Cracked teeth are some of the most difficult and varied situations to manage in dentistry. Cracked teeth present with a variety of symptoms and ones that are not easy to reproduce. It is not always clear to the patient where the pain is coming from. Diagnostic tests will help to determine the nature of the crack, the location and the potential extend of nerve damage if it exists. If no nerve damage is identified but symptoms exist such as sensitivity to sweets or cold, conservative measures can resolve the symptoms, depending on the location and extent of the crack. If a crack chips off a small corner or bit of tooth, smoothing the area may resolve the issues. If a larger portion breaks off, a restoration or filling may be required. Depending on the condition of the underlying tooth, a crown may be necessary to stabilize the tooth. If symptoms do not resolve, the crack may be internal and affect the nerve or pulp and the tooth may require a root canal in order to remove the irritated or damaged nerve tissue.
If the attachment apparatus, the bone, periodontal membrane and gums are affected the longevity of the tooth is severely compromised and should be extracted. When the dentist checks the periodontal health of the area and you hear readings like 3-2-3, or 2-2-2, these indicate attachment levels of the structures supporting the tooth. Depths of under 4 are areas you should be able to maintain at home between dental visits. If a single reading that is different from the others such as 3-8-4 exists, this can be an indication of a crackdown the root that will not heal. In this case the potential crack has affected the tissues overlying that area of the root and caused a rip or tear in the gums attaching to that area of the root. Radiographs or x-rays and further tests should be employed to confirm such a crack and rule out other periodontal conditions.
Once the acute or painful case is managed, steps must be employed to reduce cracks developing in other teeth. This goes back to diagnosis and determination of the cause of the crack. In the case of cracked teeth, it must be considered if the patient is grinding or clenching and is not only a crown for a single tooth is required, but other therapies such as mouth guard may offer protection for the remaining teeth.