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Cracked Tooth

Cracked and fractured teeth are common dental problems. As people retain their natural teeth longer (due to advances in dental technology), the likelihood of cracked teeth increases. There are many reasons why teeth may crack, for example, biting on hard objects, trauma, grinding and clenching of teeth. All of these behaviors place the teeth under extra strain and render them more susceptible to cracking.

When tooth enamel is cracked, pain can become momentarily debilitating. In the absence of pressure on the crack, there may be no discomfort.  However, as the cracked tooth performs a biting action, the crack widens. The pulp and inner workings of the tooth then become exposed, and painful irritation occurs. As pressure is released again, the two parts of the crack fuse back together, and pain subsides. If left untreated, the pulp becomes irreversibly damaged and constantly painful. The resulting pulp infection can affect the bone and soft tissue surrounding the tooth.

Symptoms of a cracked tooth may include:

  • Unexplained pain when eating.
  • Sensitivity to warm and cold foods.
  • Pain with no obvious cause.
  • Difficulty pinpointing the location of the pain.
What kind of cracks can affect the teeth?

There are many ways in which a tooth can be cracked. The specific type of crack will determine what type of treatment is viable. In cases where the crack is not too deep, root canal therapy can be performed, and the natural tooth can remain in the mouth.  In other situations, the tooth is too badly damaged and requires extraction.

Here is a brief overview of some of the most common types of cracks:

Crazes – These are generally tiny vertical cracks that do not place the teeth in danger. These scratches on the surface of the teeth are considered by most dentists to be a normal part of the tooth anatomy. A craze rarely requires treatment for health reasons, but a wide variety of cosmetic treatments can be performed to reduce the negative aesthetic impact.

Oblique supragingival cracks – These cracks only affect the crown of the tooth and do not extend below the gum line. Usually, the affected part of the tooth will eventually break off. Little pain will result, because the tooth pulp (that contains the nerves and vessels) will remain unaffected.

Oblique subgingival cracks – These cracks extend beyond the gum line and often beyond where the jawbone begins.  When a piece breaks off, it will usually remain attached until the dentist removes it. Oblique subgingival cracks are painful and may require a combination of periodontal surgery (to expose the crown) and endodontic treatment to place a crown or other restorative device.

Vertical furcation cracks – These cracks occur when the roots of the tooth separate. This type of crack almost always affects the nerve of the tooth. Because the tooth will not generally separate completely, root canal therapy and a crown can usually save the tooth.

Oblique root cracks – These cracks tend not to affect the surface of the tooth at all. In fact, the damage is only apparent below the gum line and usually below the jawbone. Root canal therapy may be possible, depending on how close the fracture is to the tooth surface.  However, extraction is almost always the only option after sustaining this classification of fracture.

Vertical apical root cracks – These cracks occur at the apex (tip of the root). Though the tooth does not require extraction from a dental perspective, many patients request an extraction because of the high degree of pain. Root canal therapy alleviates the discomfort for a while, but most often, teeth affected by such cracks are eventually extracted.

How are cracks in the teeth treated?

There are many different types of cracked teeth. Some can only be exposed using X-ray machines, while others are clearly visible to the naked eye. In cases where the tooth root is affected, root canal therapy is the most viable treatment option. The pulp, nerves, and vessels of the tooth will be removed, and the resulting space will be filled with gutta-percha.  A crown or filling will be added to stabilize the tooth, and it will continue to function as normal.

When the crack is too severe for the tooth to be saved, the dentist will perform an extraction. There are a number of restorative options in this case, such as bridges, dental implants and partial dentures. All of these structures can restore biting, chewing, and speaking functions.

If you have any questions or concerns about cracked teeth, please contact our office.

Frequently Asked Questions
Cracked Tooth, TX

A cracked tooth is a tooth that has developed a fracture or crack, which can range from a tiny surface line to a deep break that extends below the gumline. Cracks can affect the enamel, dentin, and sometimes the inner pulp of the tooth. Some cracks are minor and cause no symptoms, while others can lead to pain, infection, or even tooth loss if not treated promptly.
Common causes include biting down on something hard (ice, popcorn kernels, nuts, hard candy, or bones), teeth grinding or clenching (bruxism), an uneven bite that places excessive pressure on certain teeth, large fillings that weaken the surrounding tooth structure, trauma or injury to the mouth, sudden temperature changes (such as eating very hot food followed by cold), and natural aging of teeth over time.
Symptoms vary depending on the severity and location of the crack. Common signs include sharp, intermittent pain when biting or chewing — especially when releasing the bite, sensitivity to hot, cold, or sweet foods, pain that comes and goes rather than being constant, swelling of the gum around the affected tooth, and discomfort that’s difficult to pinpoint to a specific tooth. Some cracks cause no symptoms at all and are only discovered during a dental exam.

There are five main types: Craze lines — tiny surface cracks in the enamel that affect only the outer layer and rarely cause problems. Fractured cusp — when a piece of the tooth’s chewing surface breaks off, often around a filling. Cracked tooth — a crack that extends from the chewing surface toward the root, potentially reaching the pulp. Split tooth — a crack that has progressed to the point where the tooth is divided into separate segments. Vertical root fracture — a crack that begins at the root and travels upward, often discovered after infection develops.

No. Unlike bones, teeth cannot heal themselves once they are cracked. Without treatment, the crack will typically worsen over time as biting forces continue to stress the tooth. Even a small crack can deepen and eventually reach the inner pulp, leading to infection, severe pain, and possibly tooth loss. Early treatment offers the best chance to save the tooth.
Diagnosing a cracked tooth can be challenging because cracks often don’t show up clearly on X-rays. We use a combination of methods, including a visual exam (sometimes with magnification or a special light), bite tests to identify the source of pain, dye stains that highlight cracks, gum probing, and digital X-rays to rule out other issues. Sometimes the diagnosis requires careful detective work over multiple visits.

Treatment depends on the type, location, and severity of the crack. Options include: Bonding — using composite resin to seal small cracks. Crown — placing a custom cap over the tooth to hold it together and restore strength. Root canal therapy — if the crack has reached the pulp. Extraction — when the tooth cannot be saved, especially with split teeth or vertical root fractures. We’ll evaluate your specific case and recommend the most conservative treatment that gives the best long-term outcome.

Sometimes, but not always. If the crack extends into the inner pulp where the nerves and blood vessels are located, root canal therapy is usually needed to remove the damaged pulp and prevent or treat infection. After the root canal, a crown is almost always placed to protect the weakened tooth. Smaller cracks that don’t reach the pulp can often be treated with bonding or a crown alone.
In many cases, yes — especially when the crack is caught early. The success of treatment depends on how deep the crack is, how far it extends, and whether the inner pulp is affected. Cracks that remain above the gumline are usually treatable. Cracks that extend below the gumline or split the tooth into pieces are much harder to save, and extraction may be the only option.
Untreated cracked teeth almost always get worse. The crack can deepen and spread, leading to severe pain, pulp infection, abscess formation, bone loss around the tooth, and eventual tooth loss. Untreated infection can also spread to surrounding tissues and, in rare cases, become a serious health concern. Prompt treatment dramatically improves outcomes.
While not always an immediate emergency, a cracked tooth should be evaluated as soon as possible. Severe pain, swelling, fever, or a visibly broken tooth should be treated as urgent — contact our office right away. Even a minor crack without symptoms deserves prompt attention so we can prevent it from worsening.
Prevention strategies include: avoiding chewing on hard objects (ice, hard candy, popcorn kernels, pens), wearing a custom nightguard if you grind or clench your teeth, wearing a sports mouthguard during contact activities, addressing an uneven bite with orthodontic or restorative treatment, replacing old large fillings before they fail, and visiting our office regularly for checkups so we can catch early signs of stress on your teeth.
Yes. The back molars — especially the lower second molars — are the most common location for cracks because they bear the heaviest chewing forces. Teeth with large fillings, teeth that have already had root canals, and teeth in patients who grind or clench are also at higher risk. We pay extra attention to these teeth during routine exams.
Intermittent pain is one of the hallmark signs of a cracked tooth. When you bite down, the two sides of the crack can flex slightly apart and then snap back together when you release pressure — this is what causes the characteristic “pain on release.” Cold, hot, or sweet foods can also trigger symptoms by reaching the inner layers of the tooth through the crack. The pain may come and go for weeks or months before becoming constant.
Contact our office anytime you suspect a tooth may be cracked — even if the symptoms are mild or intermittent. The earlier we evaluate and treat a crack, the more likely we can save the tooth with a conservative procedure. Don’t wait for the pain to become severe; early intervention almost always means better outcomes and lower costs.