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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

I had a crown that was done about four months ago and it started hurting real bad. It felt like I was being hit in the face with a wet sock full of nickels. I yelped Endodontist and saw Dr. Cancellier's great reviews and he was one of the few doctors open at 8am. They were able to see me the same morning I called and he accessed my tooth and set an appointment for the next morning for the root canal. I heard so many horror stories about root canals so I was scared and nervous. Dr. Cancellier explained the whole process and told me not to worry because he would make it as pain free as possible. He wasn't lying. I fell asleep a couple of times during the procedure cause I was so comfortable. He gave me some pain meds for afterwards when the mouth numbing wears off but I didn't need it at all. Painless during and after. It was an awesome experience. If you need a root canal, save yourself some tears and pain and call this guy right now.

M.C.

I went to another dentist and was told I needed a ton of dental work to fix a bad root canal, including an extraction and an implant. Well, I am the biggest chicken when it comes to any dental work, so I thought I needed a 2nd opinion. I was so lucky that a friend’s dentist Dr. Uchizono referred me to Dr. Cancellier. Dr. Cancellier had to do a lot of scary things to my tooth, but he did save it. I went in for 2 procedures. I felt no pain. (Not even the shots, which usually take me over the edge). Dr. C and his staff were so nice and caring. I got a phone call the day and a few days later checking on me. I told them I could not believe that I was ok. I laughed and said the only problem I had was that I needed to go in for a massage after the 1st procedure because I was so tense that my shoulders needed to be worked on. The 2nd procedure went as smoothly as the first one. The only difference was that I did not need a massage, because I knew that I wouldn’t feel any pain. Thank you Dr. C for taking such good care of me and for saving me a ton of money and more, for saving me from experiencing pain.

N.A.

My dentist sent me to Dr. Cancellier for a bad root canal performed by an out of state endodontist. He was very gentle and took a lot of time with me. He noted that I had a significant amount of infection in my sinus and requested that I see an ENT before treating me further.

Later, it was determined I needed another root canal on another tooth which was discovered after I had returned to Dr. Cancellier after nasal surgery because the nerve had died. I was not looking forward to it because of the poor experience I had with a root canal at the other endodontist. The experience I had with Dr. Cancellier couldn't have been different. Both Dr. and staff were gentle and the procedure was done in half the time and with virtually no discomfort. I walked out of his office an extremely happy person.

C.H.

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