Cracked tooth diagnosis and treatment in Nottingham

Symptoms of a cracked tooth

Cracks are one of the most common — and most frequently missed — causes of tooth pain in adults. Typical signs include:

• a sharp pain when biting down, or when releasing the bite
• sensitivity to cold, and sometimes to sweet foods
• pain that comes and goes and is hard to pin down to one tooth
• discomfort that does not show up on a routine radiograph

Cracks are more likely in heavily filled back teeth, teeth that are clenched or ground, and teeth that have already had root canal treatment without a protective crown.

How cracks are diagnosed

Hairline cracks are rarely visible on an X-ray. Diagnosis relies on a careful history, bite tests on individual cusps, cold testing, dye staining and — most importantly — examination under the operating microscope, which reveals cracks that cannot be seen with the naked eye. Sometimes an existing filling has to be removed to see how far the crack extends.

Treatment options

The right treatment depends on the depth and direction of the crack:

• Shallow cracks in the enamel may need no treatment beyond monitoring or a small filling.
• Cracks into the dentine are usually protected with a crown or onlay that holds the tooth together and prevents the crack from spreading.
• Cracks that have reached the pulp cause pulp inflammation; root canal treatment followed by a crown can often save the tooth.
• Cracks that extend down the root (vertical root fractures) generally cannot be repaired, and extraction is usually the only reliable option.

Because a crack can progress with every bite, prompt assessment gives the tooth the best chance of being kept.

Preventing further cracks

If you clench or grind your teeth, a night guard made by your dentist can protect both the treated tooth and the rest of your teeth. Cracked or heavily filled teeth that have had root canal treatment should be crowned without delay.