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Cracked Tooth

Cracked and fractured teeth are common dental problems. As people retain their natural teeth longer (due to advances in dental technology), the likelihood of cracked teeth increases. There are many reasons why teeth may crack, for example, biting on hard objects, trauma, grinding and clenching of teeth. All of these behaviors place the teeth under extra strain and render them more susceptible to cracking.

When tooth enamel is cracked, pain can become momentarily debilitating. When no pressure is exerted on the crack there may be no discomfort. However, as the cracked tooth performs a biting action, the crack widens. The pulp and inner workings of the tooth then become exposed, and painful irritation occurs. As pressure is released again, the two parts of the crack fuse back together, and pain subsides. If left untreated, the pulp becomes irreversibly damaged and constantly painful. The resulting pulp infection can affect the bone and soft tissue surrounding the tooth.

Symptoms of a cracked tooth may include:

  • Unexplained pain when eating.
  • Sensitivity to warm and cold foods.
  • Pain with no obvious cause.
  • Difficulty pinpointing the location of the pain.

What kind of cracks can affect the teeth?

There are many ways in which a tooth can be cracked. The specific type of crack will determine what type of treatment is viable. In many cases, if the crack is not too deep, root canal therapy can be performed and the natural tooth can remain in the mouth. In other situations, the tooth is too badly damaged and requires extraction.

Here is a brief overview of some of the most common types of cracks:

Crazes – These are generally tiny vertical cracks that do not place the teeth in danger. These scratches on the surface of the teeth are considered by most dentists to be a normal part of the tooth anatomy. A craze rarely requires treatment for health reasons, but a wide variety of cosmetic treatments can be performed to reduce the negative aesthetic impact.

Oblique supragingival cracks – These cracks only affect the crown of the tooth and do not extend below the gum line. Usually, the affected part of the tooth will eventually break off. Little pain will result, because the tooth pulp (that contains the nerves and vessels) will remain unaffected.

Oblique subgingival cracks – These cracks extend beyond the gum line, and often beyond where the jawbone begins. When a piece breaks off, it will usually remain attached until the dentist removes it. Oblique subgingival cracks are painful and may require a combination of periodontal surgery (to expose the crown), and endodontic treatment to place a crown or other restorative device.

Vertical furcation cracks – These cracks occur when the roots of the tooth separate. This type of crack almost always affects the nerve of the tooth. Because the tooth will not generally separate completely, root canal therapy and a crown can usually save the tooth.

Oblique root cracks – These cracks tend not to affect the surface of the tooth at all. In fact, the damage is only apparent below the gum line and usually below the jawbone. Root canal therapy may be possible; depending on how close the fracture is to the tooth surface. However, extraction is almost always the only option after sustaining this classification of fracture.

Vertical apical root cracks – These cracks occur at the apex (tip of the root). Though the tooth does not require extraction from a dental perspective, many patients request an extraction because of the high degree of pain. Root canal therapy alleviates the discomfort for a while, but most often, teeth affected by such cracks are eventually extracted.

How are cracks in the teeth treated?

There are many different types of cracked teeth. Some can only be exposed using X-ray machines, others are clearly visible to the naked eye, while others are not visible clinically or radiographically. In cases where the tooth nerve is affected, root canal therapy is the most viable treatment option. The pulp, nerves and vessels of the tooth will be removed, and the resulting space will be filled with gutta-percha. A crown or filling will be added to stabilize the tooth and it will continue to function as normal.

When the crack is too severe for the tooth to be saved, the dentist or oral surgeon will perform an extraction. There are a number of restorative options in this case, such as bridges, dental implants and partial dentures. All of these structures can restore biting, chewing and speaking functions.

If you have any questions or concerns about cracked teeth, please ask your dentist.

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Testimonials

I have been a patient of Dr. Jeffrey Weiner since 1981. His work is impeccable. He is meticulous and results focused. He is not happy unless you are happy. I have referred many patients over the year to his office. His staff is always accommodating and friendly. I have had to call him and his son Dr. Jason Weiner on weekends and holidays over the years for a dental emergency and they have both responded to me quickly and with concern and advice. I receive compliments every day about my smile and it is because of Weiner Dental.

Mary P., Bensalem, PA

I know from experience that patients at Weiner Dental are very fortunate in knowing that "the apple doesn't fall far from the tree." Dr. Jason Weiner is my primary dentist. He is not only adept in the painless and creative cosmetic work that he has performed on me, his easy manner and confident professionalism allays any anxiety that I may have about any dental problems. Having also been treated by Jason's father, Dr. Jeffrey Weiner, it is evident that a caring attitude and a healing aptitude has been passed on from father to son. That same demeanor seems to be instilled in everyone at Weiner Dental. I sincerely recommend the doctors and staff at Weiner Dental. I believe that they really care.

Edward M., Huntingdon Valley, PA

I have been going to Doctor Weiner for 30 years along with my wife and children. He has always given us the best of care. I do not know t oo many doctors who care so much that they call you at home to check on you. He cares about all people. When Dr. Weiner heard we were going to visit our daughter (who is a missionary in Jaraboca, in the Dominican Republic), he sent dental supplies for the folks down there. Most of them do not have the money for toothbrushes and toothpaste. If you could have seen the look of joy on their faces...it's hard to describe. And his son Jason is following in his father's footsteps. I not only feel like I have a great dentist but a good friend! Thanks Docs.

Robert B., Philadelphia, PA

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