Cracks in teeth are common. There are 5 types of cracks, and each type can cause a wide range of symptoms. Symptoms may include increased thermal sensitivity, pain when biting or upon bite-release, intermittent pain, and a localized swelling in the gum tissue adjacent to the tooth. Some but not all cracks present in locations that can be visualized.
When a cracked tooth is suspected, an endodontic evaluation including a clinical exam and a 3D radiographic exam is recommended, as this evaluation will help determine the possible location and severity of the crack, as well as the best treatment plan to address your symptoms. Depending on the type of crack, its location, and its severity there may be the need for a crown with or without root canal treatment or tooth extraction, as not all cracked teeth can be saved.
The 5 types of cracks are listed and described below:
Craze Lines: Craze lines are superficial lines or indentations in the outer-most layer of teeth. Usually, they appear with age, and usually, they result in no symptoms and require no treatment.
Split Tooth: A split tooth results from an untreated crack in the clinical crown of a tooth, which has progressed down the tooth and root in the vertical direction. A split tooth usually requires extraction of the tooth and root, as it typically renders the tooth non-restorable or not savable.
Vertical Root Fracture: A vertical root fracture, unlike a split tooth, originates on the root surface and progresses in the vertical direction, along the root. A vertical root fracture usually occurs in endodontically treated teeth, particularly in teeth that have received posts following endodontic treatment. A vertical root fracture may result in no clinical signs or symptoms, but there is usually radiographic evidence of a vertical root fracture. The presence of a vertical root fracture often necessitates tooth extraction.
Cracked Tooth: A cracked tooth is the most common type of crack. It begins on the biting surface of the clinical crown of the tooth, that portion of the tooth that is above the gumline, which is visible to us. If the crack remains above the gumline, usually the cracked tooth can be saved, but if the crack extends below the gumline, treatment, especially endodontic treatment, becomes less predictable.
Fractured Cusp: A fractured cusp is the result of weakness in the biting surface, which causes a portion of the clinical crown to fracture. Sometimes this type of fracture does not expose the dental pulp, and therefore, it may only necessitate a prosthetic crown. However, sometimes a cusp fracture exposes the dental pulp, and root canal treatment becomes necessary.