A crack can be small in appearance and significant in effect.

Cracked teeth do not all behave the same way.

A crack may involve only the outer enamel, extend into the chewing surface, split part of a tooth, or continue below the gumline. Symptoms can come and go and may include pain while chewing, discomfort when releasing a bite, or sensitivity to temperature.

The location, depth, movement, and condition of the pulp and supporting tissues guide the prognosis. Unlike a broken bone, a crack in a tooth does not heal back together, but timely treatment may keep some cracks from progressing and help preserve the tooth.

How a cracked tooth is evaluated

The dentist reviews when the symptoms occur and examines the tooth, nearby teeth, gums, and bite. Magnification, illumination, bite testing, cold testing, gum measurements, transillumination, and diagnostic images may be used. Because a fine crack may not appear clearly on a standard X-ray, diagnosis often combines several findings.

Very shallow enamel lines, called craze lines, are common in adult teeth and usually do not cause pain. A crack that reaches the pulp or root is a different condition and needs a treatment discussion.

Treatment depends on what can be saved

• A small fractured cusp may be repaired with a filling, onlay, or crown.
• A restorable cracked tooth may need a crown to protect it from chewing forces.
• If the crack has inflamed or infected the pulp, root canal treatment and a protective restoration may be considered.
• A split tooth or a crack that extends severely below the gumline may not be predictably restorable and may require removal.