When you bite down, you feel a sharp pain.  It quickly disappears, and perhaps you ignore it.  You learn to avoid certain foods or chew only on one side of your mouth.  Does this sound familiar?  If so, you may have a cracked tooth.

What causes a cracked tooth?

A tooth may crack due to a variety of factors:

• Chewing on hard objects of foods such as ice, nuts or hard candy
• An accident or blow to the mouth
• Uneven forces of chewing pressure on your teeth
• The loss of a significant portion of tooth structure through wear, large fillings or other restorations
• Exposure of the tooth enamel to extremes of temperature, such as eating hot food and then drinking ice water
• Brittleness of teeth that have undergone root canal treatment

How can you tell if a tooth is cracked?

Diagnosing a cracked tooth can be difficult.  You may not even be able to tell which tooth hurts or whether the pain is from an upper of lower tooth.  A crack may appear as a hairline fracture on the tooth or a split that is obvious.  Unfortunately, cracks are often invisible to the eye and often do not show up on an X-ray

A common way the dentist diagnoses a crack is to have the patient bite on small isolated parts of each tooth.  When you put pressure on the isolated cracked cusp it will usually “tell you” that’s the spot!  Unfortunately, it will tell you with a sharp pain.  You can help your dentist determine which tooth is causing the problem by noting when and where you have sensitivity to hot, cold, sweet or sour as well as approximately where the pain is when you are chewing.

Why does a cracked tooth hurt?

A cracked tooth may hurt because the pressure of biting causes the crack to open.  When you stop biting, the pressure is released and a sharp pain results as the crack quickly closes.  That is why you typically have more pain when you let go rather than when you bite down.  Even though the crack may be microscopic when it opens, the pulp inside the tooth can become irritated.  The pulp is a soft tissue that contains the tooth’s nerves and blood vessels.  If the crack irritates the pulp, the tooth may become sensitive to temperature extremes as well as biting.  If the pulp becomes damaged or diseased as a result of the crack, root canal therapy may be necessary to save the tooth.

How is a cracked tooth treated?

It depends on the size and location of the crack.  Treatment can vary from bonding, to a crown, to root canal therapy and in extreme situations, extraction.  Your dentist will help you determine what is right for you.  Tiny cracks are common and usually don’t cause problems, but regular checkups are important.  They allow your dentist to diagnose and treat problems in the early stages.  If you continue to have pain on a tooth, avoid biting on that side of your mouth and call the dentist – before it is too late!