Few dental problems are as frustrating to live with as a crack you cannot see. The tooth looks normal, the X-ray is clear, yet every so often a mouthful lands on exactly the wrong spot and a sharp jolt shoots through it. The pain is usually brief, is often worse on letting go than on biting down, and may vanish for weeks at a time. What is happening is that a hairline fracture opens fractionally under load, tugging on the nerve fibres inside the tooth, and closes again as the pressure comes off. Left alone, cracks tend to travel. At Wimpole Street we use bite tests, magnification and light to locate them, and the aim of treatment is simple: stop the two halves of the tooth moving.
A sharp stab when biting on one spot, then nothing
The pain is triggered by pressure landing on a particular cusp.
Pain on releasing the bite rather than closing
A distinctive rebound sensation as the crack springs shut.
Cold sensitivity in a tooth that has no obvious cavity
Fluid movement through the crack stimulates the nerve.
Difficulty pointing to which tooth is responsible
Referred pain from cracks is notoriously hard to localise.
Symptoms that disappear for weeks and return
Depends entirely on whether food happens to load the crack.
A tooth with a large filling or that you grind on
The typical background in which cracks develop.
A filling replaces the middle of the tooth but does not hold the walls together. The remaining cusps flex outwards each time you chew, and after thousands of cycles a crack starts at the base of a cusp or the floor of the cavity. Molars and premolars with old amalgam fillings are the classic case.
Bruxism applies forces far higher and longer than eating. It creates multiple micro-cracks across the mouth, and a grinder who develops one symptomatic crack is at risk of others.
Ice, a bone, an olive stone or a boiled sweet can start a fracture in a heartbeat, particularly in a tooth that was already compromised. The event is often remembered clearly.
Teeth with steep cusps and deep grooves wedge food and concentrate forces. Lower molars and upper premolars are most often affected, partly because of their shape and partly because of where the jaw exerts most power.
After root canal treatment a tooth is hollowed and loses moisture, making it more brittle. Without a crown to bind it, it is prone to cracking and eventually splitting.
Decades of chewing, temperature cycling and small traumas gradually fatigue enamel and dentine. Cracks are considerably more common after fifty, even in teeth without fillings.
These are holding measures, not a substitute for an examination. Use any pain relief exactly as directed on the pack and check with a pharmacist if you take other medicines.
You bite on a small instrument that isolates one cusp at a time, we shine a fibre-optic light through the tooth, use dye and magnification, and take X-rays to rule out other causes. Finding the crack is half the treatment.
About this treatmentFor a shallow crack found early, removing the old filling and bonding a new restoration that splints the cusps together can stop the movement and the pain.
About this treatmentThe mainstay of treatment. A crown wraps the whole tooth and prevents the halves flexing apart. We often place a temporary crown first to confirm the symptoms resolve before the final one is made.
About this treatmentIf the crack has already reached the pulp and the nerve is inflamed or infected, it is cleaned and sealed before crowning.
About this treatmentA crack that runs vertically down the root, or has split the tooth in two, cannot be repaired. The tooth is removed and an implant or bridge is discussed.
About this treatmentFor grinders, a custom guard protects the newly crowned tooth and the rest of the mouth from the same fate.
About this treatmentA diagnostic appointment for suspected cracked tooth at Wimpole Street is expected to be £95, including the bite tests, transillumination and X-rays needed to locate it. If a bonded restoration is enough, white fillings start from £185.
Most cracked teeth are protected with a crown, indicative from £995. If the nerve is already involved, root canal treatment at around £895 for a molar is quoted in addition. Should the tooth prove unsaveable, extraction is from £250 with replacement planned separately. A night guard to protect against grinding is around £395. Everything is set out in writing before you decide.
Figures are indicative prices for Wimpole Street and are confirmed in a written plan once a dentist has examined you. Fees match our South Kensington and St Paul's clinics.
Leave your details and we will be in touch when the Marylebone diary opens. If the problem cannot wait, the same clinicians are already seeing patients in South Kensington and at St Paul's.
Related conditions
Opening 1 October 2026
Wimpole Street is not yet seeing patients. Until then, please book or call our South Kensington clinic on 020 7183 2362 or our St Paul's clinic on 020 7183 3709. Questions about the new clinic: wimpolestreet@md.co.uk.
The same clinical team already works from two other Medical & Dental clinics. Book at either one now and, if you prefer, move your ongoing care to Wimpole Street once the doors open.
