What are My Options to Repair a Cracked Tooth?

The diagnosis of a cracked tooth is a very broad one.  A crack can be a very shallow surface disruption on enamel, or it can split the entire tooth into two fragments all the way down the root.  Because of this wide range of possibilities when it comes to cracks in teeth, the treatment also varies widely.  Some cracked teeth require no treatment at all, while others cannot be saved and must be extracted.

The depth, or extent, of the crack typically determines the aggressiveness of treatment.  Understanding the purpose and configuration of tooth enamel helps us explain the different degrees of cracks, with their subsequent treatments.

The Purpose of Enamel

Enamel is the hardest structure in the body.  It is harder than bones and the other hard structures of teeth.  While it is extremely hard, it is also very brittle.  Enamel is a single continuous unit that covers the exposed portion of every tooth.  It does not cover the roots of the teeth.

Enamel protects the more sensitive inner structures of teeth from the physical and chemical stresses of eating and drinking.  A tooth with healthy, continuous enamel withstands normal eating and drinking very easily.  Any disruption in the enamel weakens a tooth and predisposes it to cracking.

What Causes Enamel to Crack?

Enamel only maintains its extraordinary strength as long as it maintains its integrity as a single unit.  The following are things that can disrupt the one-piece structure of enamel.

  • Cavities – Cavities are literal holes in tooth enamel caused by bacteria in the mouth. The bacteria eat sugar, produce acid, and slowly erode away the enamel to work their way into the tooth.  This definitely disrupts the integrity of enamel.
  • Large Fillings – Fillings are necessary to repair the damage of cavities. While they “fill in” the hole of a cavity and restore the tooth to function, they do not replace the single unit of enamel.  Fillings themselves are a disruption in enamel.
  • Trauma – We can break or crack enamel when we suffer trauma or blunt force to a tooth. This often happens in sports or auto accidents.  It can also occur if you bite into something extremely hard.  Usually this is a non-chewable substance, like a piece of metal that wasn’t supposed to be in your meal, but occasionally it can happen with hard nuts like almonds.
  • Clenching and/or Grinding – Also known as bruxism, nighttime clenching and/or grinding of the teeth puts higher than normal forces on the teeth. Over time, these forces add up to cause weakening and damage to the enamel.  We often term this kind of damage “microtrauma” because it is smaller forces sustained over a long period of time.
  • Drastic Temperature Changes – You know what happens if your windshield is covered in ice, and you pour hot water onto it? Your windshield will crack!  This is the same thing that can happen to our enamel with drastic temperature changes.  If you are chewing ice and then take a bite of hot food, the enamel may not be able to handle it.  (This is why we tell you not to chew ice!)

What are the Treatment Options for Cracked Teeth?

The following are the most common treatments performed in dentistry for cracked teeth, with a description of what criteria we use to choose them.

No Treatment

Very superficial crack lines in the outer layers of enamel need no treatment at all.  It is important to be aware of their presence and the warning that they give!  You may need to consider a preventive option like a protective nightguard to stop more damage to the teeth if you are a clencher/grinder.  You might want to stop eating almonds as an afternoon snack.  Dr. Chowning will give you specific recommendations for your situation.

Fillings

A filling is useful in removing cracked enamel and sealing it with a bonded tooth-colored filling material.  This stops bacteria from sneaking into the crack and causing a cavity underneath it.  Typically, fillings are best for cracked teeth that have no symptoms.  These cracks may extend into the enamel and even just beneath it into the dentin, but not far!

Crowns

A crown is a dental treatment that replaces the complete layer of enamel on a tooth.  The reason this is such a common treatment for cracked teeth is that it removes the disrupted enamel in its entirety and replaces it in its entirety with a single unit.  By holding the crack together, a crown can eliminate the sensitivity to temperatures and chewing that may occur with a cracked tooth.

Root Canal Treatments and Crowns

If a crack extends deeper into the interior of a tooth, it can affect the nerve within.  When the symptoms are worse than minor sensitivity to temperature and chewing, it is likely that the nerve inside the tooth has become irreversibly inflamed.  This requires removal of the nerve tissue, which is what a root canal treatment does.  After removal of this tissue, the tooth becomes dehydrated and even more brittle, so it must be covered with a crown.

Extractions

In cases where a crack has already spread into the nerve chamber of a tooth or down one or more of the tooth’s roots, the long-term prognosis of the tooth is poor or hopeless.  This means you can invest in expensive dental treatment, and it will likely fail.  The best option in these cases is to remove the tooth and discuss your tooth replacement options with Dr. Chowning.

Do You Think You Have a Cracked Tooth?

Call 940-382-1750 today to schedule a consultation with Dr. Chowning.  He will evaluate your area of concern and explain your treatment options.