Tooth Fracture

A fractured tooth, often called a cracked tooth or cracked tooth syndrome (CTS), is when a crack appears in your tooth.

The crack can sometimes be small and harmless. Other times, it can cause your tooth to break or split. Tooth fractures are most common in children and older people, although anybody can crack a tooth. If you suspect a broken tooth, see a dentist right away.

Both the crown and the root of a tooth consist of the following layers:

  • Enamel: Hard white outer surface.
  • Dentin: Middle layer of the tooth.
  • Pulp: Soft inner tissue that contains blood vessels and nerves.

Tooth fractures can affect some or all of these layers. Treatment for a cracked tooth depends on where the fracture happens and the severity of the fracture. A broken tooth may hurt or feel sensitive, though some fractures cause no symptoms. See a dentist right away. Getting treatment sooner increases the chances of repairing a cracked tooth.

Tooth Fracture

Cracked teeth don’t always cause symptoms. When they do, the main symptoms include:

  • Pain that comes and goes, particularly when chewing.
  • Sensitivity to temperature changes or eating sweet foods.
  • Swelling around the tooth
  • Toothache when biting or chewing.

The most common causes of tooth fractures are:

  • Age with many tooth cracks happening at age 50 and older.
  • Biting hard foods such as candy, ice or popcorn kernels, etc.
  • Habits such as gum chewing, ice chewing.
  • Large dental fillings or a root canal, which weaken the tooth.
  • Teeth grinding (bruxism).
  • Trauma, including falls, sports injuries, bike accidents, car accidents or physical violence.

You can’t prevent every tooth fracture. But you can reduce the risk of cracked tooth syndrome with good dental practices:

  • Avoid chewing hard foods or ice.
  • Practice good teeth and gum care.
  • Wear a mouth guard made by your dentist if you play sports or grind your teeth at night.
  • See your dentist regularly.

Fractures occur most often on the upper front teeth and the teeth toward the back of your lower jaw (mandibular molars).

Though people commonly fracture one tooth, more severe injury or trauma may fracture multiple teeth. People with dental cavities have a higher risk of fracture, even with less severe trauma.


How is it diagnosed?

To diagnose a fractured tooth, your provider will ask about your symptoms and what caused the possible broken tooth.

They will ask about trauma or injury you’ve experienced. For a thorough evaluation of your teeth, you’ll need to see a dentist. They will ask about your dental history and whether you grind your teeth or chew on ice or hard foods.

After that, your dentist will:

  • Check to see whether your tooth is broken or knocked out (avulsed tooth).
  • Ask you to bite down on a stick to see if you feel pain.
  • Inspect your teeth for crack lines.
  • Examine your gums for inflammation, since vertical fractures may irritate your gums.
  • Pass a light through your tooth to illuminate the fracture (transillumination).
  • Put a staining dye on your tooth to better see the tooth crack.
  • Take an X-ray of your teeth to see fractures and related issues, such as bone loss. Imaging may include a 3D scan called a cone beam CT scan that can show bone loss suggestive of a fracture.
  • Use special tools to locate the crack (periodontal probing) by checking if the tools get caught on the crack.

Your dentist will classify your fracture as one of the following five categories:

  • Cracked tooth: A vertical crack runs from the biting surface of your tooth up to your gum line. Sometimes the crack extends into your gum line and root.
  • Craze lines (hairline cracks): Small, thin cracks appear on the outer enamel of your tooth. Craze lines don’t cause any pain.
  • Fractured cusp: A crack forms around a dental filling. Fractured cusps usually aren’t very painful.
  • Split tooth: A crack extends from your tooth’s surface to below your gum line. This fracture splits your tooth into two parts.
  • Vertical root fracture: Cracks start below your gum line and travel toward the tooth’s biting surface. Vertical root fractures may not cause symptoms unless your tooth becomes infected
Tooth Fracture

How is it treated?

Treatment for a fractured tooth depends on how much damage your tooth has. Common cracked tooth treatments include:

Plastic resin is used to fill in the fracture.

Rough edge rounding and polishing smooths out the broken tooth.

A porcelain or ceramic cap is fitted over the fractured tooth. Often used when you don’t have enough of your natural tooth for a veneer.

Complete removal of your tooth. Used when the root and nerves of your tooth show severe damage.

Removal of damaged pulp to prevent further tooth weakening. Used when the fracture extends into the pulp.

A thin covering of porcelain or plastic goes over the front of the tooth. Often used when you have a good amount of your natural tooth left.

Consult with experienced Doctors

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