Cracked / Heavily Filled Teeth
Over time miniscule cracks can develop in the surfaces of your teeth, and although they might seem insignificant they can to quite a lot of damage. Even though tooth enamel is the hardest substance in the human body, general wear and tear can expose the teeth to a variety of different stresses leading to a condition called cracked tooth syndrome. Cracked teeth are quite different from the crazing you might see in your dental enamel, and which can often develop as part of the aging process.
Who Is More at Risk of Having Cracked Teeth?
Cracked teeth most commonly occur on the lower back teeth in the molars as these come under considerable forces during chewing.
People with bruxism and who clench or grind their teeth are more likely to have cracked tooth syndrome.
Sometimes people's teeth can meet together incorrectly, putting too much pressure on one or more teeth that can cause them to crack
Heavily filled teeth are more likely to crack as the lack of tooth structure makes them weaker than other teeth.
People who have cracked teeth are more likely to have several rather than just one, or will go on to develop more cracked teeth in the future.
What Are the Symptoms of Cracked Teeth?
A tooth with micro fractures can sometimes hurt when you bite down or chew and this pain may be fleeting and intense or it might last for quite some time. Sometimes it can be particularly painful if you eat certain foods, especially if they are particularly hot or cold. The reason for this is that every time you bite down on the tooth these tiny fractures will open up slightly allowing foods to penetrate the tooth, and allowing bacteria to get into the tooth.
Every time you bite down on a cracked tooth then it will affect the underlying dentine and could cause it to move slightly. There is the danger that this will irritate the pulp chamber right in the centre of the tooth and which contains the nerves. If the tooth isn't treated then there's the possibility the pulp will become damaged and that the tooth will need root canal therapy to remove the pulp and clean out the pulp chamber.
Diagnosing Cracked Teeth
Your dentist will carefully examine your teeth and might use a sharp instrument to feel if there are any cracks in the affected teeth. Your dentist might ask you to bite down on a dental instrument to see if it causes any pain in order to identify cracked teeth. One of the main problems with these tiny cracks is that they often don't show up on dental x-rays so diagnosis can sometimes be quite tricky.
Different Types of Cracked Teeth
There are different types of cracked teeth that require different treatment plans and these include:
Fractured cusps where the raised points of the chewing surfaces of the back teeth are fractured or broken off. Treatment may involve having an onlay, or if the damage is extensive it might be necessary to crown the tooth, especially if it is already heavily filled
Vertical fractures in the teeth can begin right from the root of the tooth working their way up to the dental crown. One of the problems with this type of fracture is that it can often create very few symptoms and will only be discovered when the bone and gum becomes infected. It might be necessary to remove the tooth, or endodontic surgery might be able to save part of the tooth.
Cracked tooth where the crack extends from the crown of the tooth down towards the root. If the crack is treated early enough than the tooth can be saved with root canal therapy, but if it extends below the gum line then the tooth will probably need to be extracted.
Split tooth is where a crack has progressed to separate the tooth into distinct segments. It might be possible to save part of the tooth with root canal treatment.
Once a tooth is cracked it cannot heal, and unless it's treated the cracks may continue to progress eventually resulting in the loss of the tooth. Protecting the tooth with a crown will give it maximum protection but might not always be enough to save the tooth. However most cracked teeth can be properly restored and will continue to function normally.
Protecting Your Teeth against Becoming Cracked
Protecting the teeth against excess pressure created during clenching and grinding will help prevent any fractures from becoming any worse. One way to do this is for your dentist to make a night guard that prevents the teeth from coming into contact during the night. If you clench and grind during the day then you might need to wear this appliance during waking hours.