Cracked tooth syndrome

Definition

Cracked tooth syndrome, common in patients over 40 years of age, refers to the symptoms of a hairline crack in a tooth.

Causes

Common causes include grinding or clenching your teeth (often while sleeping), eating hard foods, biting on hard objects, or accidents.

Signs and symptoms

Most patients complain of discomfort or pain on biting or when teeth are exposed to cold or hot temperatures. The symptoms tend to be intermittent or occasional and can persist for months.
Back teeth are most commonly affected as they are used for chewing. While some affected teeth have large fillings, many only have small fillings or, indeed, no fillings at all.

Diagnosis

Cracked tooth syndrome can be very difficult to diagnose as hairline cracks are often invisible to the human eye and patients are often unable to accurately pinpoint the offending tooth. Also, cracks typically do not show up on X-rays.
A thorough oral examination, dental history review, and the use of a powerful microscope and a fibre optic light can assist in the diagnosis. Patients with a history of a cracked tooth are likely to have other cracked teeth.

Treatment

Unlike a broken bone, a cracked tooth will not heal completely and, while root canal treatment and placement of a crown on a cracked tooth will usually relieve pain and slow down the crack, most cracks tend to spread over time. Generally, these teeth are eventually lost. If the crack extends beyond the gum line, the tooth’s future is certainly poor and an extraction is recommended.

Prevention

While cracked teeth are not completely preventable, you can take some steps to help:

  • Try not to clench or grind your teeth (often associated with stress)
  • If you clench or grind your teeth while you sleep, ask your dentist for a nightguard (mouthguard)
  • Don’t chew on hard foods or objects such as ice, hard sweets, popcorn kernels or pens etc.
  • Wear a mouthguard or protective mask when playing contact sports