Advancements in medicine have increased our life spans and dental procedures have kept up to prolong the shelf-life of our natural dentition. But life brings stresses, and our teeth hold the memory of our troubles. Stress-related habits such as clenching or grinding can cause teeth to crack. Eating hard foods combined with a rising proclivity for acidic or acid-producing diets leads to rapid dental wear and tear.
Not all cracks are equal. Some require no treatment and others require endodontic therapy (usually a root canal). In some instances, an extraction is the only option.
But why does this hurt so much?
Pain is the typical impetus for a cracked-tooth-related dental visit. Cracks are inconspicuous and blend into teeth, going unnoticed until the pain makes itself a part of daily activities.
Our teeth are highly vascularized. When a crack progresses to or near the pulp, the nerve endings in the pulp fire up are cause pain. This pain is exasperated by activities like chewing and eventually by extreme temperature changes in food. Over time, the pain manifests as a constant throbbing or bouts of spontaneous sharp jolts.
A crack is a wound in the body. Think of a cut – as it goes deeper and deeper, it hurts more and more. Unlike our skin though, a cracked tooth cannot heal itself and actually progresses over time.
Early diagnosis of a crack is by far the best way to save a tooth. This is why visiting a dentist regularly is essential. They can stymie cracks, decay or other dental problems with early detection.
Craze lines are a type of crack that remains in the upper enamel layer. They are increasingly common with advanced age. Beyond aesthetic woes, craze lines cause no symptoms and need no treatment.
Our cusps are the chewing points of our teeth. They engage with the opposite arch when we bite, talk, clench or grind. A cusp can weaken and chip off. When the segment is removed, either as a result of normal activity or by the dentist, pain is relieved. The typical methods to replace the segment are a filling or crown. If gross tooth structure is lost, a crown may be the only option. In extreme cases, an extraction may be indicated.
A fracture that extends through the tooth without separating the tooth into two segments is called a cracked tooth. If the crack extends deep beyond the gum line, an extraction is often necessary. If the crack remains in the crown portion, a root canal would be needed, followed by some sort of crown to protect the delicate pulp.
A split tooth occurs when a crack extends through the entire tooth, splitting it into two segments. In multi-rooted teeth, a portion of a tooth may be saved. An extraction is the most common treatment option and solution.
Vertical Root Fracture
A vertical root fracture is a crack that begins in the root and progresses up towards the crown. This separates it from the other cracks listed thus far. These cracks are detected on an x-ray or become notable due to pain, infection or swelling. Treatment would involve a root canal if the crack is isolated to a small portion of the tooth; that portion is removed, and the rest of the tooth left in place. The other treatment modality is an extraction.