A tooth fracture is a break or crack in the hard shell of the tooth. The outer shell of the tooth is called the enamel. It protects the softer inner pulp of the tooth that contains nerves and blood vessels. Depending on the type of fracture, the tooth may not cause any problems or it may cause pain.
Types of tooth fractures include: Craze lines—shallow cracks that cause no pain and require no treatmentFractured cusp—breaks in the chewing surface of the toothCracked tooth—the tooth cracks from the chewing surface down toward the root of the toothSplit tooth—cracks down through the root, separating a section of toothVertical root fracture—cracks begin in the root and move up toward chewing surface
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Chewing on hard foods or accidentally biting down on a hard object can lead to a crack in the tooth. Teeth can also be fractured with a blow to the face that can occur with a car accident or during a sporting event.
Tooth fractures are more common in older adults because teeth wear down over time.
Factors that may increase your risk of tooth fractures include: Teeth with current tooth decay or damageTeeth that have been restored with silver alloyChewing on hard foods like hard candy or iceCollision sports like hockey and footballTeeth grinding and jaw clenching
Not all tooth fractures cause symptoms. For example, craze lines rarely cause problems.
Other fractures may expose the sensitive pulp to fluid, food, and bacteria in the mouth. It can cause irritation or infection in the pulp. This can lead to: Pain with chewingChewing only on one side of your mouth to avoid discomfortSharp pain when you bite downPain with cold air or foodRandom pain
Vertical root fractures may not be noticed until a bone or gum infection develops.
A fracture may not be seen with the naked eye. Your dentist will ask about your symptoms. You may be asked: Do you remember biting down hard on something?When do you notice pain?What types of food cause pain?
You may not able to identify the exact tooth that has a fracture. Your dentist will look for the fracture based on your feedback. To help locate the fracture or determine the extent of the fracture, your dentist may do the following tests: Dye staining—a solution is put on the tooth to help see the crackTransillumination—passing a light through the toothPeriodontal probing—using special tools to look for the extent of crackBite test—you will be asked to bite down on a stick to find the specific tooth causing problemsX-ray—to look for certain defects, since not all fractures can be seen on x-ray
Early diagnosis may help save the tooth before the fracture progresses.
Teeth cannot heal. The treatment goal is to protect the tooth and the pulp interior.
Talk with your dentist about the best treatment plan for you. The treatment will depend on the severity of damage to the tooth. Options may include: Crown—a cap is placed over the tooth. A temporary crown will be placed at first to make sure it corrects the problem. A permanent crown will eventually be placed.Dental Veneer—a thin covering that is placed over the tooth if you have small chip in the surfaceRoot canal—may be needed if there is severe damage to the pulp. A root canal clears out the damaged pulp and places a new filler in the tooth.Tooth extraction—the tooth may need to be removed if the crack extends below the gum lineRemoval of the fractured portion—may be possible in vertical root fracture
To reduce your chance of fracturing a tooth, take these steps: Avoid chewing on hard objects such as ice, hard candy, popcorn kernels, or pens.Wear a mouth guard for sports or recreational activities.Don’t use your teeth to cut things or open plastic bags.Avoid clenching or grinding your teeth.Talk to your dentist if you grind your teeth at night.
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http://www.iowadental.org/Justman%20Cracked%20Tooth%20handout.pdf. Updated May 6, 2011. Accessed February 24, 2016.
Do you have a cracked tooth? American Dental Association website. Available at:
http://www.ada.org/~/media/ADA/Publications/Files/patient_25.ashx. Published April 2003. Accessed February 24, 2016.
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http://www.dentaltreatment.org/cracked_tooth_syndrom.pdf. Accessed February 24, 2016.
Last reviewed February 2016 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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