Sharp pain when biting down? Sensitivity that won’t quit? These are textbook cracked tooth symptoms. Research shows 79% of cracked teeth occur in molars and most patients are over 40 years old.
Cracks don’t heal themselves, they spread, let bacteria in and turn a fixable problem into an extraction. Here’s what causes them, how to spot them and what actually works to save your tooth.
What Causes Teeth to Crack?
Immediate damage:
- Biting hard lollies, ice, or olive pits
- Sports injuries without a mouthguard
- Using teeth as tools (opening bottles, tearing packaging)
- Sudden temperature shock (hot coffee immediately followed by ice water)
Gradual wear:
- Teeth grinding (bruxism) during sleep
- Large old fillings create weak points in tooth structure
- Natural aging, the enamel becomes more brittle over time
- Repeated stress on teeth with existing restorations
A tooth already weakened by a filling can crack from normal chewing. The filling doesn’t move with the tooth, creating stress fractures around the edges.
Cracked Tooth Symptoms That Matter
Classic warning signs:
- Sharp, shooting pain when biting or chewing specific foods
- Pain when releasing bite pressure (not during the bite itself)
- Sensitivity to cold or hot that lingers after the stimulus
- Pain that appears randomly and then disappears completely
- Discomfort in a general area without being able to pinpoint which tooth
The intermittent nature tricks people into waiting. Pain comes and goes because biting forces the crack segments apart (causing pain), then they slide back together (pain stops). This pattern is characteristic of cracked tooth syndrome. About 16% of cracked teeth cause pain on biting, while cold sensitivity is reported in roughly 37% of cases.
5 Types of Tooth Cracks
Craze lines: Surface cracks in enamel only. Common in adults, usually painless, monitored but not treated.
Fractured cusp: A piece breaks off the chewing surface, typically around a filling. It may not hurt but it needs repair to prevent further damage.
Cracked tooth: Crack extends from the chewing surface toward the root. Serious, if it reaches below the gum line, extraction becomes likely. Modern pain-free dental treatment with proper anaesthesia.
Split tooth: The Crack has divided the tooth into separate segments. Usually requires extraction, though partial tooth preservation is sometimes possible.
Vertical root fracture: Starts below the gum and moves upward. Minimal pain initially but it leads to infection. Hardest to save. Often needs root canal treatment if caught early.
How Dentists Find Cracks
X-rays miss most cracks, especially vertical ones. Diagnosis combines:
- Detailed symptom timeline (when pain occurs, what triggers it)
- Visual exam under magnification
- Transillumination (bright light shows crack lines)
- Bite tests with different pressure points to reproduce pain
- Special dye that highlights crack patterns
- Removing old fillings to inspect hidden damage
The diagnostic process aims to recreate the exact conditions causing pain, then trace that back to the crack location.
Cracked Tooth Treatment Options
Bonding: Tooth-coloured resin seals minor surface cracks. Quick procedure for superficial damage.
Crown: The standard treatment for cracked teeth. Covers and protects the entire tooth, preventing the crack from spreading. Most cracked teeth need dental crowns for long-term survival. Crowns after root canals are especially important to prevent re-fracture.
Root canal + crown: When the crack reaches the pulp (inner living tissue), infection or inflammation occurs. Root canal removes infected tissue, then a crown protects the remaining structure.
Extraction: Cracks extending below the gum line or splitting the tooth vertically often can’t be saved. Replacement options include implants or bridges.
Preventing Cracked Teeth
Protection strategies:
- Wear a custom mouthguard for contact sports or teeth grinding
- Stop chewing ice, hard sweets and popcorn kernels
- Use scissors, not teeth, to open packaging
- Get large old fillings assessed before they compromise tooth structure
- Attend six-monthly check-ups for early crack detection
Food caution: Crusty bread, nuts and hard foods need careful chewing. One wrong bite on a weakened tooth causes fractures.
When to Act Immediately
See a dentist straightaway for:
- Severe pain that won’t settle
- Visible breaks or missing pieces
- Swelling around the tooth
- Persistent pain when biting
Delaying lets cracks spread, bacteria enter and infections develop. A crown-fixable crack today becomes an extraction-requiring split in six months.
FAQs
Can cracked teeth heal naturally?
No, teeth can’t regenerate like bone. Cracks only worsen without treatment.
Why does cracked tooth pain come and go?
Biting pressure forces crack segments apart (pain), releasing pressure lets them close (pain stops).
Do all cracked teeth need crowns?
Back teeth (molars, premolars) almost always need crowns due to chewing forces. Front teeth with minor cracks might only need bonding.
How long before a crack becomes serious?
Varies, minor cracks can remain stable for months, while others progress to infection within weeks. Earlier treatment always gives better outcomes.
What happens if I ignore a cracked tooth?
The crack spreads deeper, bacteria infiltrate, infection develops and extraction becomes the only option.
