Signs of a cracked tooth
Cracks are often too fine to see in a mirror, and many do not show on an X-ray. What gives them away is how they behave:
- A sharp, brief pain when you bite down, or when you release the bite.
- Pain with certain foods or at a certain angle, but not every time you chew.
- Sensitivity to cold, and sometimes to sweet things.
- Pain that comes and goes, sometimes for weeks, with no obvious cause.
Why does it hurt when I let go?
Pain on release is a telltale sign of a crack. When you bite, the two sides of the crack flex apart slightly. When you let go, they spring back together, and that sudden movement irritates the nerve inside the tooth.
Because the pain depends on exactly how you bite, it can vanish for days and then come back. That makes a crack easy to ignore, and it is part of why cracks are often found late.
From craze lines to a split tooth
Not every crack is a problem. They range from harmless to serious:
- Craze lines: fine lines in the outer enamel, common in adult teeth. They do not hurt and usually need nothing.
- A broken cusp: a corner of a back tooth breaks off, often beside a large filling. It rarely reaches the nerve, so it may hurt surprisingly little.
- A cracked tooth: a crack running from the chewing surface down toward the root. This is the one that hurts on biting, and caught early, the tooth can usually be kept.
- A split tooth: the crack has run all the way through, and the tooth has come apart into two pieces. A split tooth usually cannot be saved whole.
Why catching a crack early matters
A cracked tooth does not heal. Unlike bone, enamel and dentin cannot knit back together, and every time you chew on the tooth, the crack can creep a little further.
Where it stops decides what the tooth needs. A crack held together early with a crown is often a tooth you keep for many years. A crack that reaches the nerve needs a root canal as well, and a crack that runs down into the root can cost you the tooth.
So if it hurts when you bite, chew on the other side and call the office in Pearisburg. It is not usually an emergency, but it is not something to wait out either. If a piece has actually broken off, our page on a broken tooth covers what to do first.
How a cracked tooth is found and treated
Finding a crack is part detective work. We ask exactly when it hurts, look closely at the tooth under a bright light, and have you bite on a small tool one cusp at a time until the pain shows where the crack is. An X-ray helps rule out other causes, even when it does not show the crack itself.
We show you what we find and explain why we are recommending one option over another. Treatment depends on how far the crack runs:
- Craze lines: nothing beyond keeping an eye on them.
- A broken cusp: a crown, or sometimes a large filling, to rebuild the corner.
- A crack that has not reached the nerve: usually a crown, which holds the tooth together and keeps the crack from spreading.
- A crack that has reached the nerve: a root canal, then a crown.
- A split tooth, or a crack deep into the root: taking the tooth out, then replacing it, for example with a dental implant or a bridge.
How to avoid cracking a tooth
Many cracks come from more force than the tooth was built for. A few habits make a real difference:
- Do not chew ice, hard candy, popcorn kernels or pen caps.
- If you grind or clench, especially at night, tell us. It is a common cause of cracked teeth, and it is part of what we look at with jaw and bite problems.
- Wear a mouthguard for contact sports.
- Have large old fillings checked. A tooth that is mostly filling is more likely to crack, and a crown before it breaks is simpler than a repair after.
Questions patients ask
Can a cracked tooth heal on its own?
No. Unlike bone, a tooth cannot knit a crack back together. The pain can come and go, which makes waiting tempting, but the crack usually keeps spreading, and the earlier it is treated the more of the tooth there is to save.
Will a cracked tooth show up on an X-ray?
Often not. Many cracks are too fine, or run the wrong way, to show up. Finding one usually depends on a bite test, a close look at the tooth and a careful description of when it hurts.
Does every cracked tooth need a crown?
No. Craze lines need nothing, and a small broken corner can sometimes be rebuilt with a filling. A crack that hurts when you bite usually does need a crown, because the crown holds the tooth together.
Is a cracked tooth an emergency?
Usually not, unless it is very painful, a piece has broken off, or the gum around it is swelling. It should still be seen soon, because a crack that is left tends to grow. Chew on the other side until then.