Most people dread the thought of going to the dentist when they start to feel a small ache in their gums. That first sign of sensitivity can cause fear as we start to wonder what the underlying cause and implications will be. At some stage in our lives, most of us have experienced unwanted tooth pain which can be one of the most agonizing and stressful times for our bodies. A cracked tooth can start off as a small irritating sensitivity but left untreated, it can lead to extreme pain and tenderness which is easily prevented by a trip to the dentist.
What is Cracked Tooth Syndrome?
Cracked tooth syndrome (CTS) also known as cracked cusp syndrome or split tooth syndrome occurs when there is a crack in the tooth that is too small to show up on X-rays, or is under the gum. This can make CTS challenging to identify but it mostly appears on molars (the lower back teeth). This is because molars absorb most of the force when chewing.
People that grind or clench their teeth may be more likely to have cracked tooth syndrome due to the added force applied to the teeth. Another contributing factor can be the way a person’s teeth naturally come together which can put too much pressure on one specific tooth. This added pressure can cause the tooth to crack.
In many cases, teeth that have already been treated with large fillings may be more likely to crack. As are teeth that have undergone root canal treatment as they are weaker than the surrounding teeth and more susceptible to pressure. People with one cracked tooth are more likely to have others, either at the same time or in the future. Cracked tooth syndrome presents mainly in patients aged between 30 years and 50 years, in both men and women equally.
Signs of CTS
The first tell-tale sign of CTS will be that the tooth may hurt when you bite or chew. The pain can be mild or intense and it might be a fleeting sharp pain or last for a long time. In some patients it may be painful only when eating certain foods or when they bite in a specific way. There will not normally be a constant ache, as there would be for a cavity or abscess but the tooth may become more sensitive to cold temperatures.
If left untreated and the crack gets bigger, a piece of the tooth may break off. This could lead to an infection of the surrounding gum around the fractured tooth. A pimple-like bump might appear on the gum near the tooth which will need to be drained of pus by a dentist. This is known as a fistula and may require antibiotics to ensure that the infection fully clears.
Unfortunately, many people with cracked tooth syndrome can suffer with these symptoms for months as CTS is one of the most difficult dental problems to diagnose because the pain is not predictable. You may be referred to an endodontist (a root canal specialist) if your dentist is unable to make the diagnosis.
What to Expect During the Diagnosis
Like any normal visit, your dentist will examine your mouth and teeth, focusing on the tooth in question. They may use a sharp instrument called an explorer to feel for cracks in the tooth and check for any pain while biting. Your dentist will also look at the gums around the tooth and check for sensitivity. The dentist may wish to have X-rays taken but they do not often show the crack. In some cases, if the tooth already has a filling or crown, your dentist may remove it in order to see the visible crack underneath.
Treatment for CTS
As previously stated, it is difficult to get a confirmed diagnosis for CTS and there are a number of factors that affect the type of treatment available, such as:
- Where on the tooth the crack is,
- How deep it is, and
- How large it is.
Sometimes a crack affects more than one part of the tooth and may be fixed with a crown (also known as a cap). Some cracks can affect the center of the tooth (the pulp), where the nerves and blood vessels are, and in these situations the tooth will need root canal treatment. Around 20% of cracked tooth syndrome cases will need root canals. After the root canal treatment, the tooth will no longer be sensitive to temperature but it will still respond to pressure, therefore the gum may still ache.
If the crack affects the root of the tooth in the jaw, then it will have to be removed. There is no other way to fix this type of crack and you can have the tooth replaced with an implant or bridge.
Prevention
If you are aware that you grind your teeth and you would like to prevent CTS, your dentist can make a night guard (a plastic bite piece) that you wear at night to relieve the pain from grinding. For some people, this will also stop tooth sensitivity and it can be worn at other times during the day if clenching or grinding is an issue.
It is also worth keeping a close eye on teeth that have already got crowns or root canals as they are more likely to crack than other teeth. Alert your dentist to any possible pain or sensitivity with specific teeth as soon as you become aware of the problem.
Your dentist will be able to talk you through all of your options whether it is a crown, root canal or extraction and possibly be able to prevent further issues with a night guard. Treatment of cracked tooth syndrome is not always successful. Unfortunately, some people continue to have occasional symptoms after treatment and they may require the help of a specialist.
If you believe you are suffering from CTS or think that grinding your teeth might cause CTS, speak to your dentist and arrange for a check-up at the earliest opportunity.
Our experienced cracked teeth endodontists in Charleston, SC, can help you. Call out office today!