Cracked Tooth Syndrome

A broken tooth that doesn’t necessarily look broken.

Cracked Tooth Syndrome

A broken tooth that doesn’t necessarily look broken.

A broken tooth that doesn’t necessarily look broken.

The cracked tooth syndrome is the technical term to describe an incomplete fracture happening in a back tooth that has its nerve vital. The extent and direction of this crack passing through the tooth structure are usually unknown, and it can involve, if not already, deeper layers beyond the enamel until it reaches the nerve or the root of the affected tooth.

Causes

There are a number of reasons why teeth crack and they are compounded into:

  • Anatomical risk factors: anatomical or structural features of your teeth that make them more prone to crack.
  • External risk factors: given that we normally eat a combination of cold and hot foods, sometimes in the seam meal, the temperature variation produces expansion and contraction of the tooth structures, more specifically, the enamel. These variations, added to the multiple low-frequency loads produced by chewing, contribute to the appearance and propagation of one or multiple cracks.

On the other hand, existing old and badly adapted restorations such as big amalgams or posts, weaken the tooth structure. Furthermore, occlusal factors can also be associated with the presence of deep cracks. This is usually seen in isolated back teeth, as a result of multiple previous extractions without the replacement of the missing teeth.

Other causes can include

  • Dental trauma associated with biting onto hard objects or foods.
  • Parafunctional habits such as opening objects with your teeth, chewing ice, bones, nuts or seeds.
  • Bruxism: grinding or clenching your teeth.

Signs and symptoms

Commonly, a cracked tooth can produce hypersensitivity to cold and pressure.

  • Mild to severe pain or discomfort to cold that takes longer to pass after removing the stimuli.
  • Tenderness on biting specific types of food that gets worse when the pressure is released.

This makes the diagnosis harder, as it usually can be confused with dentin sensitivity. However, the main feature of this syndrome is the clinical and radiographic absence of swelling.

Diagnosis

The diagnosis of a cracked tooth is merely based on the history of the pain. When did you start feeling it? what triggers the pain? what makes it stop? Are some of the questions that your dentist will be asking you during the examination. The thing with these incomplete cracks is, they usually do not appear as obvious on the X Rays nor clinically. Therefore, it is vital that the patient gives a very detailed description of the symptoms, so that the dentist can make the diagnosis as accurate as possible.

The dentist will also perform a couple of tests during your visit. For example, tapping on some of your teeth, or having you biting onto a special instrument to determine where the pain is coming from. However, this step can be particularly difficult in the lower teeth, as they are all connected by the main nerve that goes along from your ear to your chin. Hence, sometimes the pain felt in one tooth can refer to the ones next to it, making the diagnosis even more challenging.

Once the crack has been identified, the next step is defining the prognosis of the tooth. The prognosis refers to the possibilities of saving the affected tooth, and it will depend on the location and extent of the crack, as well as its direction (vertical, horizontal or oblique) and what tissues are involved. Basically, the deeper the crack is, and the more tissues involved, the worse is the prognosis. This will be key in determining the treatment.

The importance of early diagnosis has been widely associated with the best restorative prognosis. This means the sooner you visit your dentist when the symptoms appear, you will have more chances of needing more conservative treatments.

Treatment

The more rapidly a cracked tooth is treated, the less irreversible damage it will get. This is due to the possibility of assessing the extent of the crack before it spreads further and affects dental tissues or potentially reaches the nerve.

That said, the treatment of a cracked tooth will depend on the extent of the crack. The procedures can be as conservative as grinding the tooth out of occlusion (aiming to decrease the forces acting on it), to the elaboration of a composite filling or a restoration made in a dental lab, such as a crown or a cap. Likewise, if the crack affects the nerve, there are high chances the tooth needs root canal therapy If the crack extends beyond the nerve and reaches the root, the tooth might need to be extracted.

It is also important to bear in mind what caused the tooth to crack, whether it was a result of you grinding your teeth, biting something hard, or an existing restoration failing. Addressing the root of the problem will lead your dentist to come up with the best treatment plan. This is key, especially for patients with bruxism, or with multiple missing teeth. In their case, treating one tooth could not be the definitive solution, and full mouth rehabilitation might be needed.

    References

    • Longridge, N., Youngson, C. (2019). Dental pain: dentine sensitivity, hypersensitivity and cracked tooth syndrome. Prim Dent J. 8 (1):44-51.
    • Banjeri, S. Mehta, S.B., Millar, B. J. (2010). Cracked tooth syndrome Part 1: aetiology and diagnosis. Br Dent J. 2010 208 (10):459-463. Doi: 10.1038/sj.bdj.2010.449
    • Banjeri, S. Mehta, S.B., Millar, B. J. (2010). Cracked tooth syndrome Part 2: restorative options for the management of cracked tooth syndrome. Br Dent J. 2010 208 (11):503-514. Doi: 10.1038/sj.bdj.2010.496

    Broken Tooth

    Chipped or broken teeth are very common and are more likely as you grow older.

    Bruxism

    Bruxism is characterised by the clenching/grinding of the teeth due to repetitive jaw-muscle activity

    Cracked Tooth Syndrome

    A broken tooth that doesn’t necessarily look broken.

    Crowded Teeth

    Crowded teeth occur when the size of your jaw is not accommodating to the size of your teeth.

    Dead Tooth

    It may surprise you, but teeth do actually have living tissues.

    Dental Anxiety

    Dental anxiety is quite common and there are ways that it can be managed.

    Dental Erosion

    Dental erosion can be defined as the irreversible loss of tooth enamel caused by acids   without involving bacteria.

    Dry Socket

    Dry socket also known as Alveolar Osteitis, is a common complication associated with tooth extractions.

    Failing Old Silver Filling

    Older filling also known as amalgam filling, have been used over years and are still being used today.

    Gingivitis

    In simpler terms, it is an inflammatory disease of the gingiva.

    Gum Disease

    Gum disease is treatable and can be prevented by maintaining good oral hygiene

    Gum Recession

    Gum recession occurs when the tissues around the teeth start to recede/pull back.

    Halitosis

    Halitosis is an unpleasant odour emitted from the mouth.

    Impacted Wisdom Teeth

    Third molars, commonly known as wisdom teeth, are located at the back of the mouth

    Missing Teeth

    Missing teeth can make you self conscious and stop you from smiling often.

    Sensitive Teeth

    A common dental condition that involves discomfort  and pain when exposed to certain foods and temperatures.

    Snoring

    A partially obstructed airway during sleep causes parts of the throat or nose to vibrate as the air passes through a narrowed airway.

    TMJ Dysfunction

    Temporomandibular joint dysfunctions are a group of disorders affecting the masticatory system.

    Tooth Brush Abrasion

    Tooth brush abrasion  is the most common cause of dental abrasion.

    Tooth Decay

    These damaged areas can eventually form into holes or tiny openings.

    Toothache

    Toothache, or dental pain, is the most frequent oral pathology

    Yellow / Discoloured Teeth

    Tooth discoloration/yellow tooth is an abnormal colour of the tooth, is one of the common dental conditions for any age grouped people.

    What People Are Saying

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    Very professional, friendly and great service. I had a root canal done, the doctor that treated me was excellent. Very knowledgeable and professional. He made me feel very comfortable and I trusted him from the start. The issue was dealt with in 3 sessions. My tooth has been well taken care of, it looks and feels great. I am very happy and would definitely recommend this practice. Thank you MaxCare and all the staff.
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    Had the horrifying experience of my front tooth just breaking completely off, I went to another dentist who quoted me $6000 for an implant..but he couldn't offer me any temporary replacement... there's no way I was walking around with no tooth for a week, googled implants and maxcare popped up with a deal of $3995. I called them they saw me straight away, I was given options but all came with the promise they could fix a temporary tooth.. they were friendly and really seemed to care..I walked out with my smile and dignity intact and will be back soon to get the implant.. couldn't recommend them more highly..great service.. amazing price
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    My name is Rose, the service i received from Maxcare Dental was excellent, they gave me back alot of self confidence, i can smile again without being shy and paranoid about my teeth. Service was great, staff were friendly with a very warm and welcoming environment. Would highly recommend to others. Rose
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    23:22 03 Apr 19
    I only went to Maxcare Dental because I had a Grab One deal and it was across the road from my workplace. Normally I’ll never go into an establishment for Health Care unless it has been recommended to me AND I would never go into a Health Care establishment in Otahuhu either (personal choice).When I walked in, I was real surprised:1. It was clean and tidy (tick)2. Friendly staff (tick tick)3. Staff were professional, qualified and they knew what they were talking about and had been trained at a high level (tick tick tick)It ticked all the boxes for me. I have recommended Maxcare Dental to all my friends and colleagues (to their surprise lol). My wife has booked in to see Maxcare Dental and it’s now become my preferred choice when it comes to dental work!
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    22:45 26 Jun 19
    The dental Clínic is outstanding with also excellent professional staff. I have been attended in 4 different Clinics before coming to this one and for sure this is the best. For those who fear going to the dentists my last 2 fillings I had here I suggested not to use anesthesia and I didn't feel any pain at all. They are really careful and have wonderful hands. Easy parking and online bookings.
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    08:36 30 Jun 19
    Outstanding service from friendly and professional staff from start to finish. I have been had two treatments and both were great when home with great smile. Very happy with my dentist and treatment provided. Highly recommend this clinic.
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    23:34 30 Jun 19
    Went in for cleaning and got an x-ray done. Very friendly staff and professional service, they are really proficient at what they do. I flew back to my country with a great big white smile : D. Strongly recommend this clinic to everyone
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    07:36 14 Jul 19
    Quality of work. I strongly recommend dr.Thair
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    04:30 20 Aug 19
    I am a new patient and I thoroughly enjoy the friendly, welcoming service and affordable prices at Max care. I had several proceedures done to my teeth for tha past month and today I was very impressed and grateful that Dr Khan came in on her day off to accommodate me (shift worker)she has an extremely busy schedule but that blew me away!! I offered to pay extra but she said it was fine. I am recommending her to everyone I know she and her lovely staff pull out the red carpet treatment and make the whole experience all about you THANK YOU SO MUCH DR KHAN + MAXCARE
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    02:56 26 Aug 19
    I went to the max care all frightened but was assured it will be painless. When I went there I was blown away by the relaxed atmosphere and friendly staff . I have changed my dentist to max care because they treated me so well and informed the procedure every step of the way. She was young beautiful and yet so knowledgeable . I completely trust her. The receptionist and the assistant nurse too were so Curtiss and friendly . They really know their stuff and work as a team . The place is clean, location is easy accessible and open 7 days . It’s great for working people , can visit in the weekends and there is plenty of parking . I have been to many dentists previously , but I really recommend Maxcare Dental. I give them 10/10 . They reminded me of my appointments . Max are provided me the service beyond my expectation. And I THANK YOU😃😃😃😃😃
    juliet palmer
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    02:32 08 Sep 19
    Dr Tazeen is that rare kind of person that exudes professionalism but also is genuinely caring, and goes out of her way to advise you on what is best for your own personal dental health. In a situation where most of us are nervous and (with suction, etc in our mouths) unable to speak!) Dr Tazeen intuitively knows when to check in on you, and adjust any procedure to make you instantly more comfortable. The practice, in general, offers top quality work without the 'posh people' prices, and they stay away from sales pitches and hard-sells, while offering clear information and solid support. Highly recommended.
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    Great service with affordable cost.
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    Excellent service and extremely friendly staff prices are also excellent
    Glenis Harrison
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    I got free dental checkup .Staff is polite and professional hope i will get free cleanup as well
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    i really liked how everyone was all smiles and how they answered all my questions.
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    How much do you charge for braces for teenagers?
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    10:01 05 Oct 19
    I have been scared of dentists all my life, howewer Dr Thair Abdul Hamid made me change the way I felt about going to the dentist. Great experience.
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    03:07 21 Oct 19
    A great place for all your dental care. I went there on a Sunday and was seen straight away by a great dentice. Very clean and new place.will always go there.
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    18:56 21 Oct 19
    Excellent service. Highly recommended .
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    Dr Ramneek Kaur is brilliant. After we moved home from Sydney, Dr Kaur took over and completed my daughters orthodontic treatment with a great plan and price. She has great interpersonal skills and very accommodating. Online appointment booking as also a plus!
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    Comfortable and nice experience. Very professional. Thanks so much friendly Doc and staff.
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    Highly recommended amazing friendly staff. Very welcoming and services is fast with no pressure.
    Dainna Chapman
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    18:02 20 Dec 19
    Dr Tazeen Khan, was very professional and so kind and thoughtful right from the start, I was super nervous in seeing a Dentist. I wanted to see a female Dentist, she put my worries at ease, cared about my feelings, she worked without any breaks and always che led to see how I was feeling. Dr Khan worked so fast and had everything done in the same day, she did moulds done all in one day and her assistant was very professional as well. I've never felt so cared for in such a kind and caring way. I would recommend her to everyone.
    Debbie Cochrane
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    05:54 03 Jan 20
    DrTazeen Khan was so kind and caring, both her and her assistant were very professional, they put me at ease as I was very nervous regarding dentist's. Easy access to parking, affordable dentistry. Dr Kahn did exceptional work, she did a replacement tooth so very fast, she talked me through everything she wanted to do for the future with me. I would recommend her to anyone who needed any work done. Thank you Dr Tazeen Kahn for all you have done.
    Debbie Cochrane
    Debbie Cochrane
    06:11 03 Jan 20
    Great Service, Friendly Staff, Quality Work and Very Reasonably Priced. Very pleased with the result and service received by the dentist Mr Hassan Ahmed. Not a fan of going to the dentist but this is the place to go when that time comes.
    Tania Sharkey
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    03:47 09 Jan 20
    Convenient location, easy parking. Excellent service. Highly recommended.
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    09:04 12 Jan 20
    Service is spot on because the receptionist is very kind and understanding. The dentist is very professional and friendly so I felt at ease once I met him. The place feels like home and the music is very soothing to listen to in the waiting room. I would definitely recommend this dentist to anyone else.
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    22:45 13 Jan 20
    My wife and I both had work done at Maxcare Dental in Otahuhu and we were very pleased with the whole experience. The clinic looked very modern and clean. The receptionist was friendly and very helpful. The dentist was very professional and gave us great advise concerning care needed and after care. The cost was competive and reasonable but still a lot for a low income family. We did receive a slight discount which means alot as every cent counts. Overall, we are very satisfied with our experience, this is why we are back a second time. We'll done Maxcare Otahuhu.
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    04:40 15 Jan 20
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    05:44 15 Jan 20
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    07:37 05 Feb 20
    Amazing service. The staff are kind and really care. I have not been to a dentist in many years but Dr Tazeen Khan made feel at ease. I highly recommend Maxcare.
    Michelle Wilkinson
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    22:54 10 Feb 20
    I have had 2 wonderful experiences with the team at Maxcare Dental and usually a dental visit is anything but a wonderful experience.From the service at the reception desk to the dental assistant and dentist the environment was warm and the appointment informative. All bases were covered and i was referred to a specialist promptly.I would highly recommend their services as they are a very welcoming professional team with very affordable prices.
    Natalie Latu
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    08:49 20 Feb 20
    Awesome Experience, From the kind and welcoming receptionist to the very experience dentists every one is amazing !!! Great staff. Love how its state of the art clinic. The dentist was explaining things so thoroughly and I felt so at ease. The environment is so relaxed. Would definitely come here next time . I would highly recommend Max Care Dental.
    Siraj Khan Videos NZ
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    21:27 20 Feb 20
    Highly recommended. Great prices and very helpful staff.
    Anne Huynh
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    22:37 17 May 20
    I would like to express my gratitude for your wonderful dentist finding the infection that wasn't presenting on the 19th when I came for a review. I am very relieved now I returned so soon as I have been very unwell since the implant failure months ago and I am looking forward to becoming well again. I found his technique and skills outstanding and I will be referring people to your clinic to see him.I would also like to share that I thanked Lydia the dental assistant today. I have never thanked an assisting person before but she did an amazing job. I normally find suctioning extremely uncomfortable and usually the fluid still runs down the back of my throat causing me to gag. I would say she would be the best dental assistant I have ever experienced with excellent technique. Finally I would like to mention Anna she is always very friendly and helpful.I wanted to share my personal feeling toward your staff I encountered today and to let you be proud of them especially in the current difficult situation all New Zealanders and all businesses are facing.you have an outstanding Team working for you Rating 5/5
    Paula Hollinshead
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    02:41 27 May 20
    Had some dental work done with Dr Hassan Ahmed, very professional and pleasant experience 🙂
    Aini Su
    Aini Su
    00:14 16 Jun 20
    Went to Maxcare Dental today for a scale and polish (found them through groupon) and the dentist I saw was great. Not only did he do the scale and polish but also addressed other concerns I had too. Will definitely be back 🙂
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    04:08 17 Jun 20
    AAA+ reasonable charges. Good service, friendly staff. Introduced and recommended to my friends.
    Atiq ur Rehman
    Atiq ur Rehman
    19:50 20 Jun 20
    First experience at the clinic. Staff was friendly knowledgeable. Dr Hassan listened to my problems and quickly diagnosed the issue. We have made a plan going forward.
    Trevor Marshall
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    03:19 24 Jun 20
    We good and friendly service. I would highly recommend this guys
    Amit Sami
    Amit Sami
    02:00 22 Jun 20
    I have never enjoyed going to the dentist since young age and had struggled for a long time to find a dentist that I felt comfortable with until I visited Maxcare Dental. From the very first phone call with Anna at reception through to my visits with Dr Hassan Ahmed, they have shown sincere kindness and support throughout. They really do look after their customers and provide excellent work on your teeth! (really happy with mine!!). Will highly recommend them to all my family and friends.
    Ck Fabricius
    Ck Fabricius
    11:07 07 Jul 20
    Great service, friendly staff. I used a Groupon deal which made my visit much cheaper!
    Sheryl Main
    Sheryl Main
    23:42 09 Jul 20
    Maxcare Dental Staff was incredibly professional, friendly and very helpful.Doctor Mohammed Thank you so much for making our experience a wonderful and pleasant one.Your clear instructions made it an easy breeze first time experience.100% Recommended👍
    Mosman Tessa Gelling
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    04:58 11 Jul 20
    You have done an amazing job into ensuring that I have been well cared for. I have no other means but to thank you for the great and professional serviceWell appreciated and recommended!!
    Emz T
    Emz T
    03:40 28 Jul 20
    Excellent service and friendly staff. Husband had fillings done and he was very ecstatic about it. Second, got my little girl check up for braces and we were given good options and great informations too. Keep up good work. Thank you..😊👍🏻
    Tiffany Yape
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    23:35 03 Aug 20
    Very friendly and professional environment. Did not feel pressured into getting anything done. Were very courteous. 11/10 recommended
    Zaay M
    Zaay M
    02:41 11 Aug 20
    Pleasant first time visit to this clinic. Very welcoming and didnt feel judged for neglecting work that needs to be done, dental assistant was great too.
    Daphne Fifita
    Daphne Fifita
    20:28 11 Aug 20
    Great service at Maxcare Dental, they ensure you understand your options which is important when looking after your smile 😃 first time visiting after COVID and they have everything in place to ensure your safety.
    Gerardus Verspeek
    Gerardus Verspeek
    04:05 31 Aug 20
    These people are outstanding. Great service, great people, and skills that I can't believe. Seriously, my flatmate lined people up to have a look at my teeth after treatment ..awesome.
    Josiah Bounderby
    Josiah Bounderby
    05:08 15 Sep 20
    Highly recommended ❤️🙌🏻
    Felila Liu
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    03:15 16 Sep 20

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