Treatment
Cracked tooth assessment and treatment in Nuneaton
A sharp, brief pain when you bite on something — or when you let go — is the classic sign of a cracked tooth. Cracks do not show on ordinary X-rays and rarely announce themselves clearly, so finding one, and working out how far it has gone, takes a careful, methodical examination.
Why teeth crack
Back teeth take enormous forces, and a tooth that has already lost structure to a large filling is weaker than it looks. Grinding or clenching, chewing ice or hard sweets, an accidental bite on a stone in a cherry, or simply years of use can start a crack that slowly deepens. Root-treated teeth that have not been protected with a crown are particularly vulnerable.
Symptoms that suggest a crack
- sharp pain on biting that disappears as soon as you release;
- pain that is hard to pin down to one tooth and comes and goes;
- sensitivity to cold or sweet things in a tooth with no obvious decay;
- a tooth that only hurts when you chew on a particular spot.
If the crack reaches the pulp the symptoms change: the ache becomes spontaneous or lingers after hot and cold, and the tooth behaves like one that needs root canal treatment.
How a crack is found
There is no single test, so several are used together. You are asked to bite on a small plastic instrument tooth by tooth and cusp by cusp to reproduce the pain; dye is painted on to stain the crack line; a bright light is shone through the tooth to see where it is blocked; and the tooth is examined under the operating microscope, where fine crack lines become visible. X-rays rule out other causes and show the state of the bone. Nerve tests establish whether the pulp is still healthy.
Treatment options
What is recommended depends entirely on how deep the crack runs. A shallow crack confined to the crown of the tooth is usually treated by your dentist with an onlay or crown that holds the tooth together and stops the crack spreading. A crack that has reached the pulp needs root canal treatment before the tooth is crowned. A crack that extends below the gum or splits the root means the tooth cannot be saved, and the kindest advice is extraction and a plan for its replacement. Whatever the finding, it is explained with the reasoning behind it, and you receive it in writing.
Why early matters
Cracks only go one way. A tooth examined when the first twinges appear has every chance of being protected and kept; one that has been biting on a spreading crack for a year may not. If you have had that sharp, fleeting pain on biting for more than a week or two, it is worth having it looked at.