When a tooth has cracked, but no part of the tooth has actually broken off, this is referred to as Cracked Tooth Syndrome (CTS) and is often associated with dental pain (or toothache).
Symptoms will tend to vary from one patient to the next (which can make the condition quite challenging to diagnose) but may include: pain when biting down, chewing; and when consuming cold or sugary food or drink.
Why does a cracked tooth hurt?
Often, pain associated with biting is most severe just as pressure is released, this is known as “rebound pain.” One theory to explain this, is as pressure is applied, the fractured segments move away from one another, effectively creating more space for the nerves within the tooth, but as the bite is released, the segments snap back, rapidly increasing pressure on the nerves again.
Beyond pain associated with movement of sections of tooth, a fracture may also mean that the dental pulp within the tooth is exposed (the pulp is the “living” part of the tooth, being made up of connective tissue and housing nerves).
While CTS normally affects the crown of the tooth (the top section; visible when you smile), in severe cases the root can also crack (the root is the base of the tooth, which is embedded within the gum).
What are the treatment options?
If you’re having tooth pain, it’s recommended to start with an Emergency Dentist, who will assess and diagnose your condition. (The only exception to this rule, is if you suspect you’re suffering from a medical emergency — if you’re experiencing difficult breathing, significant swelling of the jaw, difficulty swallowing or the inability to eat or drink — you could call 000 or proceed to Accident & Emergency.)
In cases of Cracked Tooth Syndrome, your Emergency Dentist will perform a bite-test to confirm the diagnosis.
Treatments generally intended to prevent movement of the fractured sections of the tooth and thereby minimise the risk of the crack extending. This can be achieved by a core buildup and/or a dental crown. If the pulp of the tooth has become infected, root canal therapy may be indicated. In severe cases, it may make more sense to remove the tooth (extraction) than to try and preserve it.
Remember, by the time symptoms of toothache, sensitivity to hot or cold, and even facial swelling are present, your dental emergency is already quite advanced. To maximise your chances of saving the tooth, treatment should take place as soon as possible.