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    Cracked Tooth

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    Melissa Von Schober
    "Cracked tooth" is the development of a fracture that follows the long axis of a tooth. Fractures that initially do not result in loss of part of the tooth are considered incomplete. Loss of tooth structure from dental decay frequently increases tooth susceptibility to fracture.

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    Cracked Tooth

    Uploaded by

    Melissa Von Schober
    84 views2 pages
    "Cracked tooth" is the development of a fracture that follows the long axis of a tooth. Fractures that initially do not result in loss of part of the tooth are considered incomplete. Loss of tooth structure from dental decay frequently increases tooth susceptibility to fracture.

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    © Attribution Non-Commercial (BY-NC)

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    "Cracked tooth" is the development of a fracture that follows the long axis of a tooth. Fractures that initially do not result in loss of part of the tooth are considered incomplete. Loss of tooth structure from dental decay frequently increases tooth susceptibility to fracture.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    84 views2 pages

    Cracked Tooth

    Uploaded by

    Melissa Von Schober
    "Cracked tooth" is the development of a fracture that follows the long axis of a tooth. Fractures that initially do not result in loss of part of the tooth are considered incomplete. Loss of tooth structure from dental decay frequently increases tooth susceptibility to fracture.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
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    Talking with Patients

    Cracked Tooth
    Lee W. Boushell, DMD, MS*

    WHAT IS IT? pulp’s response to the presence of in ongoing fracture propagation


    the bacteria in the fracture. Crack deeper into the dentin with result-
    The term “cracked tooth” is gener-
    propagation may also extend into ant increased sensitivity. Some
    ally used to describe the develop-
    the root system of a tooth. cracked teeth are only painful
    ment of a fracture that follows the
    when chewing harder foods or
    long axis of a tooth. Shallow
    On occasion, sideways forces on chewing with the teeth in certain
    cracks (generally referred to as
    the tooth cause the vertical fracture positions. Frequently, fractures
    “craze lines”) are limited to the
    to propagate in a horizontal extend horizontally, and a portion
    outside layer (enamel) of teeth.
    fashion (Figure 1) and may eventu- of the tooth (a complete fracture)
    Excessive biting forces may lead to
    ally result in loss of part of the is obviously lost.
    progression of a surface fracture
    tooth (e.g., a complete cusp frac-
    through the enamel and into the
    ture). Loss of tooth structure from Dentists will use careful visual
    sensitive part of the tooth called
    dental decay frequently increases examination to identify the loca-
    dentin. Fractures may grow in
    tooth susceptibility to fracture for- tion of suspected incomplete frac-
    depth and width, which allows
    mation. Teeth that have therapeutic tures. Early fractures may require
    staining by food molecules and
    removal of diseased nerve tissue the use of a small light that is
    invasion by bacteria of the oral
    (“root canal treatment”) are at placed on the cheek side and
    cavity. Fractures that initially do
    greater risk for fracture of the tongue side of the tooth. The light
    not result in loss of part of the
    crown and/or the root of the tooth. passing into the tooth will abruptly
    tooth are considered incomplete.
    stop at the fracture, which enables
    Incomplete fractures that are HOW IS IT DIAGNOSED visual detection. Long-standing
    moving vertically further into the AND TREATED? fractures frequently are stained and
    dentin or “propagating” may cause Your dentist may identify enamel easily seen. Incomplete fractures
    pain during chewing or when the craze lines during routine examina- are rarely detected by standard
    teeth are pressed firmly together tions. These craze lines do not radiographic analysis. The presence
    (Figure 1). This sensitivity may cause sensitivity and do not require of bacteria in these fractures may
    cease when propagation stops and any treatment. In addition to craze result in the development of decay
    then return if the fracture begins to lines, cracked teeth that are not along the fracture. This decay may
    extend deeper into the tooth struc- sensitive are commonly seen by be visually detected by changes in
    ture. If the fracture progresses into dental health-care providers. In the color and transparency of the
    the nerve center (“the pulp”) of the most cases, the initial development tooth adjacent to the fracture
    tooth, then sensitivity during of these cracked teeth resulted in and/or by use of dental radio-
    chewing may increase to a con- an immediate pain that rapidly dis- graphs. Selective pressure applied
    tinual pain that will continue until sipated, leaving no further sensitiv- to individual cusps of a suspicious
    the nerve dies or is removed. The ity for a period of time. Ongoing tooth is used to identify if a frac-
    primary reason for the pain is the chewing pressures frequently result ture is active, its relative location,

    *Assistant Professor, Department of Operative Dentistry,


    University of North Carolina at Chapel Hill School of Dentistry, Chapel Hill, NC, USA

    © 2009, COPYRIGHT THE AUTHOR


    J O U R N A L C O M P I L AT I O N © 2 0 0 9 , W I L E Y P E R I O D I C A L S , I N C .
    68 DOI 10.1111/j.1708-8240.2008.00233.x VOLUME 21, NUMBER 1, 2009
    TA L K I N G W I T H PAT I E N T S

    procedure is the potential develop-


    ment of a vertical fracture in the
    root system. Fractures that extend
    through the pulp and into the root
    system of the tooth usually cannot
    be reinforced, and the tooth
    is extracted.

    CONCLUSIONS
    A “cracked tooth” has developed
    a vertical fracture that has the
    Figure 1. Teeth with incomplete vertical fractures (black potential to propagate over time.
    arrows) and an incomplete horizontal fracture (white Increased fracture severity may
    arrow) (courtesy of Dr. John Sturdevant, University of progressively lead to chewing
    North Carolina–Chapel Hill).
    sensitivity, tooth decay, loss of
    part of a tooth, nerve (pulp)
    and the region of the tooth that is involved the pulp of the tooth is problems, and, in extreme cases,
    involved. Fractures that begin to reinforced with a restoration that tooth removal. Regular dental
    extend onto the root surface may covers the biting surface, such as care and good communication
    create an isolated gum defect an onlay or crown. The goals of between you and your dentist
    that can be detected during a this procedure are to rigidly will allow early detection
    dental evaluation. encircle the tooth structure that of fractures. Early intervention
    contains the fracture, distribute increases the chances of successful
    Your dentist has multiple means biting pressures over the whole reinforcement procedures. Frac-
    of restoring lost portions of your tooth, and limit the potential for tures that involve the pulp will
    tooth. These include fillings placed further propagation. require its removal. The nature of
    directly in/on your tooth to create the tooth sensitivity and diagnos-
    normal shape and function. A Fracture invasion into the pulp tic findings will help your dentist
    more severe complete fracture necessitates its removal followed prescribe appropriate steps indi-
    requires the use of an onlay or by reinforcement of the cracked cated to give your cracked tooth
    crown. A sensitive tooth with an tooth as described above. An asso- the greatest chance of normal use
    incomplete fracture that has not ciated risk of the pulp removal for a lifetime.

    VOLUME 21, NUMBER 1, 2009 69

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