Cracked Tooth Syndrome

What is cracked tooth syndrome?

Some teeth may have cracks that are too small to show up on x-rays. Sometimes the cracks may be under the gum. These small cracks are known as "cracked tooth syndrome."

Cracked tooth syndrome is most common in lower back teeth (molars), since these teeth absorb most of the forces of chewing.

Some people grind or clench their teeth. These people may be more likely to have cracked tooth syndrome. Sometimes, the way a person's teeth come together can put too much pressure on one tooth. This can cause the teeth to crack.

Teeth with large fillings (especially older silver fillings) may be more likely to crack. Teeth that have undergone root canal treatment are weaker than other teeth and also may be more likely to crack. People with one cracked tooth are more likely to have others, either at the same time or in the future.


The tooth may hurt sometimes when you bite or chew. The sensitivity or pain can be mild or intense. It may last a brief time or a long time. It may be painful only when you eat certain foods or when you bite in a specific way. You will not feel a constant ache, as you would if you had a cavity or abscess.The tooth may be more sensitive to cold temperatures.

If the crack gets bigger, a piece of the tooth may break off. You may also develop an infection. This can happen in the gum around the fractured tooth. You may notice a pimple-like bump on the gum near the tooth.

Many people with cracked tooth syndrome have symptoms that come and go for several months. The tooth may be symptomatic for some time and then settle down for awhile. Cracked tooth syndrome is one of the most difficult dental problems to diagnose because the pain is not predictable. Your dentist may refer you to an endodontist (root canal specialist) for further evaluation should the discomfort persist.


Your dentist will examine your mouth and teeth, focusing on the tooth in question. He or she may use an instrument called an explorer to feel for cracks in the tooth. Your dentist also will also examine the gums around the tooth. You may have an x-ray taken, but x-rays often do not show the crack.

Your dentist may use special tools to test the tooth. One tool looks like a toothbrush without bristles. It fits over one part of the tooth at a time as you bite down. If you feel pain, the part of the tooth being tested most likely has a crack in it.If the tooth already has a filling or crown, your dentist may remove it in order to see the tooth better.

Expected Duration

How long symptoms last depends on how quickly a cracked tooth can be diagnosed. Even after a crack is found, treatment may not completely relieve the symptoms.


If you grind or clench your teeth, talk to your dentist about treatment. Grinding can increase your risk of cracked tooth syndrome.


Treatments for cracked tooth syndrome do not always relieve the symptoms.

Treatment depends on:

• Where the crack is

• How deep it is

• How large it is

Sometimes a crack affects one or more cusps of a tooth. These are the highest points of the tooth. In this case, the tooth may be fixed with a crown. Some cracks affect the pulp: the center of the tooth, where the nerves and blood vessels are. In that case, the tooth will need root canal treatment.

About 20% of teeth with cracked tooth syndrome will need root canals. After a root canal, the tooth will no longer be sensitive to temperature, but it still will respond to pressure. If you felt pain before the root canal, you may still feel some pain afterward. It probably will not be as intense or as frequent, but it may still occur.

In some cases, the tooth may need to be removed.Some cracks affect the root of the tooth in the jaw. There's no way to fix this type of crack. If your tooth is removed, you can have it replaced with an implant or a bridge.

Your dentist can make a night guard (a plastic bite piece) to help protect your teeth when grinding is a factor. This will also help relieve the pain caused in your TMJ area and teeth from grinding. For some people it can stop tooth sensitivity. The night guard can be worn during sleep. It also can be worn at other times if clenching or grinding happens during waking hours.

When to call your dentist

If you feel pain when you bite or chew, contact your dental office.


Treatment of cracked tooth syndrome is not always successful. Your dentist should talk with you about what might happen. In some people, a crown will fix the problem. In others, root canal treatment solves the problem. Some people continue to have occasional symptoms after treatment. They may need to have the tooth taken out.