Cracked Tooth Syndrome Treatment

Cracked tooth syndrome (CTS) is a dental condition in which a partial crack extends into the dentin. It may occasionally extend to or through the pulp of a tooth. CTS is defined as an incomplete fracture of dental tooth structures. It is sometimes associated with a sharp pain during chewing. During chewing function, a crack, craze, or fracture line may allow broken tooth sections to flex or move. This causes sensitivity and pain in the dentin, which is the sensitive portion of the tooth. If symptoms are present, the most common symptom is a sensitivity to biting. However, it is not uncommon for there to also be a sensitivity to cold. This can progress to a full-blown toothache, pulp death, or necrosis and abscess. When the nerve of a tooth dies or abscesses it will require a crown, crown and root canal procedure, or tooth extraction to resolve the problem. It should be remembered that cracks and fracturing can be present in tooth structure without the production of pain or other symptoms.

Cracks in tooth structure can be created in several ways. The most common is as a result of previous dental fillings. Silver mercury fillings (amalgam fillings) have been around for decades. Chances are that most people who have had a cavity have also had this silver mercury compound placed in the tooth. That is great for filling the hole, but usually is not so good as far as the structural integrity of the tooth is concerned. Too often the silver mercury filling (especially the earliest fillings) will expand or “grow” over time, which in turn places pressure on the tooth structure. Eventually, (usually anywhere from 15 – 25 years) something has to give as this stress is relieved, usually at the expense of tooth structure. Of course, the continued forces from chewing and clenching on the tooth, and the ongoing expansion – contraction cycles of temperature fluctuations with food and drink produce additional stresses on the tooth structure. The most common finding with a broken tooth is the existence of an adjacent filling which was placed without consideration for protecting the structural integrity of the existing tooth structure.

Note that most cracks in the teeth begin and propagate from an inside line angle of the filling or cavity preparation. These cracks usually extend at an angle towards the outside of the tooth. When cracks exit below the gum line or bone level, far more extensive restorative measures are often required, such as gum surgery and/or root canal treatment. Not infrequently, teeth with aged silver fillings exhibit all these problems simultaneously. A “permanent filling” does not mean that it will last forever or permanently. Fortunately, there are restorative treatments available that can prevent this outcome far ahead of its happening.

Appropriate CTS treatment must take into consideration the requirements for tying the tooth structure together in such a way that it can withstand the functional demands placed upon it by chewing and biting forces, as well as the restoration materials themselves. In the end, the objective of therapy is to create a stable solution that can withstand any and all forces that might be placed upon it, and which will allow it to function in comfort for a long duration. If you or your child has a cracked or fractured tooth, please call or visit South Coast Dentistry in Aliso Viejo as soon as possible. Together, we can repair the tooth and get you or your child back to optimal oral health.