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Cracked Tooth Syndrome

Cracked tooth syndrome describes a partial crack (fissure) which extends into the dentin. These cracks are too small to show up on x-rays. They may sometimes extend to or through the pulp of the tooth or under the gum.

Cracked Tooth Symptoms

Symptoms are usually characterized by sharp, fleeting pain in biting, chewing, or release of biting pressure. Sensitivity, usually to temperature extremes, or pain can be mild or intense, brief or long-lasting.

If untreated, it can lead to severe pain, possible pulpal infection, abscess, or even the death of or loss of the tooth.


Your cracked tooth will be examined by the dentist. However, CTS (cracked tooth syndrome) is one of the most difficult dental problems to diagnose since the pain is inconsistent or unpredictable. A bite test is usually performed to confirm the diagnosis.


RCT (root canal therapy) is indicated if pain persists after stabilization (core building) of the crown restoration.

Types of Cracks

Craze Lines
Small cracks appearing only in the outer enamel are called “craze lines”. They are common in adult teeth, are very shallow and are of no concern.

Fractured Cusp
A cusp (the arced apex of the tooth’s chewing surface) may become weakened, resulting in a fracture. The cusp may break off or may require removal by a dentist. A fractured cusp rarely damages the pulp, so RTC is seldom necessary. Your dentist will usually restore the tooth with a full crown.

Split Tooth
When a cracked tooth is left untreated, the fissure may migrate over time until the tooth is fractured into distinct, separable parts. A split tooth can never be saved intact. However, the position and extent of the fracture determines whether any part of the tooth may be saved. Rarely, endodontic treatment and a crown or other restorative treatment by your dentist my save a portion of the tooth.

Cracked Tooth
A tooth is cracked when it has developed a fissure extending vertically from the cusp or chewing surface of the tooth toward the root, sometimes extending below the gum line and possibly further into the root. Damage to the pulp is common, in which case RCT is usually necessary. Early detection and treatment are essential. If left untreated, a cracked tooth will become worse, resulting in the loss of the tooth.

Vertical Tooth Fracture
A tooth has a vertical tooth fracture when it has developed a fissure extending vertically from the root of the tooth toward the cusp or chewing surface. These fractures often present minimal indication or symptoms, and may go unnoticed for some time. They most often become evident when surrounding gum tissue and bone become infected. The usual treatment is extraction of the tooth, but endodontic treatment can sometimes save a portion of the tooth by removing the fractured root.