Cracked Tooth Treatment

A cracked tooth can range from a hairline craze line in the enamel to a deep fracture extending into the root, and the appropriate treatment depends entirely on the type, location, and depth of the crack. Common patterns include craze lines limited to the outer enamel, a fractured cusp that breaks off during chewing, a cracked tooth extending from the chewing surface toward the root, a split tooth with a crack that has progressed completely through the structure, and a vertical root fracture starting in the root itself. Cracks often produce sharp pain on biting or release of pressure, sensitivity to temperature, and symptoms that come and go as the crack opens and closes during function.

At Tri-City Endodontics, evaluation of a cracked tooth begins with a focused examination using magnification, transillumination to highlight crack lines, bite tests on individual cusps to isolate the source of pain, and high-resolution imaging including cone beam CT when the crack is suspected to extend below the gum line. The findings determine the treatment path. A crack confined to the outer tooth structure may only require a crown to hold the tooth together, while a crack that has reached the pulp typically requires root canal therapy followed by a crown. Cracks extending below the bone level or completely through the root generally cannot be saved, and the most predictable outcome in those cases is extraction followed by replacement.

Dr. Malhan and the Tri-City Endodontics team regularly receive referrals from general dentists in the Tri-Cities region for the diagnosis of cracked teeth, since the symptoms can be difficult to localize and the prognosis depends on accurate identification of the crack pattern. Patients are informed of these findings and the realistic prognosis before treatment begins, so the decision to proceed with root canal therapy, restoration, or extraction is made with a clear understanding of what can and cannot be predicted about the long-term outcome of a cracked tooth