It is possible to crack a tooth in a variety of ways. Treatment options will depend on the type of crack. If the crack is not too deep, root canal therapy can often be performed and the natural tooth can remain in the mouth. In other cases, the tooth is too badly damaged and must be extracted.
The following are some of the most common types of cracks:
Oblique supragingival cracks – The cracks are only visible on the crown of the tooth and do not extend below the gum line. In most cases, the affected part of the tooth will eventually break off. There will be little pain caused by this procedure, as the pulp of the tooth (which contains the nerves and vessels) will remain unaffected.
Crazes – Generally, these are small vertical cracks that do not pose a threat to the teeth. Most dentists consider these scratches to be a normal part of the tooth’s anatomy. In most cases, a craze does not require treatment for health reasons, but a wide range of cosmetic treatments are available to reduce its negative aesthetic effects.
Oblique subgingival cracks – It is common for these cracks to extend beyond the gum line, and often beyond where the jawbone begins. When a piece breaks off, it will usually remain attached until it is removed by the dentist. Subgingival cracks can be extremely painful and may require a combination of periodontal surgery (to expose the crown) and endodontic treatment to restore the teeth.
Vertical furcation cracks – The cracks are caused by the separation of the roots of the tooth. It is almost always the case that this type of crack affects the nerve of the tooth. Root canal therapy and a crown are usually sufficient to save a tooth because it will not usually separate completely.
Vertical apical root cracks – These cracks usually occur at the tip of the root (apex) of the root. Even though the tooth does not require extraction from a dental perspective, many patients request an extraction because of the intense pain they are experiencing. A root canal may alleviate the discomfort for a period of time, but in most cases, teeth affected by such cracks will need to be extracted.
Oblique root cracks – The surface of the tooth is not affected by these cracks. It is important to remember that the damage is not visible above the gum line and usually is not visible below the jawbone. It may be possible to treat the fracture with root canal therapy depending on how close the fracture is to the surface of the tooth. After sustaining such a fracture, the only option for treatment is almost always to extract the bone after it has been fractured.
