Cracked Tooth? Causes, Treatment & Repair

By: Dr. David Rice

When it comes to cracked teeth, is there any truth to the old saying, “If it’s not broke, don’t fix it?”

Likely not. Let’s take a closer look.

Types of Cracked Teeth

First, there are different types of cracked teeth.

1. Craze Lines

There are very superficial cracks in teeth your dentist or hygienist will call craze lines. Craze lines happen as we age. They happen from the cycling of hot and cold in our mouths.

In essence, for most, they are a normal function of using our teeth over time.

So, if you go to your favorite dental professional and you hear them speaking about craze lines, have no fear. No treatment is needed. You’re just fine.

2. Horizontal Fractures

The second type of cracked teeth is teeth that have horizontal fractures.

Horizontal fractures mean if you’re looking in the mirror, the crack goes from side to side.

The seriousness of this type of cracked tooth is location-based.

If the horizontal fracture is near the edge of your front tooth or the biting surface of your back tooth, it is most often fixable with a filling or a crown alone.

If the horizontal fracture is closer to your gum line, yet still where you can see it, you will likely need a root canal and a crown. The good news is, it is most often fixable.

Lastly, if the horizontal fracture is at or below your gum line, your tooth will likely need to be removed.

3. Vertical Fractures

The third type of cracked teeth is teeth that have vertical fractures.

Vertical fractures are more serious and most often lead to tooth loss.

Causes of Cracked Teeth

1. Trauma

The number one cause of cracked teeth is trauma, and trauma comes in many forms.

Trauma can be from falling off a bike, getting hit in the face in sports, or even from playing with a pet.

With just those few examples, you can imagine the severity of the cracked tooth is dependent on what your mouth hits/hits your mouth, along with how much force is associated.

Consulting your dentist as soon after the trauma will help.

Based on your description of the trauma, your dentist may recommend you go to the closest emergency room, come into the practice right away, or come to the practice in the following days.

2. Eating Hard Foods

Other types of traumas come from hard foods we eat-like a bone in a piece of meat for example.

They may also come from chewing ice-please don’t chew ice-it seems fun until you’re in my chair with pain and an expensive problem.

3. Bite, TMJ, or Sleep Apnea Related

Still, other types of traumas can be bite, TMJ, or sleep apnea related.

Many patients with bite issues, jaw joint issues, or sleep issues grind their teeth.

Teeth clenching or grinding is traumatic and can crack teeth just like the other forms of trauma noted above.

Please consult your dentist if you feel you clench or grind your teeth.

Cracked Teeth Symptoms

One of the greatest challenges with cracked teeth is they’re often hard to find.

That means your symptoms and your ability to share what you feel with your dentist really count.

Here is a list of symptoms you might feel.

What you feel and how intense you feel it is what you want to relay to your dentist.

  • Temperature sensitive
    • How intense is your discomfort?
    • How long does it last?
  • Bite-sensitive
    • How intense is it?
    • Is it more intense when you bite down?
    • Is it more intense immediately after you stop biting?
  • Your teeth may hurt with no stimulation at all.
    • Do your teeth hurt when you are doing nothing?
    • How intense do they hurt?

Fixing Cracked Teeth

1. Diagnosis

The first part of a dentist fixing your cracked tooth is your dentist diagnosing your cracked tooth.

As I mentioned above, often the diagnosis part is the difficult part.

Your dentist will likely take one or more X-rays. If you see a dentist who has the ability to take a 3D x-ray, they’ll be better able to find those hard-to-find cracks.

Determine the Type of Crack

Your dentist will also have you bite down on a soft instrument designed for you to bite down on.

Don’t worry. This will not make your crack worse. It will help determine if you have a cracked tooth.

It will also help determine if that crack is horizontal or vertical.

Remember-often times, horizontal cracks can be fixed, and most often vertical cracks cannot.

This test is very important along with your x-ray as it helps you not spend money and time on a problem if your problem is a vertical fracture.

Test for Hot & Cold Sensitivity

Lastly, your dentist will often test your cracked tooth to hot and cold.

It is normal for your tooth to feel cold.

It isn’t normal for your tooth to feel cold for a minute or longer after the cold source is taken away. When that happens, your dentist will be concerned the nerve in your tooth is involved.

2. Fixing the Cracked Tooth

The second part of a dentist fixing your cracked tooth is the actual fix. Let’s come full circle to where we began-types of cracks.

Craze Lines Treatment

If your cracked tooth is superficial-craze lines-your dentist will most likely review what you eat and drink-they’ll make sure you don’t have any out-of-the-ordinary habits that can’t be helped and they’ll smile and share there’s nothing to worry about.

Horizontal Crack Treatment

If your cracked tooth is more involved and horizontal, your dentist will locate the crack and based on its location, likely recommend a filling or a crown.

Vertical Crack Treatment

If your cracked tooth is very involved and vertical, your dentist will likely talk to you about the risks of keeping your tooth versus removing the tooth before it becomes infected.

Please note, if you do need to lose a cracked tooth, your other teeth will move if you don’t replace it. This is sometimes difficult to hear as dental implants and bridges can bring significant costs.

Know from my twenty-eight years that if I could have every patient who waited to replace their tooth have a conversation with you, they would all recommend being proactive.

In Summary

If you have had any form of trauma, if you have pain, if you have swelling, or if something just doesn’t feel right, your safest bet is to have your dentist evaluate you.

The best news I give is good news that little to no treatment is needed.

The hardest news I give comes when patients hope their problem goes away on its own.

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David Rice

David Rice

Founder of the nation’s largest student and new-dentist community, igniteDDS, David R. Rice, DDS, travels the world speaking, writing, and connecting today’s top young dentists with tomorrow’s most successful dental practices. He is the editorial director of DentistryIQ and leads a team-centered restorative and implant practice in East Amherst, New York. With 27 years of practice in the books, Dr. Rice is trained at the Pankey Institute, the Dawson Academy, Spear Education, and most prolifically at the school of hard knocks.