Cracked teeth demonstrate many types of symptoms. These include pain when chewing, temperature sensitivities, or even pain upon release of biting pressure. It is also common for pain to come and go, making it difficult to diagnose the cause of discomfort. Numerous papers have been written about this - the Cracked Tooth Syndrome. Pain to biting /chewing that is extremely difficult to pinpoint.
Chewing can cause movement of the cracked pieces of your tooth. Biting pressure opens the crack and when the bite pressure is released, the crack closes quickly, resulting in sharp pain. This sharp painful response is from A-delta nerve fibers within the dental pulp tissue. Continued bite trauma causes the pulp tissue within the tooth to become irritated. Eventually, the pulp will become damaged and the tooth will consistently hurt, even when you are not chewing. It is possible that cracks in the tooth can lead to infection of the pulp tissue, which can spread to the bone and gum surrounding the problematic tooth.
Cracked teeth are a bane to dentistry. Whenever your general dentist finds a crack within your tooth, coronal coverage is usually recommended. This can be a full crown or an overlay (shoeing the cusps). These restorations are recommended and designed with the idea of preventing the natural wedging effect of teeth. It is difficult to always get a successful resolution to this pain. Many patients have remarked, ‘my tooth was fine until it was cut on’, this comment is rare and unfortunately may cause frustration with your dentist and even trust issues. However, this should not be viewed through the trust lens because this is not an unusual occurrence with cracked teeth. The trauma from prepping the tooth is added to the trauma from the crack and may be the last straw to push the pulp tissue into an irreversible pulpitis. It happens. Crowns and overlays are not perfect, they are just the best we have to protect you and prevent the propagation of the crack in your tooth. Teeth can be maintained pain-free indefinitely with these restorations. For those with continued symptoms, endodontic therapy will be necessary.
The vast majority of teeth can be treated and saved via endodontic therapy. Occasionally, a tooth can’t be saved because the root canals are not accessible, the root is severely fractured, the tooth doesn’t have adequate bone support, or the tooth cannot be restored. However, advances in endodontics are making it possible to save teeth that even a few years ago would have been lost. When non-surgical endodontic treatment is not effective, endodontic surgery may be able to save the tooth (see Apicoectomy Surgical Retreatment).
We recommend that you call your restorative dentist the same week, post-treatment, to make your follow-up appointment. Dentists' schedules tend to book quickly. It is recommended that you have your permanent restoration placed as soon as possible. This step is imperative for the long-term prognosis of your tooth.
Dr. Cutbirth will discuss the properties of any temporary filling he places. The temporary is designed to seal and not allow ingress of pathogenic bacteria.
Timely follow up with your general dentist is crucial for a permanent restoration. Not following up can allow your temporary filling to leak, thus contaminating your newly completed root canal therapy. Call your dentist the same week (post-treatment) and get on their books for the completion of your restoration. It's that simple, and it puts you on the right road to retaining your tooth for a lifetime.