Does a cracked tooth need to be pulled?

Does a cracked tooth need to be pulled?

Not always. Cleveland Clinic says extraction is needed when the crack causes severe damage to the root and nerves, and the dentist may then recommend replacing the tooth with a bridge or implant. The American Association of Endodontists says a cracked tooth whose crack has reached the pulp can often be saved with a root canal and crown, but if the crack extends below the gum line the tooth usually cannot be saved and needs extraction. A split tooth generally cannot be kept whole, though part of it may sometimes be saved, and vertical root fractures often require extraction, though endodontic surgery may save the tooth in some cases.

What are the types of crack?

Both sources describe five. Craze lines are tiny cracks in the outer enamel that are common and harmless apart from appearance. A fractured cusp is a piece of the chewing surface that breaks off, often near an old filling, and rarely affects the pulp. A cracked tooth has a crack running from the chewing surface toward the root without separating the tooth. A split tooth has separated into distinct segments, and a vertical root fracture starts in the root and extends upward, often with few early symptoms. The type matters because it decides whether the tooth can be saved.

Which treatments save a cracked tooth?

Cleveland Clinic lists bonding with tooth-colored resin, contouring to smooth rough edges and adjust bite contact, crowns or veneers, a root canal if the crack reaches the pulp and causes infection, and extraction if the damage is severe. The American Association of Endodontists says chipped teeth can often be repaired by reattaching the fragment or bonding a tooth-colored filling or crown, and that a fractured cusp may get a new filling or crown. Treatment mainly relieves pain and reduces the chance the crack worsens, and most treated teeth keep working for years.

Does a cracked tooth heal?

No. Both sources say a cracked tooth cannot heal on its own, unlike a broken bone, though treatment may save the tooth. The American Association of Endodontists says some cracks keep progressing even after treatment, and that a crown gives strong protection but does not make success certain. Cleveland Clinic says prompt repair lowers the risk of further damage and infection, and that some cracks do not need treatment but a dentist should assess them.

Does a chipped tooth grow back?

No. Cleveland Clinic's chipped tooth page does not say a chipped tooth regrows. It notes that for minor chips the edges may smooth out somewhat over time, but a lost fragment is not restored on its own. Repair options are polishing for small chips, bonding, veneers for front teeth, crowns for weak or significantly damaged teeth, fillings for missing areas and a root canal if a chip exposes the nerve, with a crown often following. A dental provider chooses based on severity.

What to do right away

Cleveland Clinic says to save any fragment and store it in milk, bring it to your appointment, cover the area with dental wax or a mouth guard, with sugar-free gum as a temporary cover, keep brushing and flossing, use over-the-counter pain relief and ice packs, stick to soft foods and avoid biting with the injured tooth, and book a dental appointment as soon as possible. It says you cannot fix a chipped tooth at home. It treats a chip large enough to expose sensitive tissue as urgent because exposed tissue can become infected.

What are the signs of a problem?

Cleveland Clinic lists sharp pain when biting, sensitivity to temperature or sweets, swelling around the tooth and toothache when chewing, and for a possible abscess bad breath, persistent pain, fever, swollen gums and swollen lymph nodes. The American Association of Endodontists notes erratic pain when chewing, sometimes when pressure is released, sensitivity to hot or cold, and pain that comes and goes, which can make the tooth hard for a dentist to locate.

Preventing cracks

Cleveland Clinic advises keeping up oral hygiene and regular dental exams, wearing a mouthguard for contact sports or activities where you might fall, avoiding chewing ice, hard candy or fingernails, and not using your teeth to open packaging.

Questions to ask your dentist

Take these to your appointment.

• What type of crack do I have, and where does it end?
• Can the tooth be saved, and with what?
• Do I need an X-ray or a referral to an endodontist?
• What happens if I wait?
• If it must come out, what are the replacement options?

Frequently asked questions