09 Mar Tooth Fractures and Cracked Teeth
Teeth are made from pulp, dentin, enamel, and cementum. Enamel is the outermost coating of the tooth, and it is the strongest tissue in the body. Enamel can withhold stress from chewing and other external forces, but as with everything else, it has its limits. Enamel can become weakened if teeth are not properly cared for. Cavities are spaces left behind when enamel is damaged by external force or has decay caused by bacteria. Once the enamel layer is compromised, the tooth is more susceptible to fracture. The older teeth get, the less nutrients they contain, and the more brittle they become. Thus, fractures tend to be more common in people older than 25 years old but can occur in younger people as well. The most important thing to do is make sure you see your dentist regularly so that these problems can be caught early. In between appointments, if you suspect that you have a cracked tooth or other damage, make sure to have your Mt Pleasant dentist take a look.
There are multiple different variations of tooth fractures. Sometimes, even if the tooth is fractured, it can still be saved. One such tooth fracture is an oblique supragingival fracture. This type of crack in the tooth is located fully above the gum line and is relatively superficial. Oblique supragingival fractures can be caused by biting down on a hard object. Your dentist can remove the fractured portion of the tooth and repair the tooth with a composite filling or a core buildup and porcelain crown if the damage is large enough. Left to fester for too long, this fracture can grow to the point that the tooth will need to be extracted, so it is important to see a dentist as soon as you suspect that your tooth may be broken.
Another type of tooth fracture in which there is a possibility of saving the remaining tooth is the oblique subgingival fracture. The area of the tooth in which this type of crack occurs is below the gum line. Since it is below the gum line, the gum holds the broken piece in place, and it remains there until an oral surgeon is able to remove that fractured portion. In the meantime, the friction of the mobile tooth fragment against the remainder of the tooth can cause irritation and become excruciatingly painful. As with all the variations of fractures, there is risk of infection as well, which can compromise the surrounding teeth. In this scenario, as long as the fracture doesn’t go too deep below the gum line, only the broken piece of the tooth must be removed, and the remainder of the tooth can be saved with a core buildup and metal or porcelain crown. If the fracture continues deep down past the gum line, the whole tooth will need to be extracted. Sometimes, this type of crack originates below the gum line and continues fracturing upwards towards the crown of the tooth. In this scenario, it can be undetectable to the naked eye for a while until symptoms begin. Routine check-up x-rays during your bi-annual cleanings can catch these fractures earlier on before they become severe.
A third type of tooth fracture occurs completely below the gum line. This is called the oblique root fracture. It is a fracture of the tooth near the bone. The prognosis for a tooth with an oblique root fracture is poor, but it can be saved with a root canal followed by a core buildup and crown. Even after treatment, there is a significant risk for the bone to become abscessed and the tooth to require extraction down the road.
The final type of tooth fracture we will be discussing today is the vertical apical tooth fracture. This is a crack deep within the tooth itself. It cannot be treated with a root canal and the tooth must be extracted. The pain associated with this condition tends to be very high. The best way to identify a vertical fracture of the apex is by using a CBCT scan. These high-resolution 3-D imaging machines are commonly found in the offices of root canal specialists and oral surgeons. If a patient is referred for a root canal but a fracture is suspected, the endodontist will take a CBCT image of the tooth before treating it. In this way, they will be able to determine whether the tooth can be saved with a root canal or if its prognosis is hopeless and the tooth needs to be extracted. Depending on the location of the tooth, it can be replaced with an implant crown down the road after being extracted.
At Smileworks General and Cosmetic Dentistry, our expert dentists repair cracked teeth for patients in Mount Pleasant, SC and the greater Charleston area. From small cracks that require a filling or crown, to more severe fractures that require extraction and implant, Smileworks is the dental office best suited to treat your needs.