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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. In the absence of pressure 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 cases where 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, while others are clearly visible to the naked eye. In cases where the tooth root 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 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 contact our office.

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Testimonials

Dr. Hekmat and all of his staff are gentle and friendly. They take the fear out of going to the dentist. He has done quality work on my teeth for the last three years and fixed problems I had from previous, poor quality dental work too! I am more than willing to drive 40 miles from where I live because I've never had such a great dental experience anywhere else!

Taylor w

Dr. Hekmat is absolutely wonderful, I couldn't imagine going to anyone else. He and his entire staff are caring and knowledgable; the quality of care is as good as it gets.
This is not your typical dentist experience. When I walk in today for my appointment, there was no check-in process- the assistant working at the front desk recognized me and told me the hygienist would be with me shortly (2 minutes later, right on time). They actually take the time to get to know their patients, which is especially comforting for those of us who get a little antsy when it comes time for a dental appointment.
The facility is top-notch. It's incredibly clean, TV in the lobby, and the chairs have massagers in the back so you can focus on something besides having your teeth cleaned. The pictures on their website might look too good to be true, but it's just genuinely that nice.
Dr. Hekmat and his staff are all phenomenal. They know what they're doing, take the time to explain what they're doing, and to answer questions. I would recommend Dr. Hekmat to anyone looking for a dentist or to change dentists, he's the best!

Chelsea S.

Dr. Hekmat's offices are so clean, soothing, and modern that it almost (ALMOST ... it's still the dentist!) feels like visiting the spa when you visit. I drive up all the way from the UTC area because I trust him and his staff with my teeth and my jittery nerves! They even take a photo of you at your first visit, so that when you come back, the receptionist greets you by name and already knows who you are - very welcoming, and a unique touch. Even the lighting is warm and relaxing, and the view from the chair is of a large, grassy pond filled with ducks.

Dr. Hekmat himself is friendly, calming, and talented. He replaced several silver filings with white filings for me - and he was really, really fast. Which was really appreciated by me, because I'm a big baby when it comes to the dentist. Several months later, and I'm silver-free and my filings have done great.

Ann M.

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