Cracked teeth management
Cracked teeth gets much less attention than cavities from everyone, including the dentist. How many times have you heard the phrase “Let’s just watch it?” Now think about what that actually means? Is anybody actually “watching” anything?
Understanding the treatment of cracked teeth involves appreciating the mechanical engineering principles at play. Teeth, like engineered structures, are subjected to different forces from different directions. When a tooth cracks, its structural integrity is compromised, making it susceptible to further damage under these repeated stresses.
Crowns and overlays are designed to restore the structural integrity of a cracked tooth because they provide a more uniform distribution of bite forces, and minimizes stress concentrations that could exacerbate the crack. This is akin to how engineers might reinforce a damaged beam or column in a building to ensure it can bear loads without further deterioration.
Why not just a filling for cracked teeth?
Fillings are applied directly into the cavity or crack. While they can effectively seal the crack and restore the tooth’s surface, they do not reinforce. Fillings do not provide the same level of load distribution as crowns or overlays. Very frequently, overly large fillings are the cause for the cracks in the first place because they weakened the tooth. In engineering terms, this is similar to placing a weld on a damaged section of a beam without reinforcing the entire structure; the local repair might hold temporarily, but not in the long run.
What happens if I just let the tooth be?
- Propagation of the Crack: Since a cracked tooth is structurally compromised, the usual biting forces that do not damage healthy teeth are now excessive. These forces can cause the crack to propagate, increasing the risk of the tooth breaking. In engineering, untreated cracks in materials worsen under repeated stress, and teeth are no different.
- Infection Risk: Cracks in a tooth create pathways for bacteria to enter the inner layers of the tooth. This can lead to infections, abscesses, and severe pain. An infection in the pulp will require root canal treatment or, in severe cases, tooth extraction.
- Pain and Sensitivity: Even if the crack does not immediately lead to a complete break, it may still cause significant discomfort. The crack can expose the inner layers of the tooth, leading to increased sensitivity to temperature changes and pressure. This can make eating and drinking a painful experience.
- Worse Prognosis Even After Treatment: The biggest reason to not “let it be until something breaks” is later treatments have higher complication rates, even after identical treatment is rendered. Early intervention when the crack is small and manageable allows for more effective reinforcement, and ultimately lower cost in the long run.