Cracked tooth: symptoms, repair options and what to do now

How to tell if your tooth is cracked

A cracked tooth often hurts when you bite down and then lets go. You may also feel a sharp zing from cold or sweet drinks. Sometimes the pain comes and goes for weeks, which makes it hard to find. If that sounds like you, see a dentist soon, because a crack gets worse over time.

Cracks can start from a hard bite on ice or a popcorn kernel, grinding your teeth at night, an old large filling that weakens the tooth, a hit to the face or even sudden changes from very hot to very cold. Back teeth crack most often because they take the most chewing force.

You cannot always see a crack, and an X-ray often does not show it either. Dentists find them with a close look, a bite test, special lights and dyes and by checking the gum for a deep narrow pocket next to the tooth.

Pain that comes and goes is common with cracks. The crack closes and opens as you chew, so you may feel nothing for days, then a sharp jolt. That is why many people wait too long. If a tooth hurts the same way more than once, treat it as a real problem, even when it stops.

The five types of cracks

The American Association of Endodontists, the root canal specialists, groups cracks into five types. The order runs from the best outlook to the worst, as described in this guide from Spear Education.

• Craze lines: tiny cracks in the outer enamel. They are very common, they do not hurt and they usually need no treatment.
• Fractured cusp: a piece of the chewing surface breaks off. It is often fixed with a crown or an onlay, and the pain is usually mild.
• Cracked tooth: a crack runs from the chewing surface toward the root. Many of these can be saved with a crown, and sometimes a root canal first.
• Split tooth: the crack has spread so far that the tooth has two parts. This is usually the end result of an untreated crack, and the tooth often cannot be saved.
• Vertical root fracture: a crack that starts at the root and moves up. It can have few signs at first, and the usual treatment is to take the tooth out.

Why you should not wait

A crack that is small today can be a split tooth in a few months. Every time you chew, the two sides of the crack flex a little. Bacteria slip into the crack and can reach the nerve inside the tooth. That is when the pain gets worse, and when a simple repair becomes a root canal or an extraction.

Cleveland Clinic notes that a toothache caused by infection or damage does not heal on its own. A cracked tooth is a good example. The sooner a crack is diagnosed and treated, the better the outcome is likely to be.

There is also a point of safety. If a piece of tooth breaks off and the tooth is sharp, it can cut your tongue or cheek. If you are in a lot of pain, or you see swelling, call a dentist the same day.

Think of a crack in a car windshield. A small chip can sit for a while, but a bump or a change in temperature can make it run across the glass. A tooth crack behaves in a similar way. The sooner you protect it, the less likely it is to spread.

How dentists repair a cracked tooth

The repair depends on the type of crack and how deep it goes. Your dentist will explain the choices, and you should hear the pros and cons of each before you decide.

For a small chip, tooth-colored bonding or a filling may be enough. For a crack that runs deeper, a crown is the most common fix. A crown is a cap that wraps around the whole tooth and holds the sides together so they do not flex. If the nerve is infected or badly irritated, a root canal comes first, and then the crown goes on.

When the crack goes below the gum line or splits the root, the tooth usually cannot be saved. In that case your dentist will talk about taking it out and replacing it, often with a dental implant, a bridge or a partial denture.

A temporary crown can protect a cracked tooth for a short time while your dentist waits to see if the nerve calms down. If the pain goes away and the tooth feels healthy, the final crown goes on. If it does not, a root canal is next. This step by step approach avoids a root canal you may not need.

Ask your dentist to explain which type of crack you have. Knowing the type helps you understand the odds of saving the tooth, and it helps you decide on the plan.

Your dentist may also use the word cracked cusp for a broken corner of a back tooth. The good news is that when the break stays above the gum line, a crown or onlay can often rebuild the tooth well. The main goal at every level is the same: keep the crack from traveling down toward the root.

What to do until you see a dentist

If you think you cracked a tooth, here is what to do while you wait for your visit:

• Rinse your mouth with warm water to clean it.
• Chew on the other side and avoid hard, sticky or very hot or cold foods.
• If the edge is sharp, cover it with sugar-free gum or dental wax from the drugstore.
• Use a cold pack on your cheek for swelling, and an over-the-counter pain reliever that is safe for you.
• Save any piece that broke off. Put it in milk or a clean container and bring it with you.

How to protect your teeth from cracks

You cannot prevent every crack, but you can lower your risk. Do not chew ice, hard candy or unpopped kernels. Do not use your teeth as tools to open packages. If you play sports, wear a custom mouthguard.

If you grind or clench your teeth at night, ask about a night guard. Grinding puts heavy force on your teeth for hours, and over time that force makes cracks. Large old fillings can also weaken a tooth. At your checkups, your dentist can tell you whether a tooth needs a crown to protect it before it cracks.

Regular exams matter too. A crack that is found early costs less and is easier to treat than one that is found after it has split.

Avoid biting on the cracked tooth until it is treated, even if it does not hurt right now. Each bite can push the crack deeper.

Keep up with your cleanings. Hygienists notice worn spots and chipped edges long before they hurt, and an exam with X-rays shows the shape of your fillings. A hygiene visit is the cheapest way to catch a tooth that is about to break.

Cracked tooth care at KDA

If you bite down and feel sharp pain, we can check the tooth with digital X-rays and an exam.

KDA lists emergency care 24/7. If you are in pain, call us at 305-271-1421 and tell us what is going on. Our regular office hours are Monday to Friday, 8:00 AM to 5:00 PM, and we are closed Saturday and Sunday.

You will find us at 8833 SW 107th Ave, Miami, FL 33176, in the Kendall Mall. We have served South Florida since 1973. We take digital X-rays and 3D scans in the office, so we can see what is wrong the same visit. We accept most dental insurances and most Medicare supplemental plans, and financing is available.

Common questions

This article is general information, not medical advice. Your dentist will confirm what is right for you at your exam. General information checked against: speareducation.com, my.clevelandclinic.org, dentalcompare.com.