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Dentistry/Cracked Tooth?


For the last 2 weeks I have been hearing a very loud cracking sound when I lay down to sleep and I have almost constant pain on both sides of my lower jaw that starts about an inch back from my chin and extends an inch and a half.

I went to my dentist this morning thinking that a cracked tooth would explain the noise and that he might be able to determine the cause of the jaw pain. My dentist did 2 tests the first having me to bite down on a...tooth sleuth, I believe is what he said. Then he took something metal and taped on several teeth. He told me I didn't have a cracked teeth because the two tests did not cause me pain and I don't hear cracking when I chew. He also told me the jaw pain was not TMH because there are no sings of me grinding my teeth.

So my questions are: Should he have taken X-rays? Should I go to a different dentist for a second opinion? and Is there something that would explain the jaw pain and the cracking noise other than a cracked tooth?

Thank you

Hi Charlotte and thanks for your question.

Making a diagnosis of cracked tooth is notoriously tricky and often is made by process of elimination of various causes.  X-rays are very beneficial and insightful in terms of aiding any diagnosis, giving clear representation of what is going on inside teeth and in the deeper structures, such as the bone, TMJ and sinus cavities.  It is of course vital to know which X-rays to rays which would give the maximum diagnostic value and the quality should be flawless. the information obtained from the X-rays, together with the intra-oral examination and specific tests such as percussion, thermal and electrical tests, need then to be evaluated in context and never viewed isolation from each other.

Getting a second, or even a third opinion, is never a bad idea, especially as a positive diagnosis has not yet been made for your discomfort.  My view is that it is your body and you retain full control over what happens to it - including your mouth.  Seeking out alternative advice is nothing more than keeping your best interests at heart and making every attempt to free yourself from pain.

TMJ is a very tricky joint, being the most complicated of all joints in the body - and the smallest.  One doesn't always see evidence of clenching/grinding when TMJ pathology is present, although the two are strongly associated, so I would be hesitant to rule this out just yet.  I feel that you would best benefit from a referral to a prosthodontist - a dental specialist who would perhaps be in a better position to assist in making a diagnosis of a nature as tricky as a cracked tooth.

I hope this helps and wish you all the best further in resolving this problem, take care.

Kind regards
Dr Craig Peck


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Dr Craig W Peck ( B.Med.Sc., B.Ch.D., Clin. Botox, Cosmet. Derm.)


I am a General Dental Practitioner, with special interests in Cosmetic Dentistry & facial aesthetics and Periodontology, placing a strong emphasis on the establishment and maintenance of a healthy periodontium (the support structure of the tooth) before cosmetic options are considered. I uphold all principles of prevention above interventional treatment and try as far as possible, to remain conservative in my approach. I believe in detailed, open and honest patient discussion, establishing what the patients expectations are and what the reality is of achieving this and involving the patient at every level of the treatment. I have strong principles on ethical treatment and appropriate patient management. I have chosen to treat and rehabilitate many nervous and phobic patients, who, for whatever reason, find it impossible to take part in the very important task of even a routine check-up. I will accept questions relating to general and cosmetic dentistry (in conjunction with the use of facial cosmetic procedures) and dental fears/phobias. I will be more than willing to answer any academic questions in dentistry, biology, physiology, psychology and health sciences in general. As most dentists will tell you, there is often not only one way of dealing with a dental issue - so very often, there is no precise right and wrong way of approaching the problem. All clinicians vary when it comes to treatments and what works best in their hands is often the treatment that is advised. Be understanding of this and bear in mind that nothing lasts forever! Patients are happy to accept only a one-years warrantee when buying a new car, but seem to expect that dental work is going to last them their lifetime.


I have worked for many years in the UK and RSA as a general dental practitioner - within the NHS, private practice and the government dental health services. I am certificated for the administration of Botox and Dermal Fillers for facial lines and wrinkles as I have attended further courses in minimally invasive facial cosmetic procedures. I started seeing an increasing number of patients who presented with severe to moderate dental fears, even with full-blown phobias, so I started with the slow and patient task of tackling this problem and have successfully rehabilitated many patients. The key is good, effective, concise and understandable communication, shifting control from the dentist to the patient in order to slowly, but confidently, regain their trust back in dentistry, thereby giving them the feeling of achievement and this self-empowerment which drives them to the next level of treatment.

Academy of General Dentistry. American Dental Education Association. IAPAM (International Association for Physicians in Aesthetic Medicine). Professional Speakers, Writers and Managements Consultants in Dentistry. The British Dental Association. UK Aesthetics Group. ARC - Aesthetic Professionals. Botox. Aesthetics & Beauty. American Association for Dental Research. FDI - World Dental Federation. SOURCE1uk. World Dental Hygiene Forum. ProDentalCPD. Public Health Dentistry. Dentist Network. LinkedIn. Who's Who of South Africa.

B.Med.Sc. Degree (Medical Physiology and Medical Virology; Physiology Cum Laude; Stell 1994). B.Ch.D. Degree (Bachelor of Dental Surgery; Clinical Dentistry Cum Laude; Stell 1997). CPR and CPR-Advanced Courses (2000/2001; UK). Clinical Botox (UK, 2001). Cosmetic Dermatology (Botox and Dermal Fillers; RSA 2011).

Awards and Honors
Placed on the Dean's List at University for academic achievement (1994). Highest achievement in the subject Dental Materials. Medal from 3M and the Radiology Association of South Africa for highest achievement in the subject Dental Radiology and Imaging. Medal from The Periodontal Association of South Africa for highest achievement in the subject Periodontology. Highest achievement for Oral Medicine. Highest achievement in Oral Pathology. Received the DASA (Dental Ass. of South Africa) Gold Medal for highest achieving dental student across the 5 1/2 years of the Degree. Passed the subject, Clinical Dentistry with distinction in final year.

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