What Is It?
It’s actually no wonder there are so many cracked teeth. Teeth are subjected to great forces daily plus large temperature changes. So much so that almost everyone has cracks in their teeth. These cracks can be very painful and causes what dentists call “cracked tooth syndrome.” They also can be no problem at all. Here are some of the details.
Why Is It
Cracked tooth syndrome is most commonly found in lower back molars. That’s because these teeth repeatedly absorb more of the forces of chewing than the others.
Many people grind or clench their teeth. This is a Big Problem in many ways. These people are highly likely to have cracked tooth syndrome. Sometimes how a person’s teeth come together can cause too much pressure on one tooth or just one point. This concentrated pressure can cause the teeth to flex too much and break.
Teeth with large fillings are weakened and are also very likely to crack. This applies especially to teeth with old silver mercury fillings. These fillings expand and contract and stress the tooth.
How To Tell
You will probably find that the tooth hurts at times when you bite or chew. The sensitivity or pain can be intense. People call it a “shooting pain’. It may be painful only when you eat certain foods or when you bite in a specific way. It is a different feeling than you would have if you had a cavity or infection. The tooth may also be especially sensitive to cold temperatures.
As the crack gets bigger, sometimes a piece of the tooth breaks off. You may also develop swelling of an infection. This can happen in the gum around the fractured tooth. You may even notice a pimple-like bump that drains on the gum near the tooth.
Many people with cracked tooth syndrome have painful symptoms on and off for months. Cracked tooth syndrome is one of the most difficult dental problems to diagnose because the pain is not consistent. That makes it very hard to be sure of the problem.
Finding It
Your dentist will examine your mouth and teeth, focusing on the tooth in question. He may use a pointed instrument called an explorer to feel for cracks in the tooth. Your dentist will also check the gums around the tooth. He may have X-rays taken, but X-rays often do not show the crack.
Your dentist may use a special instrument to test the tooth. It looks like a toothbrush handle but without bristles. It fits over one part of the tooth at a time as you bite down. If you feel pain, the part of the tooth being pressed most likely has a crack in it.
Prevention
If you grind or clench your teeth, talk to your dentist about treatment options. Grinding does increase your risk of cracked tooth syndrome. Here in my Encino dental office I can make a night guard to prevent grinding of your teeth. This will relieve the pain from grinding and sore muscles. For some people it can also stop tooth sensitivity. The night guard can be worn during sleep. It also can be worn at other times if clenching or grinding happens during waking hours.
Treatment
Treatment depends three thing that tell the story. 1. How large is it 2.Where the crack is located and 3. How deep the crack is. In my Encino Dental Office I take a history to answer these questions first thing.
Sometimes a crack starts with one or more high spots of a tooth. In this case situation the tooth may be fixed with a crown. Some cracks affect the nerve at the center of the tooth. In that case, the tooth will need root canal treatment and a crown.
In some cases, the tooth may need to be removed. Some cracks affect the root of the tooth into the jaw. There’s no way to fix this type of crack. If your tooth is removed, you can have it replaced with an implant or a bridge. We can discuss it in my dental office here in Encino.
When To Call Me
If you feel sharp pain when you bite or chew, contact me ASAP. The problem just gets worse. Treatment of cracked tooth syndrome is not always successful. I will talk with you about the alternatives that might happen and your treatment options.
Tip of the Day: Keep your tooth brush where it will be dry. There should also be air circulation. Kept dry, a brush will have a lower bacteria count.
Allan Melnick, DDS
