Cracked Tooth

Cracked and fractured teeth are common dental problems. As people retain their natural teeth longer (due to advances in dental technology), the likelihood of cracked teeth increases. There are many reasons why teeth may crack, for example, biting on hard objects, trauma, grinding and clenching of teeth. All of these behaviors place the teeth under extra strain and render them more susceptible to cracking.

When tooth enamel is cracked, pain can become momentarily debilitating. When no pressure is exerted on the crack there may be no discomfort. However, as the cracked tooth performs a biting action, the crack widens. The pulp and inner workings of the tooth then become exposed, and painful irritation occurs. As pressure is released again, the two parts of the crack fuse back together, and pain subsides. If left untreated, the pulp becomes irreversibly damaged and constantly painful. The resulting pulp infection can affect the bone and soft tissue surrounding the tooth.

Symptoms of a cracked tooth may include:

  • Unexplained pain when eating.
  • Sensitivity to warm and cold foods.
  • Pain with no obvious cause.
  • Difficulty pinpointing the location of the pain.

What kind of cracks can affect the teeth?

There are many ways in which a tooth can be cracked. The specific type of crack will determine what type of treatment is viable. In many cases, if the crack is not too deep, root canal therapy can be performed and the natural tooth can remain in the mouth. In other situations, the tooth is too badly damaged and requires extraction.

Here is a brief overview of some of the most common types of cracks:

Crazes – These are generally tiny vertical cracks that do not place the teeth in danger. These scratches on the surface of the teeth are considered by most dentists to be a normal part of the tooth anatomy. A craze rarely requires treatment for health reasons, but a wide variety of cosmetic treatments can be performed to reduce the negative aesthetic impact.

Oblique supragingival cracks – These cracks only affect the crown of the tooth and do not extend below the gum line. Usually, the affected part of the tooth will eventually break off. Little pain will result, because the tooth pulp (that contains the nerves and vessels) will remain unaffected.

Oblique subgingival cracks – These cracks extend beyond the gum line, and often beyond where the jawbone begins. When a piece breaks off, it will usually remain attached until the dentist removes it. Oblique subgingival cracks are painful and may require a combination of periodontal surgery (to expose the crown), and endodontic treatment to place a crown or other restorative device.

Vertical furcation cracks – These cracks occur when the roots of the tooth separate. This type of crack almost always affects the nerve of the tooth. Because the tooth will not generally separate completely, root canal therapy and a crown can usually save the tooth.

Oblique root cracks – These cracks tend not to affect the surface of the tooth at all. In fact, the damage is only apparent below the gum line and usually below the jawbone. Root canal therapy may be possible; depending on how close the fracture is to the tooth surface. However, extraction is almost always the only option after sustaining this classification of fracture.

Vertical apical root cracks – These cracks occur at the apex (tip of the root). Though the tooth does not require extraction from a dental perspective, many patients request an extraction because of the high degree of pain. Root canal therapy alleviates the discomfort for a while, but most often, teeth affected by such cracks are eventually extracted.

How are cracks in the teeth treated?

There are many different types of cracked teeth. Some can only be exposed using X-ray machines, while others are clearly visible to the naked eye. In cases where the tooth root is affected, root canal therapy is the most viable treatment option. The pulp, nerves and vessels of the tooth will be removed, and the resulting space will be filled with gutta-percha. A crown or filling will be added to stabilize the tooth and it will continue to function as normal.

When the crack is too severe for the tooth to be saved, the dentist will perform an extraction. There are a number of restorative options in this case, such as bridges, dental implants and partial dentures. All of these structures can restore biting, chewing and speaking functions.

If you have any questions or concerns about cracked teeth, please ask your dentist.

Testimonials.

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Testimonials

7/9/2019--Over the past several years I had a number of dental problems which were addressed by several Doctors in the Dr. Ted Filandrianos and Associates Service. These included regrouping of some teeth (Dr. Steve Bader), installation of implants (Dr. John Govostes) and restoration (Dr. Ted Filandrianos). In all cases I found the service and the quality of the work to be of the highest quality. The regrouping of the teeth and the installation of implants were very successful. Dr. Ted Filandrianos in particular, with whom I had interacted for a longer period of time, in addition to his outstanding technical skills and the use of state of the art digital imaging tools, he worked patiently over a number of months to address difficult anatomical problems towards an excellent outcome. Also, the Dental Assistants, that I interacted with during my treatment, were very skillful and highly professional. Similarly, I found Zuzana, the dental hygienist, to be highly professional and skillful. She makes your periodic visits to be something you look forward to it rather than to dread it. It will not be an exaggeration if I say that Zuzana is the best hygienist I have had during my entire life. Finally, Emily and Ali, who run the front office, are highly professional. They were always strive to accommodate the patient's needs and time requirements. Particularly, if you are facing a dental emergency they will always figure out ways to accommodate you. In conclusion , during my long life with a number of difficult dental problems I sought treatment in a number of dental services in the Boston area. I found the dental care that I received by the Dr. Filandrianos and Associates Service to be by far the best.

Theodore Moustakas

06/19/19--A recommendation for a dentist: His skill, his up to date equipment (computer driven replacements of tooth decay) and the efficiency of his office.
Dr. Filandrianos is the most efficient, and thoughtful and - yes - pain free doctor in his field that I have ever encountered. I have had dental work done in Ohio, Washington , New York, Baltimore, Guatemala city and Panama city....and the care and treatment I have had from"Dr. Ted", as he is known, surpasses them all. He is a very kind person. His staff is always excellent, considerate and efficient. His notifications of appointments and willingness to make changes in scheduling , when necessary, have made him and his office people and dental assistants the most appreciated in their field, I cannot give a higher recommendation . I am grateful to have found this office whenI first came to live in Boston.

Gay P. Lord

06/18/2015--Carolyn Z.

I wish there were a Yelp "location" category called "The Universe"...because Dr. Ted Filandrianos and the outstanding dental team in his Newton Centre office are the absolute BEST in the Universe.

I should know. I've had it all there...cleanings, fillings, root canals, extractions, bone grafts, implants, crowns...and every single treatment was performed impeccably...and as an added treat, with chair-side manners that make you feel relaxed, anxiety-free and...dare I write this about a dental experience?...well-loved! Dr. Ted and his colleagues will do everything they possibly can to save a tooth. And when they can't, these brilliant, topnotch specialists will spring into action with their specialties...and save the day!

Dr. Ted has saved or restored so many of my teeth. He is the perfect blend of scientist and artist and his work is second to one. Add to that the warmest and most empathetic treatment I've ever received from a dentist (I used to dread the dentist!) and you have, as I said, the best dentist in the Universe. I also want to say that if you ever, ever need a dental implant, and I needed two...and a bone graft...right after an extraction of an infected tooth...and you are nervous about it...periodontist Dr. Jean-Marie Biebuyck aka "Dr. B" will remove that anxiety when he puts his talents to work. I could not believe it. He calmed me, he assured me that all was going well, he made me laugh a few times and, most importantly, he was visibly proud of how well each procedure turned out and put me at ease each step of the way.

And how about those dreaded root canal treatments? Not here. Just this past weekend, I was in horrific pain from an infected lateral incisor (top). Dr. Ted put me in touch with my now-hero Dr. Barry Goldberg, the endontist in his office - and Dr. Goldberg called me and put me on an antibiotic immediately (on a Sunday!) so that I'd be prepared for the next day's root canal appointment. His chair-side manner is exceptional as well...and he put me at ease from "hello". I love how he explains what's going on with the tooth while we look together at the x-rays - and the steps he is going to take. Even the way he administers Novocaine is a pleasant experience if you can believe that. I just went back yesterday so Dr. Goldberg could fill the canals and put a temporary filling - and everything went perfectly. No more pain - and he saved my porcelain crown...he was so careful when working on it! Next step - permanent filling with Dr. Ted.

I could go on and on (which I already have!) but I also need to mention that Zuzana is an outstanding dental hygienist who knows I can act like a 3-year old baby when it comes to the probing during a cleaning - and she makes it as painless as possible with her talent and skill.

And the dental assistants (I apologize for not remembering all the names from the past several years) are wonderful...topnotch...and a huge component of the overall positive experience I've had in Dr. Ted's office...so I want to thank Marina and Wendy for being the best and taking good care of me.

Now...last but in no way least...I need to give a shout out to the very professional and vibrant Emily and Ali who are at the front desks - and who help ensure that Dr. Ted's practice runs smoothly. Whether it's a phone or in-person conversation, you will feel like the only patient in the practice...because of how Emily and Ali greet you, treat you, listen to you and reassure you that you are in the best dental office...in the Universe! Dr. Ted struck gold when he found them!

But don't take my word for any of the above. Experience it yourself - and you'll see what I mean!

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Theodore Filandrianos, DMD | 1400 Centre Street, Suite 101, Newton Centre, MA 02459

Phone: (617) 440-9198