A patient by the name of Sandra, age 45, called us six months ago. She reported that one of her teeth occasionally hurt when she was eating. This pain was intermittent, and only occurred when she bit down on a certain molar located toward the bottom front of her mouth. The pain was very sharp, but lacked the aching that is normally associated with a cavity, fracture, or abscess.
Sandra had even looked closely at the tooth in the mirror and did not find any visible fracture or recession of the gum line. The dentist suspected that she might have cracked tooth syndrome. This is a condition that results when one or more fine cracks form in the tooth When a person bites down a certain way, the pressure spreads that small crack and exposes the nerve to pressure, which in turn results in a sharp, jolting pain that immediately disappears again when the pressure is taken off the tooth and the crack closes.
Cracked tooth syndrome is not the same as what people typically refer to as a fractured tooth. In cracked tooth syndrome, the cracks are almost always too small for a person to see. Even dentists have to use special instruments in most cases to detect them. Although these cracks are very small, they are deep enough to affect the enamel, the dentin, and in some cases, even the nerve.
Cracked tooth syndrome can be generated by a number of causes. Some develop slowly, and some are the result of severe trauma to the mouth. Repetitive chewing over a period of time can cause very fine cracks, called stress fractures, that lead to cracked tooth syndrome. Bruxism (or teeth grinding at night) can also crack the teeth. Any type of trauma resulting from a fall or blow to the mouth can cause one or more cracks to form in a tooth that absorbs all or most of the force. Chewing on ice and hard candy is another notorious culprit of this condition.
If cracked tooth syndrome remains untreated and continues to work its way down to the nerve cavity, then either a root canal or even tooth extraction becomes imminent. We hoped this would not be necessary in Sandras case, and got her into our office as soon as possible for treatment.
Our computer allowed us to quickly pull up Sandras medical history, revealing she had suffered anxiety for several years that in turn caused Bruxism. Further exploration of the tooth with our intraoral camera confirmed that she indeed was suffering from cracked tooth syndrome. There was a small, but severely deep, crack inside of the tooth that had was dangerously close to breaking into the nerve chamber. Had the syndrome remained undetected for as little as another 3 to 6 weeks, the split would have worked its way to the nerve, and we would have had to perform a root canal.
Instead, and much to Sandras relief, we were able to replace the cusp of the tooth and replace it with a crown. Last week, Sandra sent an email thanking us and reporting that the pain has completely left her tooth.
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