Treating The Cracked Tooth.

Cracked teeth have been problematic for more than 4 decades.

The reason is that this dental condition has a set of signs and symptoms that occur together as a complex, which is referred to as a cracked tooth syndrome (CTS). The primary symptoms of CTS are momentary, sharp, shooting pain caused by the micro-movement of the cracked dentin surfaces as biting forces are initiated and released during chewing.

Such movement causes nerve pulp stimulation through the dentinal tubules and a pain response. Lower molars have the highest incidence of CTS, followed by upper molars and first pre-molars. The most prevalent age range for cracked teeth is 30-60 years.

Cracks can occur in teeth along developmental fissures with or without restorations.

Ten typical clinical findings of CTS are:

• A sudden, sharp pain with chewing
• Sensitivity to thermal changes, especially to cold
• Symptoms continue from weeks to months
• The patient’s inability to localize the offending tooth
• Pain on lateral pressure
• No pain on vertical tooth percussion
• A vital response to pulp testing
• Negative radiographic findings
• Weak tooth structure (teeth with large fillings)
• Bruxism or unusual chewing habits

Cracked Tooth Syndrome can be diagnosed by dental history, signs and symptoms, and isolation of the offending tooth or teeth by evaluating the results of diagnostic procedures. The cracked tooth is treated by stabilizing the crack and preventing expansion, the full coverage crown best satisfies this. The difficulties in managing patients with CTS occur in the diagnosis and early treatment phases.

The clinician must know the signs and symptoms, take a thorough history, and examine the patient before beginning definite treatment. The full coverage crown most often remedies CTS. Untreated symptoms result in the need for more extensive treatment to save the tooth (ROOT CANAL TREATMENT) or possible loss of the tooth.

Early treatment of symptoms is always wise.