Cracked Tooth Syndrome


Cracked Tooth Syndrome Symptoms

Cracked tooth syndrome (CTS) is one of the leading causes of tooth loss. Also known as cracked cusp syndrome or split tooth syndrome, CTS happens when a tooth has a fracture, crack, split, or break that is too small to appear on X-rays or is under the gum line.

Cracked tooth syndrome symptoms are varied and can be irregular—making cracked teeth challenging to diagnose. Sometimes, a fractured tooth may not even produce any symptoms. Unlike cavities or an abscess, the pain associated with a fractured tooth is not constant and is often unpredictable.

Common signs of a fractured tooth are:

  • Erratic pain while chewing or biting (especially when the bite is released)
  • Sensitivity to heat, cold, or sweet foods
  • Pain that comes and goes
  • Swollen gums around the tooth with the fracture
Craze Lines Fractured Tooth
Craze Lines and Fractured Incisal Edge Requiring Bonding Or A Porcelain Veneer.

Why Treatment is Needed When Teeth Crack

Diagnosing and treating cracked tooth syndrome is common at Lakefront Family Dentistry.

“Many of our patients don’t notice any pain unless they are using the tooth. However, being proactive is the best choice if a patient suspects a tooth fracture or has intermittent and unexplained pain. If a patient waits too long, the crack can worsen, and the tooth may become unfixable—leading to an extraction, grafting, and implant. If a patient suspects that their tooth may be cracked or fractured, they should come to see us for an evaluation as quickly as possible.”Dr. Mark Phillipe, DDS

One of the key reasons for seeking treatment as early as possible is because a fractured tooth will never heal completely like a broken bone. Early intervention is key to preventing infection and additional damage that can lead to tooth loss. With CTS, outcomes are better the earlier treatment is sought.

What Causes Teeth to Fracture?

Teeth can fracture for a variety of reasons, including:

  • Teeth grinding (bruxism)
  • Large dental fillings that weaken the tooth
  • Chewing or biting hard food (such as ice, nuts, or hard candy)
  • Injuries to the mouth (such as car accidents, sports injuries, falls, or fights)
  • Abrupt changes in temperature (such as eating something hot and then drinking ice water)
  • Age (the majority of teeth cracks occur in patients over the age of 50)
Split Tooth
Split Tooth

Which Teeth are More Prone to Cracking?

Although any tooth can break or fracture, the commonly affected teeth from cracked tooth syndrome are the molars in the back of the lower jaw. Patients with multiple dental cavities also have a higher risk of cracked teeth. Although CTS usually affects only one tooth, patients who have undergone severe trauma may have multiple fractured teeth.

Types of Tooth Fractures

Not all tooth cracks are the same. The treatment and outcome of a patient experiencing cracked tooth syndrome will depend on the type of crack, location, and the extent of the fracture. The five types of tooth cracks are described below.

  • Craze lines. Also known as hairline cracks, craze lines are small cracks on the outer enamel of a tooth. These types of cracks are quite common. Luckily, they are shallow, painless, and normally do not require treatment other than for cosmetic reasons.
  • Fractured cusp. Typically appearing around a dental filling, a fractured cusp occurs when a piece of a tooth’s chewing surface breaks off. The good news is that fractured cusps usually do not damage the pulp (e., the soft center of a tooth where the nerves, blood vessels, and connective tissue are located) and usually do not cause much pain. Fractured cusps can be treated with a new dental filling, bonding, or placing a crown over the damaged tooth.
  • Cracked tooth (vertical crack). This occurs when a crack extends from the chewing surface of a tooth down toward the gum line. Early diagnosis is critical because once the crack extends into the gum line and the root of the tooth, extraction is the only treatment. If caught early enough, a root canal may be necessary, and a crown can help to keep the crack from spreading.
  • Vertical root fracture. In these cases, a crack starts below the gum line and travels upward to the chewing surface. These types of cracks usually produce minimal symptoms and often go undetected until the bone and gum tissue become infected. Extraction of the tooth is often required.
  • Split tooth. As the name implies, a split tooth occurs when a tooth cracks from top to bottom—resulting in a tooth that can be separated into two parts. Although the entire tooth cannot be kept intact, part of the tooth might be able to be saved.
cracked tooth syndrome teeth
Cracked Tooth Syndrome

Diagnosing Cracks in Teeth

As mentioned previously, diagnosing cracked teeth can be challenging since x-rays do not always show the crack and the symptoms can be so variable. Here are some of the methods that our dentists use to diagnose cracked tooth syndrome.

  • Take a dental history to learn about any behaviors (g., bruxism, chewing on hard foods) or occurrences (e.g., trauma) that may have resulted in tooth fractures.
  • Perform a visual exam using a magnifying glass and/or light to identify or illuminate a fracture.
  • Conduct a physical exam. This may involve probing for gum inflammation, asking patients to bite down on something, and using a dental explorer to see if it “catches” on the edge of a crack.
  • Use dental dye to highlight a crack.
  • Perform x-rays to identify teeth with poor pulp health, which can indicate the presence of a crack.
Cracked Tooth Syndrome Treatment

Our dentists will decide how to fix cracked tooth syndrome based on the location, severity, and type of fracture. Below is a list of possible treatments that may be recommended.

  • Cosmetic Contouring. Used primarily for craze lines, this procedure can round rough edges and smooth out the teeth.
  • Bonding involves using plastic resin to fill the crack.
  • A veneer is a thin covering of porcelain that is placed over the front of a tooth. Veneers can be an option when a large amount of the natural tooth is still in place.
  • A porcelain crown is placed over the damaged tooth to protect it. Lakefront Family Dentistry uses CEREC, which allows us to offer same-day placement of crowns. A crown is usually the best option if there is not enough of the natural tooth left.
  • Root Canal. When cracks extend into the gum line and the pulp of the tooth, a root canal will be performed to remove the damaged areas. A root canal will prevent an infection that otherwise would eventually spread out of the tooth and into the jaw. With severe cracks, a root canal is the only procedure that will offer pain relief.
  • When cracked tooth syndrome has damaged the tooth’s structure, nerves, and roots, completely removing the tooth may be the only option. After the extraction, bone grafting and a dental implant will be used to replace the tooth.

In minor cases, Dr. Phillipe or Dr. Hauser may recommend no treatment if the fracture does not affect appearance, causes no pain, and does not extend deep or far.

If you suspect that you may have a fractured tooth or are experiencing intermittent pain that comes and goes, contact Lakefront Family Dentistry by calling (951) 244-9495 during business hours to schedule a consultation or appointment. You can also make an appointment online anytime.


Our Patients Rank Dr. Mark Phillipe, DDS, and Dr. Derek Hauser, DDS, as the #1 Private Cosmetic and Family Dentist Practice in the Inland Empire!