What is Cracked Tooth Syndrome?

All I knew when I slid into the dentist's chair was that twice within a week, when I bit on an apple, I felt a sharp pain. This was new territory to me. Nobody in my family had experienced anything beyond a couple of fillings. Only after I left two hours later with a temporary crown did I realize how puzzling cracked tooth syndrome can be to both patients and dental professionals.

Overview

When a small crack in a tooth extends at least as far as the dentin layer of a tooth, the patient could be suffering from cracked tooth syndrome. Dentin lies below the tooth's enamel. Some tiny cracks can extend to an even deeper level, into the pulp.

What's so unusual about this condition is the number of patients who show no obvious cracks during a manual exam by a dentist. And most of these cracks are rarely even seen on X-rays, according to Web Dentistry Today.

The tiny cracks are most often vertical hairline fractures. Detecting one can be hampered by the patient's inability to identify exactly which tooth is the source of the pain.

Often, the only way a dentist can locate the fracture is by using a tool known as a tooth sleuth. This gadget fits over just one tooth. By systematically asking the patient to bite down on each tooth, the dentist can isolate the problem.

The most likely tooth to be affected is one with a large filling or one on which a root canal has already been performed. Individuals with one crack are somewhat predisposed to more. Patients who grind their teeth or chew objects with hard surfaces like ice are also likely candidates for this type of injury.

Symptoms

When I thought about it, I realized that my tooth hurt only when I released a bite. Some patients report pain during prolonged chewing, the Colgate Oral and Dental Health Center reports. The pain is sharp but typically stops as soon as the individual stops putting pressure on the tooth.

The pain associated with cracked tooth syndrome occurs when fluids seep through the break and affect a nerve inside the tooth. Sometimes the trigger is a sweet or a cold food. Some patients even report that only specific foods cause them pain.

Since the discomfort is unpredictable, it's not unusual for a patient to have this condition for months before realizing anything significant is amiss. Eventually, a piece of the tooth might break off. The tooth could eventually become infected.

Diagnosis and Treatment

In addition to a tooth sleuth, a dentist might use a tool known as an explorer to probe for cracks. Sometimes examining gums around the affected tooth will identify it. Two other ways to diagnose cracked tooth syndrome when X-rays show no abnormalities are use of a very bright light and staining a tooth.

Unfortunately, treating the affected tooth doesn't always bring relief to the patient. The type of treatment utilized generally depends on the location of the crack, its size and its depth.

I never figured out the cause of my crack. Since it affected more than one point on the tooth and was very deep, I needed a root canal and a temporary crown. I had to return about a week later for a permanent crown.

When a crack affects a tooth's pulp, the patient will probably need a root canal. This occurs in about one in every five instances of cracked tooth syndrome. This procedure typically relieves much of the pain but not necessarily all of it.

In the severest set of circumstances, dentists are forced to remove a tooth affected by cracked tooth syndrome and will probably recommend a bridge or an implant to fill its space.

Sources:

http://webdentistrytoday.com/Oral-Conditions/cracked-tooth-syndrome.html

http://www.colgate.com/app/CP/US/EN/OC/Information/Articles/Oral-and-Dental-Health-Basics/Common-Concerns/Bruxism-Tooth-Grinding/article/Cracked-Tooth-Syndrome.cvsp

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