Fig. 2: This is a molar with a fractured "cusp" The molars usually have four main cusps that make up the biting surface of the tooth. If decay is present inside the tooth, it can weaken the cusp, causing it to fracture. This usually occurs during eating. If a cusp fractures, it can result in pain to biting and or cold/hot temperatures. To determine if a tooth with a fractured cusp can be saved, a thorough exam of the remaining tooth and surround structures must be completed by the dentist, or specialist.
What is a cracked tooth? Teeth undergo all kinds of stresses everyday. Biting forces, severe temperature changes, and bacterial invasion are just a few examples that can cause cracks in teeth. Grinding and bruxism are very common causes of cracked teeth as well. The most common cracked teeth are lower molars. Cracks often form around previously placed fillings that can slightly expand or contract after initial placement. Tiny cracks can start forming that are not even visible to the human eye. Once the crack becomes bigger, problems can arise. Symptoms include temperature sensitivity and/or pain on biting (especially during the release action). In many cases the crack can be treated with a full coverage restoration, like a crown. If the crack has been present for a long time, there may have been irreversible damage to the nerve. In these cases a root canal treatment and crown is needed to save the tooth. These teeth are often worth saving and may still last a very long time if treated properly. However, the long term prognosis (chance of sticking around) is decreased if the crack continues to spread to the root of the tooth. If the root becomes cracked, it harbors bacteria that we are unable to clean out and the tooth has to be extracted. It is not necessarily easy to identify a cracked tooth. The crack can be microscopic and may only be found once the infection in the jaw starts to form. Once the infection starts the dentist may be able to find the problem area with a routine exam and xray. In some cases, it may take years to see that a problem exists so it is important to tell your dentist if you experience any pain to biting or hot/cold temperatures.
DISCLAIMER: This information contains general guidelines only. If you have a tooth that you think needs treatment, please have your dentist or specialist conduct a proper exam to determine your specific options.
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