CRACKED TOOTH SYNDROME

 

Tooth fractures usually occurs due to traumatic injuries to the teeth. Cracked tooth syndrome also known as CRACKED CUSP SYNDROME or SPLIT TOOTH is a condition where a tooth is incompletely fractured or cracked but no part is broken off. It involves enamel, dentin and pulp but the pulp is still vital.

Such cracks are difficult to be seen on xray as these are under the gums. This syndrome mostly affects the lower back teeth as they bear the maximum chewing forces.

CAUSES OF CRACKED TOOTH SYNDROME

• Chewing something really hard which puts a lot of pressure on the tooth and it cracks down.
• Directly opening cans and bottles from teeth. Its a big NO NO to open bottles from your teeth.
• Parafunctional habits like clenching and grinding of teeth makes people more susceptible to this.
• Teeth that have undergone root canal treatments or teeth with high points on restoration, improper crown placed are also at a larger risk.

SIGNS AND SYMPTOMS

• Excruciating pain at initiation or release of biting pressure.
• Increased sensitivity to cold temperature i.e, while drinking cold beverages or eating cold food. Eating and drinking sugary substances also cause a lot of pain.
• Pain during grinding of teeth.

HOW TO DETECT ??

1. Fibre optic light- It is used to transilluminate a fractured line. Most cracks run mesiodistally and are rarely detected by radiographs.

2. Dye- Staining the fracture with a dye, such as methylene blue, is a valuable aid in detecting the fracture. 

3. Tooth slot- It is a small pyramid shaped plastic block with a small concavity at the apex of the pyramid to accommodate the tooth cusp. The occlusal force is directed to one cusp at a time, exerting the desired pressure on the questionable cusp.

 MANAGEMENT

1. By immediate reduction of occlusal contacts by selective grinding at the site of crack or against the cusp or cusps of the occluding antagonist.

2. Removal of intracoronal restoration in suspected teeth may reveal a crack in the enamel running into the dentin. If the patient has an incomplete fracture of only enamel and dentin, a full crown restoration immobilising the fragments maybe successful.

3. A root canal treatment maybe advised if the pulp is affected.

4. A tooth maybe extracted in the case where crack is extended into the root of the tooth under the bone. You can have the extracted tooth replaced with an implant or a bridge.