A cracked or fractured tooth is a common dental problem that requires root canal therapy. A tooth can crack for many reasons, including grinding, clenching, biting on hard objects and trauma. All of these behaviours put extra stress on the teeth, which makes them more prone to cracking.
A tooth crack can widen as you use that tooth to bite or chew. This puts the pulp inside the tooth at risk of being exposed. You may feel discomfort when there is pressure on the crack, and the pain can subside when the pressure is released. If the crack is left untreated, the pulp can be damaged, causing you constant pain. The pulp infection can also affect the tissue and bone around the tooth.
What Kind of Cracks Can Affect the Teeth?
There are different types of tooth crack and the type will determine what type of treatment is needed. If the crack isn’t too deep, a root canal can be done to save the natural tooth. If the crack is too extensive, the tooth may need to be extracted.
Small vertical cracks or scratches on the surface of the teeth that are considered part of the tooth anatomy. Crazes rarely require treatment, but there may be optional treatments to improve the appearance.
Oblique Subgingival Cracks
These cracks extend below the gum line and sometimes even to the jawbone. A piece that’s broken off will typically stay attached until the dentist removes it. This type of crack is painful and can require periodontal surgery and root canal or other restorative methods.
Vertical Furcation Cracks
Occur when the tooth’s roots separate. This type of crack typically affects the nerve of the tooth. Since the tooth won’t separate completely, a root canal and crown can save the tooth.
Oblique Supragingival Cracks
Only affects the crown and do not extend below the gums. Typically, the affected part eventually breaks off. This type causes little pain because the pulp is unaffected.
Vertical Apical Root Cracks
This type of crack appears at the tip of the root. Although an extraction is not required from a dental perspective, patients often request one due to the amount of pain. Root canal therapy can temporarily ease the pain but eventually, the tooth is often extracted.
Oblique root cracks
Most of the damage is below the gum line and rarely affects the surface of the tooth at all. Depending on how deep the crack is, a root canal may be a viable option. However, tooth extraction is the most common treatment for this type of fracture.
How Are Cracks Treated?
Some cracks can only be seen with an X-ray machine, while others are visible to the naked eye. If the crack affects the root of the tooth, a root canal is the recommended treatment option. The pulp, vessels and nerves will be removed and the space will be filled with gutta-percha. A filling or crown will be applied on top to restore functionality.
If the crack is too extensive for the tooth to be saved, a tooth extraction is usually performed. To restore functionality and aesthetics, bridges, dentures or dental implants may be recommended.