Cracked Tooth Management

Cracked tooth syndrome relates to a variety of symptoms and signs caused by a crack in a tooth. Early diagnosis and treatment are important to improve the chances of saving a crack tooth.

Most cracked teeth can be saved. If a crack is located and treated early, your dentist may be able to prevent the crack fro progressing through the tooth. These cracks may propagate and involve the pulp, nerve and root.

The syndrome may involve:

  • Teeth with large fillings or restoration where the crack runs under a weakened cusp (the raised edge of a tooth)
  • Teeth with minimal or no fillings where the tooth has been subjected to heavy biting forces due to grinding
  • Teeth that have suffered trauma.

Symptoms and sign of a cracked tooth

  • Sharp and erratic pain upon chewing (especially when biting on grainy food) or after release of biting pressure; not all cracks cause pain
  • Pain or discomfort when the crack is exposed to cold or hot food or liquids
  • Sensitivity to sweet foods
  • Difficult in pinpointing which food hurts or whether the pain is coming from a top or bottom tooth
  • The crack may not be visible to the eye or detectable on a dental x-ray film
  • If the crack extends below the gum, a pocket of gum disease extending along the root surface
  • Often, a patient will present with a history of other cracked teeth

Causes of cracked tooth syndrome

  • Cracked tooth syndrome has come more common because people are keeping their teeth longer than in previous generations. As a result, people often have large fillings that may weaken the teeth and make them prone to fracture.
  • Many people’s lives are more stressful nowadays, leading to clenching or grinding of the teeth, particularly at night. This is called bruxism. Bruxism can cause teeth to crack
  • Over the years, daily wear and tear from clenching, grinding and chewing can slowly cause cracks
  • Chewing on hard foods or substance, such as ice, sweets or pencils
  • Trauma such as a blow to the teeth, especially if the upper and lower jaws have been rammed together.


Diagnosis can be difficult because symptoms are not consistent. Also, cracks vary greatly in length and location. Often, cracks are not discovered until a variety of symptoms are present. Diagnosis may involve the following issues.

The examination

Your dentist may check for:

  • Sings of tooth wear
  • Your “bite
  • Cracks on the surfaces of teeth
  • Large fillings with weakened cusp.
  • Radiographic exam (X-rays)
  • Removal of a filling
  • Staining
  • Transillumination
  • Temperature Change

Treatment for a cracked tooth

  • To increase chances of successful treatment, early treatment is important. Treatment depends in the extent and position of the crack.
  • Removing the weakened cusp and placing a large filling or crown (cap) in the tooth
  • If the tooth is heavily restored, a crown is an effective treatment.
  • Sometimes a stainless steel band is placed to see if the tooth pain can be stopped. If discomfort stops, a filling or crown will then be placed.
  • If the discomfort does not stop,  root canal treatment may be needed before the crown or filling 
  • Dentist may refer you to an Endodontist or prosthodontist
  • In some cases, extract the tooth.


  • If you clench your teeth or grind them together (bruxism), particularly at nighttimes, you can have a special night guard made to protect your teeth. Your dentist can fit you with a night guard, also called an occlusal splint.
  • Avoid chewing on hard objects such as ice, hard sweets, pens or pencils.
  • Wear a protective mouth guard when playing contact sports.
  • Practice good dental hygiene to minimise the need for fillings.

Even with these precautions, teeth can still develop cracks.