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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

If you want to know what I think of Dr. Afzali and her staff all you really need to know is that I live in Portland and I fly to San Diego to see Dr. Afzali for all my dental work. That might seem a bit extreme, and perhaps it is, but hear me out before you decide. A couple of years ago when I was living in the Bay Area I had to have one of my front teeth removed and dental implant inserted in its place by a dentist in the Bay Area. The implant looked a little shorter and darker than my other teeth, and even made my gum above it look a bit darker than the adjacent gum. In short, it didn't look natural. So I wasn't completely satisfied with how my smile looked, but I thought that was the best that could be done. It wasn't.

Last summer while I was in San Diego visiting my parents I went to Dr. Afzali for a routine cleaning. She examined my mouth and immediately asked me whether I was happy with the way my implant looked. When I said I wasn't, she explained that she could make it look better and possibly even indistinguishable from my other teeth. She was right. My implant looks just like my other teeth, and my gum is pink again. In fact, my new implant looks so natural that I sometimes forget it's an implant. I couldn't be happier. One final point. Dr. Afazli's entire staff is great. When I walk in they all make me feel like I'm the most important patient they have. And Julie is particularly great. Because I live in Portland my visits to Dr. Afzali's office had to me perfectly timed with receipt of the various parts necessary for my procedures. Julie made sure that everything arrived when necessary, without fail, so that no flights or appointments had to be rescheduled.

Riley P.

Recently, while on a trip from Canada to visit friends in San Diego, I broke a tooth. I phoned RB Dentistry and was given an appointment without delay. Dr. Mary Afzali was reassuring and professional and did an excellent job fixing the broken tooth. Her dental assistant, Marinette, was kind and gentle and made me feel comfortable throughout the procedure. Julie at Reception was welcoming, warm and made me laugh with her wonderful sense of humour and handled the insurance processing with no complications. Thank you so much Dr. Afzali, Mari and Julie for one of the most pleasant dental appointments I've had in a long time! Hope to see you in Vancouver, B.C. sometime!

Pam C.

I know I am in good hands with Dr. Afzali at RB Family Dentistry. The cavity fillings and tooth root fillings I got there were done so well that when I went to the Southwest College Dental Hygenist school to help out a friend, they could barely even detect the fillings! The teachers there were very impressed. At RB Family Dentistry, the staff and hygenists are friendly, organized and very knowledgable, and the Dr. always gives me as much time as I need and answers all of my questions. The office is beautiful and state-of-the-art. They never try to sell me on additional products or services that I don't need.

Scripps Ranch M

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RB Family & Cosmetic Dentistry
16776 Bernardo Center Dr. #105 San Diego, CA 92128
Phone: (858) 485-0044 URL of Map