You may ask, “What’s Cracked Tooth Syndrome?” It doesn’t sound like a very original name, does it?
But, it’s actually a pretty common condition.
Cracked Tooth Syndrome typically affects teeth that are heavily filled, usually with an old silver amalgam filling.
Cracked Tooth Syndrome typically occurs when a large silver amalgam filling acts as a wedge cracking the tooth structure around the filling.
Cracked Tooth Syndrome occurs when a large silver amalgam filling acts as a wedge cracking the tooth structure around the filling.
The problem with old silver amalgam fillings is they don’t bond directly to the tooth; silver amalgam fillings are usually held in place by retention rather than bonding.
Like all hard materials, tooth structure is affected by stress; repeated biting or chewing can cause hairline stress fractures at the bottom corner of the silver amalgam filling. (Think of the silver amalgam filling as a “wedge” you’d drive between two objects to force them apart.)
Once the hairline fractures are formed, biting on the tooth causes it to flex microscopically, stimulating the nerve. The tiny fluid-filled tubules that run from the outer surface of the tooth to the inner pulp chamber where the nerve is housed, flex as well. This flexing allows the crack to open and close, which in turn causes the fluid to push and pull on the sensitive nerve – this can cause pain when biting or putting pressure on the tooth. The nerve is further aggravated by the crack and the bacteria that gets pumped into the pulp chamber via the tubules; this can make the tooth sometimes sensitive to hot and cold.
If left untreated, the crack will eventually spread and deepen, which may result in part of the tooth fracturing off. If the tooth fractures below the gum-line, it may become unsalvageable. The crack can also cause the root to fracture vertically, causing the tooth to be unsalvageable. Or an abscess can form when bacteria gets into the pulp chamber, resulting in a root canal to save the tooth.
The only real solution to cracked tooth syndrome is to restore the tooth with a permanent crown. At TimberCrest Dental Center, we use tooth-colored porcelain crowns which immobilize the crack so chewing forces move the tooth as a whole. This prevents the tooth from further cracking and splitting apart. The crown is bonded over the entire tooth, sealing all the micro-cracks and covering the tubules, thus reducing the chance of bacteria entering the pulp chamber via the tubules (and reducing the need for a root canal).
Cracked Tooth Syndrome may also require the need for a root canal. This depends on how deep the crack extends and how effectively the nerve recovers from the repeated flexing and trauma of the cracking. The longer you wait to crown a tooth diagnosed with Cracked Tooth Syndrome, the more likely the need for a root canal.
If you’ve been diagnosed with Cracked Tooth Syndrome, or suspect you may have Cracked Tooth Syndrome, don’t hesitate to call our office for an appointment. Restoring the tooth early can go a long way toward eliminating the need for a root canal.