A fractured tooth is a fairly common occurrence. While teeth are incredibly strong, the day-to-day wear and tear of using our teeth can lead to cracking, chipping, and even breaking. Sometimes, the chipping of a tooth can be so small that you may not even notice it. Other times, the fracture is large enough to be visible, or jagged enough to feel with your tongue. In extreme cases, by damaging your tooth you may have exposed the nerve inside the tooth, which can cause pain.
Endodontists are the dental professionals who specialize in the root and pulp of our teeth–the layers beneath the enamel. In addition to performing root canals, they are able to diagnose and treat fractured teeth, as cracks that reach beneath the surface of the tooth can have serious implications for the inner layers.
If you experience a minor chip in your tooth, make a non-emergency appointment with your dentist to have it treated. A broken or cracked tooth is an urgent matter, and you should try to see your dentist as quickly as possible. Some dentists have in-house endodontists on staff, but if yours does not, ask to be referred to a specialist. Unfortunately, fractured teeth do not heal, but dental solutions can seal or cover the tooth to prevent the fracture from deepening or spreading to the root of the tooth.
Causes and Symptoms of a Fractured Tooth
A common cause of fracturing a tooth is biting down on a hard object. You may chip or fracture a tooth when chewing ice or hard candy, or when using your teeth in improper ways, like to open or loosen something. A hard impact to the face can be dangerous for many reasons, and this includes damaging your teeth. For those who play contact sports, a mouth guard should always be worn. If you fall while walking, or are about to collide with another hard surface, try turning your face away to prevent a direct impact.
Cavities and old amalgam fillings that don’t support the entire tooth can weaken your enamel and may lead to cracks in your teeth. People who clench or grind their teeth are also prone to fractures, and if you have a history of grinding your teeth at night, you may consider consulting your dentist about using a mouth guard.
The severity of your symptoms depends on the size and location of the fracture. A small chip on the surface may very well cause no pain or discomfort. When a tooth cracks completely, the sides can move against each other during chewing, and this leads to discomfort and irritation in the layers beneath (the pulp). If left untreated, the pulp will become irritated enough to cause pain. By this point, the pulp–which contains the nerves and blood vessels–can no longer heal itself. Sometimes, a crack can be large enough that it strikes right down to the nerves and you may experience pain immediately.
When exposed, the nerves in our teeth are extremely sensitive. Pressure and movement from chewing, biting down, and even releasing your bite can cause varying degrees of discomfort or pain. Extreme temperatures can irritate the tooth, as can very sweet or sugary foods. The pain can be constant, or it may come and go. Eventually, an untreated fracture can lead to tooth decay or infection of the pulp.
Treatment and Procedures for Fractured Teeth
Dentists and endodontists determine the proper treatment for a fractured tooth depending on the extent and location of the crack. There are actually several different kinds of fractures in teeth, some of which require more intensive treatment than others, and your dental professional must diagnose your fracture before they proceed. In most cases where the tooth has not decayed or become infected, restoring the tooth and preventing further damage is an entirely feasible and routine procedure.
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Chipped teeth: A
surface-level chip in your tooth will rarely need treatment. These are
considered minor fractures, and your dentist will more than likely use filling
material only if there appears to be a risk of the chip getting worse. For
aesthetic appearances, your dentist can file down and polish the tooth.
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Craze lines: Craze
lines are also surface-level fractures. In this case, they are minor cracks on
the enamel that don’t reach below the surface. Your dentist may decide that
treatment isn’t necessary, or they may polish the area to smooth out the
surface.
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Fractured cusp: Fractured
cusps occur when a piece of the tooth’s chewing surface breaks off. They often
occur around fillings, but are generally considered to be minor fractures. It
is rare that a fractured cusp damages the pulp, and it usually does not cause
pain. Dentists often place a new filling or crown over the area to protect the
fracture from deepening.
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Cracked tooth: A
cracked tooth involves the entire tooth–a
fracture that reaches from the enamel down to the nerve. While the tooth is not
broken into pieces, the crack will gradually spread. It is at this stage when
you may need to consult with a specialist for treatment. Sometimes, cracks can
be repaired with filling material, but more often than not, a crown is
necessary to prevent it from worsening. If the pulp becomes damaged, an
endodontist may need to perform a root canal. A serious break exposes the nerve
and will almost always cause pain or bleeding. In this case,a root canal is
critical to remove the exposed nerve.
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Split tooth: A
split tooth often results from the prolonged spreading of a cracked tooth, and
causes a completely vertical break that splits the tooth into two separate
parts. An endodontist will likely perform a root canal and cover the root with
a crown. Molars have more than one root, and when they split, it is sometimes
possible to save one of the roots. The endodontist will remove the roots that
cannot be saved and cover the remaining piece with a crown. When no roots can
be saved, the tooth must be removed.
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Vertical root
fractures: These fractures begin in the root of the tooth and move upward
toward the surface. They can often go unnoticed because they show minimal
symptoms until the surrounding bone and gum become infected. Extraction of the
tooth is the most common treatment, but if the tooth can be saved by removing
the fractured portion, endodontic surgery may be performed.
Even in cases when a fractured tooth must be removed, there are still options available to preserve your smile and overall oral health. Dental technology has advanced in leaps and bounds; innovations like dental implants allow dentists to anchor and reinforce prosthetic teeth that look and function like natural teeth. No matter how severe the fracture in your tooth, consulting your dentist as soon as possible and determining the appropriate treatment can effectively resolve the issue.