Accidents are inevitable, sometimes you may bruise your arm and other times lose scrape your knee. However, when accidents involve your mouth, the most common trauma reported by dentists is cracked tooth or fractured teeth. Whether you got into a bar fight or had an embarrassing close encounter with an invisible glass door, cracked teeth can cause you immense pain especially upon pressure. Cracked tooth syndrome deals with minor, undistinguishable cracks or craze lines on your teeth that are ridiculously hard to detect, even by experienced dentists, according to the American Dental Association (ADA)!
It is for this reason that early diagnosis is crucial in order to effectively save your cracked tooth and restore it back to health. If you have ever been rushed to an ER for broken teeth, you know that dentists often suggest you immerse your fallen out teeth in a container of milk to help attach it back into your mouth. But what happens when the tooth hasn’t completely been broken off but has cracks in it, the depth and extent having undisclosed yet? For cracked tooth syndrome, your treatment is meticulous and strategically planned to preserve the health of the fractured tooth. We discuss the various treatment options available for your cracked teeth.
TREATMENT OF CRACKED TOOTH
If you’ve cracked a tooth, chances are that you may soon be in immense pain. The diagnosis and treatment planning should ideally begin prior to this stage of pain and discomfort. Immediate treatment of the tooth will depend on the size of the involved portion of the tooth and the extent to which it is spread out. A tooth that has a relatively small crack and fortunately avoids the pulp may be easier to treat and no necessary extra caution might be needed.
However, if the portion of the tooth that is cracked is considerably large and closely approaching or involves the pulp, the treatment should begin with stabilization. This aims to prevent the movement of the segments of the involved tooth so that they do not move or flex independently during mastication or chewing. The stabilization of the tooth segments is done with an orthodontic stainless steel band in conjunction with occlusal adjustment. It aids in the immediate relief of symptoms. It is also to be considered that the crack line does not exhibit microleakage. If any fluid oozes out of the crack, it coils potentially result in pulpal necrosis. It is necessary to note that permanent stabilization and cuspal protection of the tooth with an acrylic or cast metal crown is necessary for the longevity of the restored tooth.
Restoration or filling
Ideally, when there is a small, identifiable peripheral crack, with no signs of pulpal involvement, it is a relatively easy case to begin dental filling. The affected portion may be removed and in its former place, a dental restoration is inserted to restore the functional abilities of the tooth. Composite, pinned amalgam, or appropriate cast metal restorations are used to restore the shape, size, and appearance of the compromised tooth section.
If the repair is to be done in an anterior tooth or one that can be readily visible when you smile, the dentist may make an informed decision to replace the cracked section with tooth-colored dental material known as composite.
In cases where you have a seemingly large central crack with no pulpal involvement, your dentist may decide to opt for tooth bonding as a safe and effective method of restoring your fragmented tooth. Immediately after stabilization and occlusal adjustment, bonding of the tooth is initiated whereby a resin material is attached to the tooth surface to seal or fill the gap left behind by the crack and to make the tooth functional long-term.
Bonding is a simple, non-invasive procedure that typically does not require numbing of the tooth with an anesthetic. The dentist first etches the tooth surface to allow the microporosities on the tooth to open up and relay better retention of the material to be applied on top of it. Next, a tooth-colored resin is applied on the tooth surface to replicate the look of natural teeth. After adequate shaping and polishing, the tooth is cured with UV light to set the material in place. Dental bonding a cost-effective technique to correct cracks in teeth while also incorporating superior finish, greater strength, and flawless esthetics.
If the crack is long and deep (with or without the involvement of the pulp) but doesn’t quite reach the root or below the gum line, a crown may be the best treatment option to restore the tooth. Immediate stabilization with an orthodontic band or an acrylic crown along with occlusal adjustment may be done. If there are signs of pulp involvement, the tooth may still be salvageable. The American Academy of Endodontists (AAE) informs that if the crack has extended into the pulp, the tooth may be treated with an additional root canal treatment before the placement of a crown in order to protect the crack from spreading.
A pulp extirpation is done as part of the root canal treatment wherein the infected pulp and bacteria inside the pulp chamber are removed with a thorough cleaning of the inside of the tooth. If there isn’t enough tooth matter left to bond, the dentist will recommend placing a full-coverage crown over the tooth surface. Permanent crowns can be made from metal, porcelain, fused-to-metal, all-resin, or all-ceramic. Depending on the tooth, the crown material is chosen. Anterior teeth may be treated with porcelain crown whereas rear molars may work better with cast metal crowns. Crowns are crucial for cracked teeth because they provide permanent stabilization to the weakened tooth.
If the crack extends well below the gum line, the tooth is no longer treatable and needs to be extracted, according to the AAE. That is why early treatment is crucial as a cracked tooth that is not treated progressively worsens, eventually resulting in tooth loss. Teeth with hopeless prognoses, such as vertical crack, crack extending through pulpal floor, poor crown-root ratio, crack extending below the alveolar bone level, etc. may all be destined to extraction.
You may be worried that once the unsavable tooth is extracted, you will have to live with a gaping space in your mouth. Fortunately, that may not be the case with the introduction of dental implants. Implants are prosthetic appliances that include a titanium post that is drilled into your jaw bone and a porcelain crown that fits over it like a real tooth crown. Although invasive, dental implants have a success rate of over 98% and are increasingly praised by patients and dentists alike for being revolutionary in their function.
PREVENTING CRACKED TEETH
Cracked teeth aren’t always preventable, but a few strategies can help keep teeth cracking sufficiently away from you.
- Avoid biting into hard foods or items, such as hard candies, ice, popcorn kernels.
- If you are a habitual teeth grinder or clencher, seek dental help immediately
- Use mouthguards when playing contact sports such as ice hockey
- Maintain proper oral hygiene by brushing and flossing regularly
If you’ve cracked a tooth, eating, drinking, and even sucking in air may be painful to do. Until you reach the dentist’s office, bite on clean, moist gauze, or cloth to help relieve your symptoms temporarily. Avoid using topical oral pain medications or ointments, or place aspirin on the affected areas to eliminate pain symptoms. Timing is key in the diagnosis of cracked tooth syndrome. Connect with brilliant dentists at 4Smile to inspect your teeth for any signs of cracks!