Fractured Tooth

1.Why does a cracked tooth hurt?

The crack will expose the inside of the tooth (the ‘dentin’) that has very small fluid filled tubes that lead to the nerve (‘pulp’). Flexing of the tooth opens the crack and causes movement of the fluid within the tubes. When you let the biting pressure off the crack closes and the fluid pressure stimulates the nerve and causes pain.

2.How can I prevent my teeth from fracturing?

Most fractures cannot be avoided because they happen when you least expect them. However, you can reduce the risk of breaking teeth by:

• Trying to eliminate clenching habits during waking hours,
• Avoiding chewing hard objects (eg bones, pencils, ice),
• Avoiding chewing hard foods such as pork crackling and hard-grain bread

3.How does the dentist treat a cracked tooth?

It depends on the direction and severity of the crack. If the crack is small enough, it may be removed by replacing the filling. Bonded white fillings and bonded amalgam fillings will hold the tooth together making it less likely to crack. Sometimes the cracked part of the tooth fractures off during the removal of the filling and this can be replaced with a new filling. Your dentist may first place an orthodontic band around the tooth to keep it together. If the pain settles, the band is replaced with a filling that covers the fractured portion of tooth (or the whole biting surface). Other options include the placement of gold or porcelain fillings or even a crown. If the crack goes too far vertically, there is a possibility the tooth may need to be removed and replaced with an artificial one. (See bridgework, denture, and implant). The nerve may sometimes be affected so badly that it dies. Root canal treatment will be required if the tooth is to be saved.

4.Will my tooth become better?

Unlike fractures elsewhere in the body, this crack will never heal. There is a small chance that the crack will get worse even with a crown placed. This may lead to the need for root canal treatment, or even removal of the tooth. However, many cracks can be fixed without root canal or tooth removal.

5.What type of forces cause teeth to crack?

Front teeth usually break due to a knock, an accident or during biting. Back teeth can also be fractured from a knock. They are much more likely than front teeth, to crack from forces applied by the jaws slamming together rapidly. Other forces occur during sleep because people grind their teeth with a much greater force than they would ever do while awake. The first sign of problems may be what we call “cracked tooth syndrome” – a sore or sensitive tooth somewhere in the mouth that is often hard for even the dentist to find. In some individuals the grinding, called bruxism, causes tooth wear rather than fracture.

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