What is it?
Cracks run parallel to the long axis of the tooth. Because the X-ray beam passes through the same plane, the crack usually does not register on the image. Diagnosis therefore rests on symptoms and clinical tests.
The distinguishing finding is that the pain comes not while biting but at the moment you release. Biting separates the two parts of the crack, releasing snaps them back, and that sudden movement in the dentinal tubules becomes a nerve signal.
Signs
You will not necessarily have all of these at once.
Why does it happen?
- 01
Clenching and grinding
Force spread over years does more than tire the enamel; it produces micro-cracks that deepen over time.
- 02
Large old fillings
A wide filling thins the tooth's own walls; the remaining walls flex under chewing force and crack.
- 03
Biting suddenly on something hard
An olive stone, ice, or an unexpected fragment of bone can start a crack in one bite.
- 04
A root-treated tooth
A tooth that has lost its vitality is more brittle; without a protective restoration the risk of cracking rises clearly.
How does it progress?
- Stage 1
Within enamel and dentine
The tooth can be saved by protecting it with a crown; the pulp is untouched.
- Stage 2
Reaching the pulp
Root canal treatment comes first, followed by a protective restoration.
- Stage 3
Vertically down the root
The tooth usually cannot be saved; extraction comes into play.
How is it treated?
Superficial enamel cracks often need no treatment and are monitored. Cracks extending into dentine are treated with a restoration that holds the tooth together, usually a crown or onlay; the aim is to stop the cusps from flexing apart.
Diagnosis uses a bite test, transillumination and staining. Some cracks only become visible once an existing filling is removed, so the diagnosis sometimes becomes clear alongside the first step of treatment.
- Pain on biting starting to repeat with every bite
- Pain that starts on its own and worsens at night
- Swelling or discharge at the gum
- Visible separation in the tooth
How is it prevented?
- Use a night guard if you clench; without the force being spread, new work cracks too
- Have root-treated back teeth covered with a protective restoration
- Take care with ice, hard stones and mouthfuls containing bone
Frequently asked questions
- Can a cracked tooth heal itself?
- No. Enamel and dentine do not regenerate in a way that closes a crack. The aim is not to heal the crack but to support the tooth so it cannot propagate.
- Does every cracked tooth need extraction?
- No, most can be saved. Extraction generally arises when the crack extends vertically down the root.
This content is for general information and does not replace an in-person examination. Symptoms overlap between conditions, and a diagnosis can only be made clinically.