Treatment
Cracked and split teeth in Burton upon Trent
A sharp, split-second pain when you bite down — or when you release — is the signature of a cracked tooth. Cracks hide from ordinary X-rays and rarely give a clear account of themselves, so finding one and establishing how far it has travelled takes a methodical examination rather than a quick look.
How cracks start
Back teeth bear heavy loads, and a tooth already hollowed by a large filling has less structure to bear them with. Clenching or grinding, chewing ice or boiled sweets, an unexpected stone in a cherry or simply decades of use can begin a crack that creeps a little deeper each year. A root-treated tooth that has never been crowned is especially at risk.
What a crack feels like
- a sharp jab on biting that disappears the instant you let go;
- pain that is hard to locate and comes and goes;
- cold or sweet sensitivity in a tooth without any visible decay;
- discomfort only when you bite on one particular spot.
If the crack reaches the pulp, the character of the pain changes: it begins on its own or lingers after hot and cold, and the tooth behaves like one that needs root canal treatment.
Finding the crack
No single test settles it, so several are combined. You bite on a small plastic instrument, cusp by cusp, to reproduce the pain; dye is painted on to stain the line; a strong light is passed through the tooth to see where the crack interrupts it; and the tooth is studied under the operating microscope, which shows hairline cracks clearly. X-rays rule out other causes and show the bone, and nerve tests establish whether the pulp is still alive.
Treatment depends on depth
A shallow crack limited to the crown of the tooth is usually dealt with by your dentist, who fits an onlay or crown to hold the tooth together and stop the crack spreading. A crack that has reached the pulp calls for root canal treatment before the tooth is crowned. A crack that extends below the gum or splits the root means the tooth cannot be kept, and the right advice is extraction and a plan for its replacement. Whatever the finding, you receive it in writing with the reasons behind it.
Why sooner beats later
Cracks only grow. A tooth examined at the first twinge has every chance of being protected and kept; one that has been chewed on for a year while the crack lengthens may not. If biting has been producing that sharp, fleeting pain for more than a couple of weeks, have the tooth assessed.