ask dr. dyer

What causes a cracked tooth and how is it diagnosed?

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That’s not really an easy question. In the past, vague symptoms of pain were first addressed with root canal treatment. Then if the pain persisted, the patient would just live with it until the tooth had to be extracted. That still happens today, because cracks are hard to diagnose. A regular dental xray rarely will reveal a cracked tooth. This is a two dimensional xray and a crack is usually masked by parts of the tooth that are not cracked.

In these images, a patient heard the crack happen. His dentist sent him to me for evaluation. I took a three dimensional xray and it revealed the crack.

What causes cracked teeth. The short answer is clenching and grinding. I hear regularly that “my tooth broke while I was eating mash potatoes” or something similar to that. Grinding your teeth can cause them to flex. Just like a paper clip finally breaks with bending, teeth can crack with clenching and grinding. Cracks start small and enlarge over time. You can tell if you clench by asking yourself, “are my teeth touching?” At rest, your teeth should be apart just slightly. Clenchers and grinders almost always have their teeth together. After years of this habit, it just feels normal.

If you have a sudden pain when chewing or persistent pain after root canal, we do have the technology to determine why.