Dentistry/Cracked Tooth Options
QUESTION: Hello Dr. Dalin,
I recently cracked a molar and for now it only hurts when I bite down on food a certain way. It has been like this for about a month now and I don't know what my options are. I went to my dentist that I have been going to for many years and he said that he doesn't see anything there. He also took an xray and tapped the tooth but there was no pain. He said that there was no way that it could be cracked because it is a virgin tooth with no fillings.
I'm pretty sure he is wrong because when I take a picture of the tooth with my camera phone I can see a crack. Also, when I was eating a chicken wing last month I bit down on a little piece of bone a little too hard and I felt a sharp pain. There was no blood, but once I felt I had pain when I would eat I immediatley did some research. All my symptoms were of a cracked tooth and I'm not sure what I need to do.
I have scheduled an appointment with a new dentist who has a lot of great reviews. He is a bit more expensive than my current dentist, but I will pay any price when it comes to keeping myself healthy. I haven't gone to see him yet and I'm worried that my only option is to have it crowned.
I have researched quite a bit on this matter because I am a bit nervous about this tooth possibly being taken out or needing a root canal. There a various sites on things like this and I figured that my options would either be a crown, onlay, or filling.
My question to you is what should I do? I know you can't see the severity of the crack, but could you maybe state each option depending on the severity of the crack? That would be very helpful and It would help me calm my nerves.
ANSWER: it is rare to crack teeth without fillings but it definitely does occur. i have something called a tooth sleuth that i use that can diagnose a cracked cusp in a very simple manner. this is what is the best way to figure this out. you merely bite and release with this plastic piece on each cusp tip. when you release and feel the zing...this is where the crack is located. it is a simple device but i have used it for the past 20 years or so and it is very accurate and dependable. we call this cracked tooth syndrome: there is a crack in the tooth but the piece has not broken off...symptoms are cold and chewing pain. if a crack is present then most often, the crown is the only way to correct the problem. these things are a yes/no diagnosis. you cannot ever tell the severity of the crack until you start treating it. good luck...i hope this helps. feel free to recontact me if you have any other questions or need anything clarified.
jeff dalin, dds
---------- FOLLOW-UP ----------
QUESTION: Thank you for your quick response!
Yes, my dentist said that it was rare to crack an unfilled tooth. I definitley question whether this tooth was maybe weak and that is why it cracked when I bit into the bone. Also, I didn't know that I had a piece of bone in my mouth because it was so small. I only realized it when I had bit down and felt a sharp pain for a few seconds.
Its funny how I have 2 other filled teeth and they haven't cracked, but the tooth with no filling did. I don't feel any cold/warm sensitivity, its only when I chew on food a certain way. Especially if the food is chewy.
So when you say that you don't know what the severity of the crack is until you treat it, what does that mean? Do you mean that the only way to find out the extent of the damage is to drill into it until you no longer see the crack? Also it seems that the crack is only on the back of the tooth. Its not in the middle.
what i meant by that is this: if you put a crown on the tooth and the pain totally stops, then the crack was superficial and all is then treated. if you put a crown on and the pain gets worse, then the crack was probably into the nerve and a root canal is needed. you just really do not know until you see how the tooth ultimately feels. my feeling is this: i never keep drilling after a crack until i no longer see it. you will end up doing a lot of root canals if you do. i like to do a normal preparation and that is all. most of the time, this is plenty of reduction and the pain goes away. lastly, cracks most often extend over the sides of the teeth (called the marginal ridges of the tooth). that is number one location.
jeff dalin, dds