Finding a cracked tooth can be difficult since the tooth may be grossly intact. Diagnosis requires a high level of suspicion and persistence.
Patient Presentation |
Pain Duration |
Usual Association |
aching provoked by many stimuli, including percussion |
may be prolonged |
pulpal damage |
sensitive to selective pressure, biting or thermal stimuli |
usually short duration |
pulp not involved |
If the tooth is not immediately obvious, then it must be searched for. Selective pressure or biting on an individual cusp may trigger the pain and indicate the affected tooth.
Means of demonstrating the crack:
(1) radiograph (many negative)
(2) staining
(3) transillumination, preferrably using a highly collimated light source
(4) if a filling is present, removal of restoration and examination of base
Type of Damage |
Definitive Treatment |
Prognosis |
not involving pulp |
cast restoration with circumferential reinforcement |
excellent |
involving pulp but not extending to the root surface or pulpal floor |
root canal with cast restoration with circumferential reinforcement |
good |
involving pulp and extending to the root surface or pulpal floor |
extract with prosthesis |
good |
Specialty: Otolaryngology