Cracked tooth syndrome (CTS) is a dental condition in which a partial crack extends into the dentin. It may occasionally extend to or through the pulp/nerve of a tooth. CTS is defined as an incomplete fracture of dental tooth structures. It is sometimes associated with a sharp pain during chewing. During chewing function, a crack, craze, or fracture line may allow broken tooth sections to flex or move. This causes sensitivity and pain in the dentin, which is the sensitive portion of the tooth. If symptoms are present, the most common symptom is a sensitivity to biting. However, it is not uncommon for there to also be a sensitivity to cold. This can progress to a full-blown toothache, pulp death, or necrosis and abscess. When the nerve of a tooth dies or abscesses it will require a crown, crown and root canal procedure, or possibly tooth extraction to resolve the problem. It should be understood that cracks and fracturing are also very commonly present in tooth structure without the production of pain or other symptoms. A patient would need to be seen by the doctor to determine the exact cause of pain, as many problems present with the same symptoms.
Cracks in tooth structure can be created in several ways. The most common is as a result of previous dental fillings. Silver fillings (amalgam fillings) have been around for decades. Chances are that most people who have had a cavity have also had this silver mercury compound placed in the tooth. The material is adequate for filling the hole, but compromises the structural integrity of the tooth. The continued forces from chewing and clenching on the tooth puts stresses on the tooth structure and something has to give and its usually at the expense of tooth structure. Note that most cracks in the teeth begin and propagate from an inside line-angle of the filling or cavity preparation. These cracks usually extend at an angle towards the outside of the tooth. When cracks exit below the gum line or bone level, far more extensive restorative measures are often required, such as gum surgery and/or root canal treatment..We can usually spot these problems early enough and we have great restorative treatments available that can prevent this outcome far ahead of its happening.