Treating Cracked Teeth

Apr 13, 2023 | Cosmetic Dentistry

Teeth are strong. In fact, tooth enamel is the strongest substance in the body. At 96% mineral composition, it’s even stronger than bone. But that doesn’t mean that our teeth are unbreakable.

Chips and cracks still happen, and when they do, they’re often quite painful. Thankfully, the Wilmington, NC, dentists at Salling & Tate are experienced with diagnosing and treating cracked teeth so our patients can get back to a normal dental routine.

How Do Teeth Crack?

Major tooth cracks aren’t exactly common. While most cracked teeth are seen in older people and caused by aging, they can also be caused by:

  • Teeth grinding (also known as bruxism)
  • Biting into hard foods (candy, ice, etc.)
  • Extreme temperature changes in the mouth
  • Large fillings that, over time, weaken the tooth structure
  • An injury, like a car accident, fall, or a blow to the head/mouth

Symptoms of Cracked Teeth

Very tiny cracks in the teeth can occur and exist for many years without the patient experiencing any pain. Larger cracks, on the other hand, are often accompanied by some or all of the following symptoms:

  • Hot, cold, or sweetness sensitivity
  • Pain during chewing, biting, or releasing a bite
  • Pain that comes and goes throughout the day
  • Swollen gums around the painful tooth

Severely cracked teeth that are left untreated can become infected. If you suspect you have a cracked tooth and are experiencing the following symptoms, you may have an infection and should see your dentist as soon as possible:

  • Bad breath
  • Extreme pain while eating/chewing
  • Extreme hot/cold sensitivity
  • Swollen or tender glands/lymph nodes in the neck
  • Severely swollen gums
  • Fever

Diagnosing Cracked Teeth

Even if you aren’t experiencing any signs of tooth infection, you should consider visiting your dentist if you think you might have a cracked tooth. Whether you can see the crack or chip, or are just experiencing symptoms, it’s much better to make an appointment to see your dentist than it is to remain in pain and risk an infection.

Once you’re in the dentist’s chair, they’ll start their assessment by asking you about your recent dental history, how/when you think the crack may have happened, and whether you’ve eaten any particularly hard foods or have been grinding your teeth lately. Next, they’ll take some or all of the following steps to determine if and where there is a crack:

  1. Doing a visual examination is the first step to looking for cracked teeth.
  2. Feeling the teeth with a finger or dental explorer can also reveal chips and cracks.
  3. Using dental dyes stains teeth, and makes cracks more prominent.
  4. Looking for signs of gum inflammation is often a major indicator that a tooth is damaged.
  5. A bite test can indicate to dentists where and when the patient is experiencing pain while chewing.
  6. X-rays can reveal some cracks and not others, but they can also show where tooth pulp has been damaged – a sure sign of a crack.

Types of Cracked Teeth and Treatments

There are several different types of tooth cracks, each requiring a different treatment method. For the purposes of this article, we’ll discuss the most common types of tooth cracks and how each can be repaired.


Craze lines are teeny, tiny cracks in the enamel of teeth. They can be caused by anything from mouth piercings to biting your nails to simple wear and tear. Most craze lines don’t cause any pain.

Treating craze lines is unnecessary unless they become large or painful over time. Whitening treatments can help reduce the appearance of some craze lines, while others may require porcelain veneers to cover up.


Fractured cusps occur when part of the chewing surface of a tooth cracks or is chipped off. Often, fractured cusps are seen near fillings, where the original structure of the tooth has been compromised or weakened. Vertical cracks go from the top of the tooth to the gums, but do not extend down into the gum line.

Treatment for vertical cracks and fractured cusps depends on the size and location of the crack. If the tooth’s pulp has not been affected, dentists can typically use porcelain crowns, or bonding to fix fractured cusps or small vertical cracks. However, if the tooth’s pulp has been damaged by the crack, a root canal or extraction may be in order.


Cracks that start above the gums and extend deep below the gum line can split a tooth in half. These cracks are often extremely painful and require immediate dental care. In some cases, split teeth can be treated with a root canal. In other cases, the tooth must be extracted. The type of treatment your dentist chooses will depend on their evaluation and the seriousness of the crack.


This type of crack starts in reverse of the others, beginning with a crack in the bottom of the root and often traveling all the way up to the top of the tooth. Vertical root fractures aren’t always painful, but they can become infected if not treated. Vertical root fracture treatments typically involve extraction.

As dentists, we strive to help our patients by treating cracked or chipped teeth quickly and efficiently. If you think your tooth may be cracked, get in touch with us to schedule an appointment. Even if you are having a dental emergency outside of our regular hours, you can call us for help at 910-256-9040