Cracked tooth syndrome

Crack tooth syndrome By Dr Rosalind Ho

Crack tooth syndrome is a painful condition of the tooth associated with some signs and symptoms

History:

1 usually related to excessive occlusal or biting forces

2 patient bit something hard

3 patient grinds and /or clench teeth at night.

Typical Signs and Symptoms;

1 sharp pain on biting and chewing

2 usually involve the molars , non-vital teeth or root canal treated tooth even crowned ones. 

3 A deep bite and /or strong jaw muscles may be present.

4 Facets of wear may be seen on the teeth.

Reason for the sharp pain

When the tooth is cracked, there is a micro movement of the separated parts. If the crack reached the pulp, there is sudden fluid movement and bacteria to the pulp resulting in thermal sensitivity. Untreated, the crack may propagate resulting in total crack and extraction. Or the tooth dies and needs further treatment.

How the dentist test:       

1 trahsillumination         

2 staining

3 pulp test

4 bite

5 probing   

6 restoration removal to detect

7 use oral camera to magnify tooth                                                                                           

                                                                                                                          

Differential Diagnosis

Crack and craze lines are different. Craze lines are restricted to enamel and  are not cracks .

Management:

1 Root canal treatment may or may not be needed depending on the diagnosis.

2 a temporary crown or band may be placed to test out the tooth with the understanding. If still pain, to start root canal treatment followed by permanent crown.

3 Tackle predisposing factors.

1. Night guard is indicated for night grinders.
2. Botox injections into their masseter  and temporal muscles to reduce strong muscular action ( works for a period of time)
3. Patient should avoid biting hard food like ice.