Do you experience sharp pain when chewing or biting or sensitivity to hot and cold temperatures? You may have cracked tooth syndrome (CTS) – an often uncomfortable and painful dental condition.
CTS occurs when tiny cracks appear in the enamel (biting surfaces) and dentin layer (inner part of the tooth), extending into the pulp chamber and causing a fracture. This exposes the nerve endings to various temperatures, pressure, and other stimuli, causing sharp pain when chewing or biting, sensitivity to temperature changes, and discomfort when biting down.
Patients aged 30–50 are most commonly affected by CTS, with equal occurrence between genders. It affects mandibular molars, maxillary molars, and maxillary premolars, in that order. Fractures tend to occur in a direction parallel to the forces on the cusp of the incline.
CTS is one of the most challenging dental problems to diagnose, and left untreated, it can lead to severe complications. Read on for a comprehensive overview of CTS symptoms, treatments, and common solutions.
Classification of Cracked Tooth Syndrome
CTS is progressive and classified based on corporal or periodontal ligament involvement and the extent of the fracture.
- Craze lines: They are microfractures in the enamel that every tooth has. They don’t penetrate beyond the enamel and don’t cause any symptoms. Tooth trauma from bruxism or parafunctional habits like nail biting can cause craze lines.
- Fractured cusp: A complete or incomplete fracture of the tooth originating from the occlusal surface, extending gingivally, and crossing the pulpal floor in the vertical direction without any involvement of the periodontal ligament. Occlusal trauma and undermined cusps from previous restorative procedures are the most common causes.
- Cracked tooth: Similar to a fractured cusp, but the crack extends subgingivally in a mesial-distal direction and is more centered. Cracks may be contained within the crown or extend vertically into the tooth’s root.
- Split tooth: A complete fracture of the tooth originating from the occlusal surface and extending through the dentin into the periodontal ligament and marrow spaces. It results in the separation of angulated segments and is usually caused by bruxism, a traumatic bite, ice-chewing, or extensive restorations in weakened teeth.
- Vertical root fracture: A complete or incomplete root split in an up/down direction that may span across the root or be restricted to only certain areas along its length. It’s usually discovered on routine periapical X-rays.
The prognosis of CTS depends largely on early diagnosis and treatment. Its progressive nature means that any delay in treatment can result in further destruction to the tooth and surrounding structures. It helps to understand CTS symptoms so you can seek timely diagnosis and treatment.
Typical Cracked Tooth Syndrome Symptoms
Cracked teeth can cause severe, intermittent pain that ranges from mild to sharp and intense depending on the fracture type. The most common CTS symptoms are:
- Pain when biting or chewing on the affected side
- Sensitivity to hot and cold foods and beverages
- Discomfort when releasing the bite
- Swelling and tenderness of surrounding gums
- Visible cracks or chips on the affected tooth for severe fractures
- A grinding or grating sensation when biting
- Toothache that radiates to the jaw, ear, and neck
It helps to seek proper medical attention if you experience any of the above symptoms for cracked tooth syndrome pain relief. Neglecting the early warning signs can worsen the condition and lead to more extensive damage.
Diagnosis, Treatment, and Common Solutions for Cracked Tooth Syndrome
The diagnosis of CTS is made by a combination of clinical and radiograph findings. A full mouth examination is essential, especially on the affected side. Your dentist will review the medical and dental history, especially any past trauma or previous restorative treatments in the area. Standard diagnostic tests include:
- Tactile examination: A thorough evaluation using a dental explorer and probe to check for soft tissue involvement.
- Bite test: Biting down on a piece of tooth sloth, rubber wheel, or cotton roll to check for pain upon pressure release.
- Cold test: Using an ice cube to check for sensitivity and pain.
- Radiographs: Taking X-rays from different angles to check for any root fractures and subgingival cracks. A cone beam CT scan can help detect bone loss and periodontal involvement.
- Transillumination: Using a fiber optic light to check for fractures within the crown.
- Use of dyes: Applying dyes such as methylene blue dye to the tooth’s surfaces and observing for any discoloration that could indicate a crack.
Treatment options depend on the fracture’s type, location, and severity. The goal is to restore the full form and function of the tooth. Common options include:
- Dental crown: Fitting a porcelain, ceramic, or metal crown over the affected tooth to restore strength, prevent further damage, and improve aesthetics.
- Root canal therapy: Removing infected pulp, cleaning and sealing the canals, and restoring the tooth with a crown.
- Bonding: Filling the affected tooth with composite resin to seal cracks and chips.
- Cosmetic contouring: Rounding and polishing rough edges to give the tooth a more natural shape.
- Veneers: Bonding a porcelain or resin veneer to the tooth’s outer surface for improved aesthetics and protection. It’s perfect for minor fractures and chips.
- Extraction: Removing the tooth if it’s too severely damaged to be saved and replacing it with a dental implant or bridge.
Preventive measures such as using a night guard to prevent teeth grinding, wearing mouthguards during sports, and avoiding hard foods can help reduce the risk of cracked teeth. Brush and floss your teeth regularly and visit your dentist every six months for routine checkups.
Manage CTS Quickly, Effectively, and Affordably Today
Cracked tooth syndrome can be a painful and challenging condition. Prompt diagnosis and treatment is the key to successfully managing CTS.
Our dentists at The Dental Team are well-equipped to diagnose, treat, and manage CTS quickly, effectively, and affordably. Our goal is to restore the form and function of your tooth and help you maintain a healthy, beautiful smile. Get in touch with us today to learn more about cracked tooth syndrome and our available solutions.