12/25/08

"Cracked Teeth"

A very common occurrence is to have a crack in a tooth. Often the teeth most likely to suffer from cracking are these that have been heavily filled during the life of the tooth. The cavity that causes the need for the filling causes a weakening of the remaining tooth structure. Like all materials, teeth are subject to stress fatigue. After many bites on the tooth (stress cycles) a hairline fracture can develop, usually at the bottom corner of the cavity. A person that is predisposed to clench or grind their teeth due to life stress have a much higher likelihood to create stress cracks in their teeth, even in teeth that have never had a filling.
Once cracks are created in the enamel of the tooth it hurts to bite by flexing the enamel crack. As the tooth flexes microscopically, the nerve deep in the interior of the tooth is stimulated via very small tubes situated in the inner core of the tooth, below the enamel. These small tubes run down to the nerve and fluid in the tubes run down to the nerve and the fluid in the tubes move in them – which you feel as a sharp pain. The nerve in the tooth is aggravated by the crack and by bacteria being pumped into it via the small tubes. The nerve becomes inflamed because of the toxins in bacteria. A classic symptom of nerve inflammation is hot and cold sensitivity.
If nothing is done the crack continues to slowly propagate (spread) like a crack in glass such as the windshield of your car. Sometimes the crack goes off to the side of the tooth and a fragment of the tooth breaks off. The crack can also go deep into the root and at times right into the tooth nerve. It is hard to predict the course of the untreated cracked tooth, but usually it is a slow downhill slide as the crack deepens. It is not a good idea to leave a cracked tooth alone, because a small crack can be treated effectively, but a bigger one can lead to root canal treatment or extraction of the tooth should the crack split the tooth root completely.
Unless the crack is immobilized and splinted together the tooth is very likely to deteriorate. Although various methods have been employed in an attempt to stick the crack together, chewing forces are extremely powerful and these patch-up solutions are fairly unpredictable and ineffective. The only real-solution is to bind the whole tooth together with a "cap" or crown, so that any chewing force moves the tooth as a whole, rather than splitting it apart.
Those of you in your adult years who have had a lot of dental work done over your lifetime have a much higher risk if suffering from cracked tooth syndrome. If you are noticing hot & cold sensitivity of pain when biting on firm foods, seek help from your dental professional and they will evaluate your condition and recommend solutions.
Merry Christmas & Happy New Year!!!