What Is Cracked Tooth Syndrome?
Cracked tooth syndrome refers to a condition where a tooth has a small, incomplete fracture that causes symptoms but may not be visible during a standard examination. Unlike a clearly broken tooth, these cracks are often hairline fractures that affect the tooth's structure without separating it into distinct pieces.
The crack typically runs vertically through the tooth, from the chewing surface towards the root. When biting pressure is applied, the crack flexes slightly, irritating the pulp (nerve) inside the tooth and causing pain. This explains why symptoms often come and go—they depend on how and where you bite.
Because these cracks can be extremely fine, they may not appear on standard visual checks or routine X-rays. Symptoms can persist for months before the cause is identified, which is why specialised examination techniques are often needed.
Common Causes of Cracked Teeth
Tooth cracks can develop for various reasons, often as a result of accumulated stress over time rather than a single incident. Only a dental professional can confirm whether a crack is present and determine its cause.
Biting Hard Foods
Chewing on hard items such as ice, boiled sweets, nuts, or unpopped popcorn kernels can cause teeth to crack, particularly those already weakened by fillings.
Teeth Grinding or Clenching
Bruxism—habitual grinding or clenching—places repeated stress on teeth, which can lead to fractures over time, often without the person being aware.
Large or Old Fillings
Teeth with extensive fillings have less natural structure remaining. The filling material and remaining tooth may expand and contract differently, creating stress that can cause cracks.
Dental Trauma
Injuries to the mouth—from sports, accidents, or falls—can cause immediate or delayed cracking, sometimes in teeth that initially appear undamaged.
Natural Wear Over Time
Years of normal chewing function can gradually weaken teeth. Combined with other factors, this wear can eventually result in cracks developing.
Symptoms of Cracked Tooth Syndrome
The symptoms of cracked tooth syndrome can be frustrating because they are often inconsistent and difficult to reproduce. Common experiences include:
Sharp Pain When Biting
A sudden, sharp pain when biting down on food, which often disappears when pressure is released.
Pain When Releasing Bite
Discomfort that occurs specifically when releasing the bite rather than when applying pressure.
Sensitivity to Temperature
Heightened sensitivity to hot or cold foods and drinks, which may linger after the stimulus is removed.
Intermittent Discomfort
Pain that comes and goes unpredictably, sometimes absent for days or weeks before returning.
Difficulty Locating the Pain
Uncertainty about which tooth is causing pain, as the discomfort may seem to move or be hard to pinpoint.
Symptoms vary between individuals. Some people experience significant discomfort, while others may have only occasional, mild symptoms.
Why Cracked Teeth Can Be Difficult to Detect
Diagnosing cracked tooth syndrome can be challenging, even for experienced dental professionals. Several factors contribute to this difficulty:
- Cracks may be microscopic and invisible to the naked eye
- Standard dental X-rays often cannot capture vertical fractures
- Symptoms may be inconsistent, making diagnosis challenging
- The crack may only cause pain under specific biting conditions
- Other conditions can produce similar symptoms
These challenges highlight the importance of a thorough clinical examination using specialised techniques, rather than relying solely on X-rays.
How Dentists Diagnose Cracked Tooth Syndrome
Diagnosing cracked tooth syndrome requires a systematic approach using multiple examination techniques:
- Clinical examination: The dentist will visually inspect the tooth, looking for visible crack lines, and assess the condition of any existing restorations.
- Bite tests: Using a special instrument, the dentist will have you bite down on individual cusps of the tooth to identify which area triggers pain.
- Magnification and transillumination: Dental loupes or microscopes, along with bright light shone through the tooth, can reveal cracks not visible to the naked eye.
- Dental imaging: While cracks may not always show on X-rays, imaging helps rule out other causes of pain such as decay or infection.
- Ruling out other conditions: The dentist will consider alternative diagnoses to ensure accurate treatment planning.
This thorough approach helps identify the affected tooth and assess the severity of the crack.
Treatment Options for Cracked Teeth
Treatment for cracked tooth syndrome depends on the crack's location, depth, and extent. The goal is to protect the tooth from further damage and relieve symptoms where possible.
Protective Restorations
For minor cracks, a bonded filling or composite restoration may protect the tooth from further damage while preserving tooth structure.
Dental Crowns
A crown encases the entire visible portion of the tooth, holding the cracked segments together and distributing biting forces evenly to prevent crack progression.
Monitoring Minor Cracks
Some small, stable cracks may be monitored over time rather than treated immediately, with regular assessment to check for any changes.
Root Canal Treatment
If the crack extends into the pulp (nerve) of the tooth, root canal treatment may be needed to remove damaged tissue before placing a crown.
Tooth Extraction
When a crack extends below the gum line or splits the tooth vertically, extraction may be the only viable option to resolve pain and prevent infection.
The prognosis for a cracked tooth depends on the crack's characteristics. Your dentist will discuss realistic expectations and the most appropriate treatment approach for your situation.
Professional Assessment for Cracked Teeth
Cracked tooth syndrome requires professional assessment using specialised examination techniques to determine the extent of the crack and the most appropriate treatment approach. Early evaluation can help prevent crack progression and preserve the tooth where possible.
A dental examination and imaging can help identify the affected tooth. Depending on the findings, crown treatment to protect the tooth may be recommended. If the crack has affected the nerve, root canal treatment may be required before placing a crown. If pain is severe or worsening, urgent dental assessment is available.
For your convenience, assessment for cracked teeth is available at both our Central London locations: our South Kensington dental clinic and our City of London clinic near St Paul's.
Can a Cracked Tooth Heal on Its Own?
Unlike bone, tooth enamel and dentine cannot repair themselves. A crack in a tooth will not heal naturally, regardless of how much time passes. This is an important distinction that explains why cracked teeth typically require professional intervention.
Symptoms may fluctuate—sometimes disappearing entirely for periods—but this doesn't indicate healing. The crack remains, and in many cases, it will gradually progress. What may start as occasional sensitivity can develop into more frequent or severe pain as the crack deepens.
Early assessment offers the best opportunity to treat the tooth conservatively. Waiting until symptoms become severe may limit treatment options, potentially making the difference between saving a tooth and needing to extract it.
Reducing the Risk of Cracked Teeth
While not all tooth cracks can be prevented, these measures can help reduce your risk:
- Avoid chewing on very hard foods such as ice, hard sweets, or non-food items
- If you grind your teeth, discuss a protective night guard with your dentist
- Wear a mouthguard during contact sports or high-risk activities
- Attend regular dental check-ups so potential problems can be identified early
- Address bite issues or uneven teeth that may concentrate forces on certain teeth
