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                                                        DR. DAN PETERSON

                                                                      1415 SAGE STREET ~ GERING, NEBRASKA 69341 
                                                             
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CRACKED TOOTH SYNDROME

Type of Cracks Solution
Cracked Tooth Syndrome Considerations
Symptoms Broken Tooth-causes
Diagnosis  
Types of Cracks

Craze lines

Most adults have have craze lines and they cause little concern.  They are tiny cracks that only affect the outer enamel of the tooth, are painless and may affect the cosmetic appearance of the tooth. These lines allow light to pass through them to light up the whole crown of the tooth.  If there is a crack, light will not pass through. 

Fractured Cusp

When a cusp becomes weakened, a fracture may result.  A fractured cusp rarely damages the pulp. This tooth will need to be restored with a full crown
.


Cracked Tooth

This type of crack extends from the chewing surface of the tooth and vertically migrates towards the root.  Damage to the pulp is common. A root canal treatment is usually necessary. A cracked tooth that is not treated will worsen, resulting in the loss of the tooth. 


Split Tooth

A split tooth is usually the result of an untreated cracked tooth. It can be identified by a crack with distinct segments. The position and extent of the problem will dictate whether any portion of the tooth can be saved. 



Vertical Root Fracture

A vertical root fracture begins at the root and extends towards the chewing surface of the tooth.  Treatment may involve root surgery if a portion of the tooth can be saved  extracted.


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Cracked Tooth Syndrome

    Cracked tooth syndrome is a very common problem that affects teeth that have large fillings in them.  Decay and large fillings causes a weakening in the remaining tooth structure over time.   A hairline fracture often develops at the bottom corner of the filling.

     Grinding your teeth will cause massive increase in the stress and stain on your premolars and molars increasing the risk of this condition.  Also, having worn down fillings or canines will increase your risk factors toward this condition.

    The reason it hurts to bite when you have a cracked tooth is the fact that your tooth is flexing which microscopically stimulates the  nerve in the tooth.  These hairline cracks open and close which applies pressure on tubules that run down the nerve of the tooth causing fluid to push and pull on the tooth's nerve resulting in pain. The nerve in the cracked tooth is also being exposed to bacterial toxins that become inflamed making it sensitive allowing infection to spread to the nerve and bone tissue underneath resulting in an abscess.  If the crack goes untreated it will spread and deepen like a crack in glass and a part of the tooth may break off causing a need for a root canal or extraction.

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Symptoms:

bulletSensitive to hot and cold
bulletPain upon release of biting pressure which may come and go when you release from biting because the crack will close quickly causing pain.

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Clinical Test To Check Diagnosis

The only way to diagnose a fracture is through interpreting a tooth's response to temperature and touch.

bulletThorough dental history.  
bulletCheck for a history of trauma, clenching or bruxism and chewing habits like, ice
bulletHistory of bite adjustments
bulletExamine the teeth with an explorer
bulletCheck hot and cold sensitivity. If a sharp pain is felt with temperature, and the pain rapidly diminishes with removal of the stimulus, then a fracture is more likely.
bulletProbe the gum tissue for pocketing   
bulletCheck for a cracked filling 
bulletUsing a cotton roll, rubber wheel or bite stick, you will be asked to bite down liken on chewing gum to help isolate each tooth 
bulletX-ray films
bulletA filling might need to be removal to help visualize the crack and assess nerve involvement. 

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Solution

       A fracture will probably not improve and will eventually need to be treated. Teeth do have a limited ability to heal themselves. Unfortunately, fractured teeth do not heal themselves like other bones in your body. The only real solution to hold the tooth together and to prevent the tooth from breaking is with a crown.  A crown will allow chewing forces to move the whole tooth rather than splitting it apart. This full crown is bonded over the entire tooth to seal all the small cracks and prevent bacterial leakage thus allowing the nerve to recover and stabilize.

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Considerations

     About 10% of cracked teeth have nerves that can still die and need root canal treatment.  Early treatment can help to minimize this from happening.  If you decide to refuse treatment for this condition remember that that tooth is like a ticking time bomb that will suddenly flare up and cause sever pain, swelling, pus and possible bone loss that will put stress on your immune system and may affect your overall health.

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Broken Tooth What causes teeth to break?

One factor is silver fillings. These fillings have been found to enlarge as they age which may cause some outward pressure as you chew or bite.  Over time this can cause a broken tooth.   A more common type of fracture is when the inside area of the tooth breaks off, this fracture can usually be easily repaired.  Bruxism is one of the most common causes of teeth breaking.

February 27, 2007

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Source of pictures: Dr. Stropko

February 27, 2007

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          If you have any questions please e-mail me at: drdpeterson@scottsbluff.net
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PLEASE NOTE: The information contained herein is intended for educational purposes only.  It is not intended and should not be construed as the delivery of dental/medical care and is not a substitute for personal hands on dental/medical attention, diagnosis or treatment.  Persons requiring diagnosis, treatment, or with specific questions are urged to contact your family dental/health care provider for appropriate care.
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