This is becoming one of the biggest problems in dentistry today and a large cause of why teeth are having to be extracted. This generation of humans are living longer than any other previous generation. So our teeth are being asked to do a lot more for us then they have in the past. Signs and Symptoms 1. Pain on chewing or when you release the biting pressure (this is because the crack is opening and closing). The chewing pain may be intermittent or only occur when it is hard or grainy foods that land on the weakened spot. Often the pain is very short, sharp and specific. Some people "learn" how to avoid eating on the cracked tooth and feel as though the problem as gone away. The problem can then get worse. 2. Sensitivity to hot, cold foods or sweet things 3. Can slowly progress to a constant toothache (this usually means that the nerve of the tooth is now damaged and is also likely to need root canal treatment).

Treatment of Cracked Tooth Syndrome

This diagram shows a heavily amalgam filled tooth that has lost around 70% of its strength. Over time the tooth can ultimately fracture.

Before the tooth fractures it may become sensitive to chewing hard foods or hot, cold or sweet

A crown is the only long term solution to hold the cracks together or restore the broken tooth. The tooth is now twice as strong as a healthy tooth.

The two major causes of cracked teeth are;

Large Fillings - teeth with fillings in them are mechanically weaker, as there is less tooth structure present to hold the tooth together. If the filling in the tooth involves more than one third of the tooth then the strength of the tooth can be down to 30% of its normal strength. Every time you eat, grind or clench the tooth will flex slightly. After doing this many thousands of times a fracture or hair line crack can propagate just like a crack in a car's windscreen. The silver amalgam fillings also contain mercury that will expand and contract with temperature changes at a much greater rate than the remaining tooth structure. This is why mercury is used in thermometers. The mercury expansion in the silver amalgam filling further weakens the tooth.

Habits - this involves people who clench or grind their teeth or chew on objects such as hard sweets, nuts or ice. The tooth is not strong enough for this constant trauma. Up to 80% of people will clench without any realisation while sleeping. These clenching or grinding forces are up to ten times stronger than when eating food! It is no wonder that many people will then cause damage to their teeth or fillings and report that it was only soft food they were eating when the tooth / filling fractured!

The tooth opposite has a silver amalgam (mercury) filling in it. The silver amalgam filling takes up more than one third of the whole tooth and reduces its strength by more than 70%.  This tooth has been crowned and is now stronger and just as real looking as a healthy tooth.This tooth should remain stable for a lifetime with proper preventative care.

Treatment

A visit to your dentist as soon as possible is important to increase the chances of saving the tooth or preventing more extensive and expensive treatment.

A simple crack is where the nerve of the tooth is not involved. These teeth often require a crown. A filling cannot properly hold the crack together and is not a recommended option.

The crown, however acts like metal rings that hold a barrel together. Large fillings destabilize teeth and, over time, biting forces of the opposing teeth can cause cracks, breakage, inflamed roots and pain. Crowns should be placed onto teeth instead of large filling to avoid additional problems.

In much less than 10% of cases the crack may involve the nerve (complex crack ) and the tooth could still remain or become problematic even after the crown is placed. This is due to bacteria that cannot be removed from the crack and it could enter the nerve. In these cases root canal can still be done through the crown and a white filling can then be placed in the middle of the crown.

The crown will continue to hold the tooth together and the tooth will normally last a lifetime. In very rare cases the crack can cause the tooth root to split below the crown. In these rare cases the tooth may have to be removed (extraction).

Your Enhance Dental dentist will advise you of the appropriate treatment for your tooth.