Cracked teeth are more common than you might think. Largescale research carried out in the US in 2018 found that out of the 14,386 molars examined, 4504 (or 31%) showed signs of crack tooth syndrome.
Cracked tooth syndrome (CTS) is challenging to identify because the crack is often very small (sometimes too small to locate using x-ray equipment) or occurs under the gum line, so it can’t be seen.
As a result, patients typically show symptoms of intermittent pain for months before any cracked teeth are identified.
That said, there are some key tell-tale signs.
Symptoms of cracked teeth
Any discomfort with cracked tooth syndrome can result in sudden but sharp tooth pain when biting into food or when teeth are exposed to hot or cold temperatures. As such, it often gets dismissed as a one-off problem meaning that people are typically reluctant to follow it up with a trip to an emergency dentist.
In other cases, CTS often presents the same discomfort that stems from other problems such as sinusitis, TMJD, headaches, ear pain or atypical orofacial discomfort. An incorrect diagnosis can lead the patient to seek treatment for these problems rather than the source of the issue of cracked teeth.
Nonetheless, if crack tooth syndrome is not dealt with, the tooth crack can get larger over time, resulting in more significant discomfort and an increased risk of developing a tooth infection. Typically, our No Gaps Dental Teams see many patients at this stage of the problem as a dental emergency.
The most commonly affected teeth are mandibular second molars, followed by mandibular first molars, then maxillary premolars. The ease of diagnosis can depend on the whereabouts of the tooth fracture.
So how do you diagnose CTS?
Cracked teeth diagnosis
We’ve already mentioned that crack tooth syndrome (CTS) can be challenging to diagnose; however, the detection of slight cracks can be achieved using a combination of
- A thorough oral examination
- sound knowledge of the patient’s oral history (patients with a history of cracked teeth are typically predisposed to develop others), and
- the use of a fibre-optic light and magnification known as transillumination.
A word about transillumination
Fibre-optic light is one of the best ways to detect crack tooth syndrome early. When the tooth is cleaned and a light source placed on it, most cracks will appear when used in conjunction with magnification, making them easier to spot and treat.
So now we know what CTS is, how it’s diagnosed and what causes it
As with many oral conditions, multiple possibilities can cause a tooth to crack, but some common causes include:
- Habitual behaviours like nocturnal teeth grinding (known as bruxism)
- Teeth that are not aligned adjacently (This problem can place excess force on teeth, thus causing them to crack)
- Teeth that have noticeably large fillings (these teeth are generally weaker and, therefore, prone to cracking)
- Teeth that have previously undergone root canal therapy
Behaviours like jaw clenching or teeth grinding can sometimes place excess pressure on teeth 100% more than normal biting. The same goes for teeth that are not adequately symmetrical. When mastication occurs in misaligned teeth, adjacent teeth can be prone to micro-cracking because uneven force is applied. This leads to crack tooth syndrome.
Treatment for cracked teeth
Typically patients seek treatment for cracked teeth when the pain becomes more constant, and they need to see an emergency dentist for a same-day appointment. Inevitably, CTS treatment will depend very much upon how large and troublesome the tooth cracks are.
For example, if cracked tooth syndrome is picked up early, applying composite bonding to the crack should be sufficient to protect the tooth and stop the damage from becoming larger.
On the contrary, when cracks become more extensive, they may require protection from a dental crown, or a root canal if the tooth has become infected, or, in a worst-case scenario, the tooth may be beyond repair and need extracting during a dental emergency appointment.
Inevitably, the sooner crack tooth syndrome is noticed, the quicker, less invasive and less costly treatment is likely to be.
So how do you prevent CTS in the first place?
Teeth are remarkably strong, but if you’ve suffered previously with cracked teeth, are prone to jaw clenching, or teeth grinding, or regularly use teeth for anything other than biting or chewing food, it’s best to book regular six-monthly dental check-ups.
Dentists are becoming more aware of cracked tooth syndrome and the problems it causes, so regular check-ups enable the dentist to pick a tooth problem up sooner rather than later.
As a top tip, don’t forget to talk to your dentist if you’ve been diagnosed with bruxism, have a history of cracked teeth, or are acutely aware of any tooth sensitivity, no matter how sporadic. Your dentist can help to prevent cracked teeth by issuing a custom nightguard to prevent damage during bouts of teeth grinding.
Ultimately, the last thing you want is to contact your emergency dentist for dental emergency treatment, as this inevitably means that the cracked tooth is no longer a minor issue and further treatment is required.
If you want to know more about crack tooth syndrome or would like to book in for an overdue check-up, contact our team at No Gaps Dental on (02) 8007 6727. With 15 conveniently located dental centres to choose from, getting a dental check-up here in Sydney couldn’t be easier. Get in touch and experience peace of mind knowing that your smile is in its best health.
Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.
References
Dentistry IQ – Cracked Teeth – A more Serious Problem in 2018 than in 1964
https://www.dentistryiq.com/dentistry/article/16367380/cracked-teeth-a-more-serious-problem-in-2018-than-1964
PubMed – Diagnosis of a cracked tooth syndrome
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3467890
PubMed – Bite Force And Influential Factors on Bite Force Measurements
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2853825/#:~:text=They%20have%20concluded%20that%20bite,clenching%20compared%20to%20unilateral%20clenching