Dental Professionals

Detecting Cracked Tooth Syndrome

By Dr. Linda Niessen / Baylor College of Dentistry
Monday, October 3, 2005

Three months ago, Carla Obara developed a pain in her lower back molar. It hurt when she chewed.

"I thought it was just a sensitive tooth," she said. "Then it started hurting when I bite down on food. From there, it just got worse. Every time I would chew anything, it would hurt—even gum."

Obara has a very common problem: cracked tooth syndrome. It usually affects teeth that have large fillings in them.

"And it just got worse, the pain," she said. "And then Monday, it just cracked when I was eating."

Cracked tooth syndrome symptoms include:

• Pain upon release of biting pressure
• Sensitivity to hot, cold or sweets

"A cracked tooth is a tooth that when it’s loaded, it moves independently of itself," explained Dr. Jeff Roy, an Irving dentist. "It flexes. And along those fracture lines, there is sharp sensation or pain."

Dentists can diagnose cracked tooth syndrome by having the patient bite down on the suspicious tooth using a variety of instruments—including one called the fracture finder. "These things are as frustrating for the dentist as the patient sometimes," Dr. Roy said. "It’s hard to reproduce it in the office." X-rays may or may not be helpful in diagnosing cracked tooth syndrome. In Obara's case, the x-rays indicated no problem. "We want to catch that crack early before it gets to the nerve or down to the root surface and you lose the tooth," Dr. Roy said. Carla Obara is lucky. Her fractured tooth can be saved with a porcelain crown. If you have pain when you bite down, suspect a cracked tooth as the cause of the problem—especially if you have fillings in your back teeth or molars. Nighttime grinding also can cause cracked tooth syndrome. Your dentist can prescribe a custom-fitted mouth guard to wear while you sleep to protect your teeth.

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