Cracked Tooth Syndrome

Dr.Alan Wishneff Boca Raton Florida Dentist Dr. Alan Wishneff D.D.S.
Restorative Dentistry / Oral Health
May 8, 2016

Cracked tooth syndrome is a dental condition that is characterized by sharp pain Cracked toothwhen chewing without any visible reason. This pain is caused by a “hidden” crack in the tooth. The teeth that cause cracked tooth syndrome usually have fractures that are too small to be seen on x-rays. Fractures can also be below the gum line, making it even more difficult to identify. The fact that people today live longer and keep their teeth for more years increases the risk of having a fractured tooth and experiencing cracked tooth syndrome problems.

Cracked tooth syndrome has to be identified and treated early enough before the damage puts the tooth at risk. Once the crack reaches the pulp camber, the pulp tissue becomes exposed to bacteria and bacterial toxins. This causes further inflammation and can develop into a tooth infection.  An untreated cracked tooth can result in pulpal necrosis (death of the nerve), and tooth abscess (infection) requiring root canal treatment. In severe cases the tooth can split in two reducing the chances to fix the cracked tooth and usually tooth extraction is necessary.


Cracked tooth syndrome is caused by a crack on the tooth. As people keep their natural teeth longer, fractures in teeth are becoming more common. Along with the extended period of time that teeth are being used, the number of dental procedures performed on teeth is increasing the risk of teeth eventually cracking. There are a number of other reasons why cracked tooth syndrome may be caused by fractures:

  • Natural wear – over the years, the repetitive everyday use of the teeth for biting and chewing may cause cracks on the teeth.
  • Clenching and grinding – teeth grinding or bruxism is a major cause of fractured tooth syndrome. Grinding and clenching put excessive pressure on teeth making them susceptible to cracks.
  • Bad chewing habits – biting pencils, chewing on ice or hard foods.
  • Trauma to the mouth.
  • Large fillings weaken the structure of the tooth and can cause a tooth to fracture.
  • Complications during/after endodontic therapy.


One of the most experienced symptoms is a sharp pain when applying biting pressure in a certain area of the mouth. Most of the time you cannot tell which specific tooth hurts. Minor tooth fractures are unlikely to cause symptoms, so the problem may exist for a long time before the cracked tooth syndrome symptoms appear. Other symptoms include:

  • Tooth sensitivity to hot and cold temperatures.
  • Pain in a tooth when biting or chewing. Pain is usually not as constant as it would be with tooth decay or a tooth abscess. The pain may only flare up when eating certain foods or when chewing in a specific way. When the pain is experienced upon the release of biting pressure, it is a sign that it is a case of cracked tooth syndrome.
  • Increased tooth mobility.


Diagnosis of cracked teeth is often difficult, because the crack may not be visible. This is actually the characteristic of cracked tooth syndrome; symptoms of sharp pain without the dentist to be able to see any problem with the tooth, either by clinical examination of the mouth, or sometimes neither by radiography (x-rays).

A detailed dental history, focusing especially in history of trauma, bruxism, chewing habits and bite adjustments, can help significantly in the diagnosis of cracked tooth syndrome.

The dentist will first identify which tooth has the problem. This is done by a biting test using an instrument that rests on one tooth at a time. After the tooth is identified the test is performed on each of the cusps of the tooth in order to have a more precise location of the problem. The dentist will perform a thorough examination of the tooth, checking for any signs of problem that could explain the symptoms e.g. tooth decay or fractures. A sharp instrument called an explorer is used to feel for cracks on the tooth and probe the gums around the tooth to feel for irregularities under the gum line.

X-rays usually do not show the small cracks that cause cracked tooth syndrome. Only if the cracks are wide enough, they may show up as shadows. In some cases of old vertical root fractures, vertical bone loss parallel to the root fracture can be seen in x-rays.

In case of a cracked root in a tooth with a restoration, it can be quite difficult to verify cracked tooth syndrome without removing the restoration. Sometimes a special dye might be used to temporarily stain the tooth, and check to see if it is fractured. After identifying the cause of the cracked tooth syndrome, the dentist will recommend the most suitable way to fix the cracked tooth.

For more information about this topic or any other dental topic, contact Dr.Wishneff  at [email protected]  or call (561) 488-3111Dr. Alan Wishneff is a Boca Raton Dentist dedicated to bringing patients state-of-the-art dental care. As a cosmetic, family and restorative dentist, he helps patients enjoy a natural and healthy smile. He is trained in cosmetic dentistry, including porcelain veneers; advanced cosmetic bonding techniques; oral surgery; medical emergency procedures; advanced crown and bridge; advanced TMJ; implant dentistry; endodontics-root canals: utilization of most advanced dental materials. Dr, Wishneff and staff are dedicated to providing great smiles in Boca Raton for more than 30 years. After more than two decades of practicing dentistry in Boca Raton, Dr. Wishneff is more committed than ever to this community.

Image: By Coronation Dental Specialty Group (Own work) [CC BY-SA 3.0], via Wikimedia Commons

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