Cracked or incompletely fractured teeth are more common than most people realize and are often difficult to accurately diagnose. Generally, symptoms involve sensitivity or pain on biting and/or cold and sweet sensitivity. Discomfort from this problem needs a stimulus to be elicited and unlike some other dental problems, discomfort doesn’t normally occur spontaneously. Some habits, such as clenching, grinding or chewing ice or hard candy can increase the incidence of the problem. Because symptoms of the cracked tooth may mimic other dental problems, such as a cracked or loose filling, a loose or ill-fitting crown or inflamed nerve, it is important to make a careful diagnosis. Bite tests and trans illumination (shining light across the tooth) and microscopic evaluation are helpful evaluation aids. X-rays often do not show partial cracks, but may reveal less obvious clues.
It is almost always best if cracks can be diagnosed early, so that complete fracture, requiring root canal or extraction can be avoided. Teeth treated with a root canal can also be painful to biting if they become cracked because they are surrounded by ligaments and bone, both of which have nerves. It is often confusing to patients that a tooth with a nerve removed can still hurt.
If you have consistent discomfort when chewing, drinking cold beverages or eating sweets, which seems unusual, it’s a good idea to be evaluated to rule out a fracture of a tooth.