Cracked Tooth

A cracked tooth has a fracture line running through it, often too fine to see with the naked eye or on an X-ray. Cracks range from harmless surface lines in the enamel to deep fractures that reach the nerve or split the tooth. When a crack causes pain on biting, it is often called cracked tooth syndrome. A crack is different from a chipped tooth, where a piece of the tooth has broken away.

Why It Matters

Unlike a broken bone, a crack in a tooth does not heal. It can slowly lengthen with chewing forces. If it reaches the pulp, the nerve can become inflamed or infected; if it extends far down the root below the gum, the tooth may not be savable. Diagnosing and protecting a cracked tooth early gives the best chance of keeping it.

Clinical Details

• Craze lines: Very fine lines in the enamel only. Common in adult teeth, painless and usually only a cosmetic concern.
• Fractured cusp: A corner of the chewing surface breaks off, often around a large filling. Rarely affects the nerve; treated with a new filling or a crown.
• Cracked tooth: A crack runs from the chewing surface down towards the root without separating the tooth. Treated with a crown to hold it together, plus root canal treatment if the pulp is involved.
• Split tooth: A crack that has progressed until the tooth separates into segments. Usually it cannot be saved intact; sometimes part of it can be kept.
• Vertical root fracture: Starts in the root and often has few symptoms until the gum or bone around it becomes infected. Usually requires extraction.
• Typical symptoms: Sharp pain when biting, especially on releasing the bite; brief pain with cold; pain that comes and goes and is hard to pinpoint.
• Common causes: Large fillings that weaken the tooth, clenching or grinding, biting hard objects, and trauma.
• Diagnosis: Bite tests on individual cusps, magnification, transillumination (shining a light through the tooth) and checking for deep, narrow gum pockets.
• Protecting the tooth: A full-coverage crown is the usual way to hold the cusps together. A night guard may be advised if grinding is a factor.

FAQ

What does a cracked tooth feel like?

Usually a sharp, unpredictable pain when chewing, often felt as you release the bite, and short-lived sensitivity to cold. The pain is typically not constant, which is why cracks are easy to miss.

Can a cracked tooth heal on its own?

No. There is no natural or home remedy that repairs a crack. Treatment aims to stop it spreading and protect the nerve.

Can a cracked tooth be fixed?

Many can. A crown is often used to hold the tooth together, with root canal treatment if the nerve is affected. Most treated cracked teeth function well, although some cracks continue to progress despite treatment.

Does a cracked tooth need to be pulled?

Only if the crack extends deep below the gum line or into the root, or the tooth has split. A crack confined to the crown of the tooth can usually be restored.