur from this issue. A hairline fracture most often develops from tooth stress—grinding and abrasive biting and can be prevented with night splints and avoidance of hazardous food objects such as pork crackling, nuts, frozen food and seeded fruit.

What problems can a cracked tooth cause?

Tiny fluid filled tubes ‘tubules’ are situated in the dentine layer. They run down to the nerve as the tooth flexes which can cause the crack to open and close, thus causing discomfort. Cracks may allow bacteria to enter the nerve canals via the tubules causing further inflammation.  Symptoms can include pressure and temperature sensitivity.

If treatment is neglected, the crack can expand and extend to the nerve canals causing greater pain.  As the nerve dies, the decay can spread to the bone beneath the tooth and cause an infection known as an abscess.  The resulting pain is often intense and painkillers and antibiotics don’t always effectively control the pain.

What can be done to treat cracked teeth?

Cracked teeth can be the most difficult and unpredictable dental conditions to treat.  Pain often comes and goes and is difficult to pinpoint, many cracks are so thin they cannot be seen by the human eye, and are not even detectable on x-rays. Once your dentist has determined the location and severity of the crack, he will discuss the appropriate treatment option with you.


Some cracks may be treated with a simple filling.  Once the old filling is removed the crack becomes more obvious, and the cracked section is removed. So long as not much tooth structure has been lost, your dentist may then perform a simple filling to restore the tooth to its full function.


Teeth that have several cracks or very large cracks usually require crowns.  A crown can be made of either gold or porcelain and provides maximum strength with high quality aesthetics.

Note: Gold crowns provide the most strength, and when in the back of the mouth, present no problem aesthetically. Porcelain crowns provide a high level of strength and aesthetic appeal.

Crowns cover all surfaces of the teeth and hold the supporting tooth structure.  This prevents existing cracks from flexing and provides relief from pain.

Root Canal Treatment

Cracks that have reached the nerve canals may require root canal treatment prior to any restorative work including crowns.

A tooth that has been root filled and crowned

Root canal treatment is the process of cleaning and removing the infected pulp and applying a dressing with sedative medicaments to remove all infection present. The root canal is then filled and the tooth remains, functioning like a normal, healthy tooth. Once the tooth has been root filled, your dentist may fit a crown depending on the amount of tooth remaining and expected longevity.


If a vertical crack has extended right to the end of the root, the only option is extraction. It is impossible for a dentist to ‘hold together’ the root surfaces as they are enclosed in bone. Root canal treatment will not be successful in these cases, as bacteria would still enter the root canals through the crack. Extracting a cracked tooth has the potential to be difficult and these teeth are often removed surgically to prevent breakage.

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