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Cracked Tooth and Teeth

What is a cracked tooth?

A cracked tooth is defined as a tooth that has a fracture, split, crack or craze running somewhere through it.  A tooth fracture can exist inside the tooth or in the outer tooth covering.  The crack can run in any direction, can penetrate through the whole tooth, or just a portion of the tooth.

Some dentists will take a very aggressive approach to a cracked tooth, while other say just wait for the tooth bit to fall off and repair it then.  Which direction your dentist takes may be determined by the presenting symptoms and the area of the tooth he thinks may be at risk.

However, there are risks in leaving a cracked tooth untreated.  It can tooth can crack further compromising more of the tooth, there is more possibility of infection setting in, the tooth may even split in half requiring the whole tooth to be extracted.

Internal cracked teeth

A tooth with an internal crack is not likely to become infected, not likely to be affected by heat, nor cold, nor sugary foods.

In fact I've had a crack inside my tooth for some time now. The main symptom of an internal cracked tooth for me is the ocassional grimace of pain when biting down on something hard in just the right way.  Otherwise the tooth causes no problem, no ongoing toothache, so my dentist said just to leave it. 

Eventually, maybe in several years, the internal tooth fracture will grow and take a piece of the tooth with it, but it should be easy enough to repair then.  This may change from person to person dependant on where the crack is.

The crack doesn't always show up on xrays nor dental examination, as it depends on which way the crack is running and what fillings are in the tooth already, whether the crack is internal or external, so the diagnosis is made on symptoms to a large extent.

If the tooth causes more constant or more frquent episodes of pain, then the dentist may want to fix the cracked tooth straight away.


External Cracked teeth or tooth symptoms

Sharp pain when biting on something hard is a symptom of a cracked tooth.

Toothache when the tooth is exposed to heat or cold is another cracked tooth symptom.

Toothache to sugary foods, again another symptom of a cracked tooth.

An odd cracked tooth symptom is that you may not be able to tell which tooth is troubling you.  This is partly because tha pain may be absent for the most of the time and only present for a few short seconds.

Other cracked tooth symptoms include:

More likely to show up in dental examinations or X-rays.

If the crack goes under the gum line, there is the risk that germs will get into the gum, causing toothache and pockets of infection - which may have symptoms of pain or odor.

Risk of disease entering the tooth, causing toothache.


Causes of cracked teeth

A cracked tooth can be caused by something coming into contact with the mouth, like a fist, cricket or baseball bat or hard object.

A crack tooth can also be caused by a filling causing a weakness in the tooth, which then develops a crack - like when the tooth has a large filling in it.

Bruxism also known as teeth grinding, can cause many teeth to crack and break and abnormally wear down.

Hard lollies, hard foods, hard ice, when bitten down on can cause cracks in teeth to develop.

Just the normal prolonged wear and tear of living longer can cause teeth to crack.


Preventing cracked teeth

Pretty straight forward, avoid the causes as much as possible.  Bruxism can be treated via a night mouth guard, contact sports via a properly fitted mouth guard.  Keep teeth clean to prevent cavities, which in turn requires fillings, which in turn may sometimes weaken a tooth and make it ripe for developing a crack.


Diagnosis of a cracked tooth

As stated above, the diagnosis of a cracked tooth is made on the presenting symptoms.  What needs to be added to that, is that it includes the what isn't found.

The dentist needs to rule out several competing diagnoses.  Is there a cavity, an abscess, a crack in a filling, an alignment problem, with a tooth or teeth in that area of your mouth.

Normally if something else is found, the symtpoms will be put down to that.  If the symptoms persist after all teeth have been fixed up, then the diagnosis of a cracked tooth is more likely.


Cracked tooth Treatment

The treatment for a cracked tooth depends on how aggressive your dentist is in wanting to repair and how much toothache of other discomfort the tooth or teeth are causing you.

When your dentist decides it is time to do something about the cracked tooth

If one cusp of the tooth is compromised by the crack, the treatment will more than likely involve removing the weakened area and filling it with a large filling.

If more than one cusp is compromised by the crack, then the remedy is normally an expensive crown, with much of the tooth removed in the process.

If the dentist pursues the idea of a crown being the viable option for your cracked tooth, then decisions have to made about whether the cracked tooth or teeth will need root canal work first - which is another procedure entirely. Each cracked tooth to be crowned may be checked to see if it can be stopped from aching by the use of a special sedative dressing, bound in place by a steel band.  If  the toothache cannot be stopped, then root canal work is needed first, before the crown is put on.

Sometimes the dentist will be able to tell you that you will need root canal work on your cracked tooth, because they found that the pulp of the tooth has been compromised through the crack.

Warning:  If the crown is put on and then it is decided that root canal work is needed, the expense can soar through the roof, as the crown either has to be drilled through or removed, either way it runs the very real risk of the crown being destroyed - about $2,000 down the drain.

For the sake of a few hundred dollars, some will choose to have the root canal done first, to be on the safe side.

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