A cracked back tooth is one of the most common problems with teeth today. Typically the further back in the mouth, the occurrence of a tooth problem increases. The uncomfortable tooth often is not broken. Broken back teeth are usually less painful than a cracked tooth before it breaks.

The signs and symptoms of a cracked tooth are:

• Temperature sensitivity is especially noticeable when pressure is placed on the tooth
• The tooth location is far back in the mouth. Therefore, the last molar is most likely, and the risk decreases with each tooth forward.
• The problem tooth often shows significant wear signs, indicating more than normal function against the tooth it bites against.
• When checked with an inked paper called articulating paper, extensive ink areas are left on the tooth rather than a more normal point-to-point contact between the teeth.

• Teeth with large dental fillings are weaker and more susceptible to cracking and breaking.
• The tips of the canine teeth (eye teeth) are worn off.

Why do teeth crack?

To understand this, you must first understand what is expected. In a normal situation, the upper and lower back teeth touch each other with point contacts. When a person chews, the back teeth do not touch when the jaw moves from side to side. The four canine teeth (two uppers and two lower) guide the jaws apart, sending a signal to the brain to open the mouth when the jaw slides left or right. The back teeth only make contact when the jaws are fully together. Ideally, the at-risk back teeth only receive vertical force down the tooth center, where they were designed to receive heavy pressure best. Side forces on back teeth are not well tolerated and place the tooth at risk of developing a crack(s). If there is a filling in the tooth, especially a large filling that is also a silver/mercury amalgam, the tooth crack risk dramatically increases. People who grind their teeth have an increased risk of developing a cracked tooth.

What to do to prevent or treat cracked back teeth.

If the tips of the four canine teeth are worn down, allowing the back teeth to come into contact heavily in side-to-side movements, the individual should consider the value of placing a dental restoration on the canines to improve jaw guidance by eliminating or lessening side-to-side forces on the back teeth.

If a person grinds their teeth at night, they should consider wearing a protective night guard over the upper or lower teeth to lessen the stress on the teeth and the jaw muscles.

Tooth grinding and heavy tooth wearing can indicate tooth interference with normal jaw closure. The dentist may feel the individual could benefit from adjusting the bite.

If, on routine examination, the dentist notices a darkened crack line in a tooth, the dentist should consider placing a protective crown or onlay restoration. This contains the walls of the tooth on either side of the crack preventing the crack from propagating through the tooth.

If left untreated, the crack could extend through the tooth to the nerve (pulp) area requiring root canal treatment. If the crack extends through the nerve area to the middle of the tooth where it meets the jaw bone, the tooth would need to be removed.

Cracked Tooth Restoration

If the cracked portion ultimately breaks off the tooth, it frequently breaks down to where it emerges from the bone, requiring a crown-lengthening surgical procedure before the dentist can restore the tooth with a dental crown.

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At the center of each of your teeth is a hollow space occupied by nerve and blood vessel tissue called the dental pulp.  This dental tissue was essential to the tooth while forming, providing sustenance to the developing tooth.  Once the tooth has matured, the pulp is not a necessary part of a functioning tooth.

SOURCES OF TOOTH DAMAGE

If a tooth is subjected to trauma, damage can occur to the pulp.  The sources of injury include the following:

• Severe tooth decay.
• Physical impact o the tooth or its supporting bone.  The tooth may be fractured or broken.  Even if the tooth is not visibly damaged, the trauma shock is often enough to injure the pulp. Some cracked teeth are repairable, and other types of cracks and splits are not.
• Severe wear of tooth surface through attrition, abrasion, or erosion.
• Advanced periodontal disease.

Severely damaged pulp will die.  The dead cells provide what is commonly called a pulpal abscess.  Often it will be accompanied by pain.  A damaged pulp can also be sensitive or painful.  Discomfort is not always immediate, and symptoms differ for a live injured pulp or dead pulp.  Information you provide us in conjunction with an examination and x-ray will provide the diagnosis in most cases.

Except when a fracture of the affected tooth makes it unrestorable, your dentist can save many injured teeth potentially for the rest of your life.  To do this, the damaged pulp is removed from the tooth in endodontics therapy or root canal therapy.  When deemed necessary to preserve a tooth, a root canal procedure can accomplish this with little or no discomfort.

ROOT CANAL THERAPY

To treat a tooth with root canal therapy, a hole is made in the tooth’s center to allow the dentist access to the damaged pulp.  Small instruments, called files, and a solution used to dissolve tissue are used through this access cavity to clean out the pulpal tissue that could provide nourishment to germs.  Once the pulp has been removed to the root’s tip, the space previously occupied by the pulp is filled with cement, an inert material designed to prevent germs from accessing the tooth, which could cause future infection.  Sometimes, a root canal may carry out these steps in a single office visit.  Often, though, two, three, or more visits are required.

FEES FOR ROOT CANAL

The number of roots in the tooth determines fees for a root canal.  This fee only covers root canal therapy and does not cover the cost of restoring the tooth. The visible part of the tooth is called a dental crown.

RESTORING THE TOOTH

Endodontically treated teeth all need to be restored following treatment.  This will be limited to a bonded filling in the access cavity in some instances.  Often, the damaged tooth will require an inlay or crown to restore it to normal appearance and function.  The American Dental Association recommends that all endodontically treated back teeth be protected with a crown or inlay because of the high fracture incidence.  Tooth restoration is a separate and distinct portion of treatment from the endodontic therapy provided.

Chandler Cosmetic Dentist
Kelly Jorn Cook, DDS
3800 West Ray Road, Ste 19
Chandler, AZ 85226

Phone: (480) 899-4477 

https://www.kellyjorncook.com

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