Darren Gardner DDS, Provo Dentist
This tooth has a very serious crack. It is completely pain free, but without a crown to strengthen it, it is in serious danger of splitting down the root while chewing. It will also need a root canal to prevent infection. Without a crown, this tooth will likely break so badly that it will need to be extracted.
What Causes A Tooth To Crack?
Teeth are very hard, but are prone to cracking over time with repeated stress. I often find patients that have multiple teeth with fractures in them which are caused by:
- Chewing ice
- Biting on hard objects
- Habitually chewing hard foods such as unpopped popcorn kernels
- Clenching
- Grinding
- An uneven bite that concentrates the stress on certain teeth, rather than distributing the biting stress equally
- Old silver fillings that expand and wedge the teeth apart. Teeth with large fillings in them are especially prone to fracturing because the tooth is significantly weaker.
All of these place extraordinary stress on the teeth and over time cause the tooth to break. It is important to eliminate harmful habits, like chewing ice and hard objects, before the damage is done. A dentist may need to help you manage the other risks for cracked teeth.
Clenching and Grinding
Cracked teeth are found most commonly in patients that clench or grind their teeth at night. Research has shown that those who clench and grind their teeth at night put two to three times the amount of pressure on their teeth than when they are awake. These patients show more wear and tear on their teeth at a younger age and experience more cracked and broken teeth. These patients also end up having more root canal treated teeth than the average patient. A night guard (made by a dentist) worn at night will protect the teeth from premature wear and cracking by reducing the amount of pressure that is placed on the teeth at night while clenching and grinding.
Uneven Bite
Your dentist can evaluate your bite to see if it is placing excessive stress on certain teeth and can offer solutions to correct it. Solutions may include simple adjustment of the bite, orthodontics, or restorations.
Amalgam Fillings
The larger the filling, the thinner the surrounding tooth is. Old techniques used to emphasize creating sharp angles in the tooth when preparing a cavity for a filling. We now know that sharp angles concentrate stress and those are the areas that fractures begin. Old silver amalgam fillings also expand and wedge the tooth apart along these sharp angles. Chewing on hard foods or objects also in effect wedge the teeth apart.
What Should Be Done For A Cracked Tooth?
Some cracks are more serious than others. The most serious ones are like the photo above where the crack is going down the middle of the tooth, toward the nerve, and down the root. Other fractures haven't reached that point yet, but are heading that direction. Protecting the tooth with an onlay or crown strengthens the tooth to prevent the crack from continuing to grow. It is important to restore the tooth with a crown or onlay before the tooth breaks because the tooth may break and expose the nerve and need a root canal to eliminate the pain. The tooth may also break below the bone and need additional surgery to be able to save the tooth. Occasionally, the tooth may break so badly that it cannot be saved and must be extracted.