Cracked teeth are some of the most common dental emergencies, especially as people retain their natural teeth longer thanks to advances in endodontics, cosmetic dentistry, and preventive care. A cracked tooth or broken tooth can happen for many reasons, including biting hard objects, trauma, nighttime grinding, clenching, and long-term gum disease weakening the supporting bone. These stresses make teeth more likely to crack.
When tooth enamel splits, pain can strike suddenly and sharply. Without pressure, a cracked tooth may feel normal, but when you bite down, the crack flexes open. This exposes the pulp inside the tooth, causing irritation and sensitivity. When pressure is released, the crack closes again and the pain fades. If left untreated, the pulp can become damaged or infected, sometimes requiring root canal therapy, apicoectomy, or even extraction.
A cracked or broken tooth may cause:
Sharp, unexplained pain when chewing
Sensitivity to hot or cold foods
Intermittent pain with no clear cause
Trouble locating the exact tooth that hurts
Different kinds of cracks require different treatments. Some cracked teeth can be saved with root canal therapy and crowns or caps, while others are too damaged and must be removed. Below are the most common types:
Tiny, surface-level vertical cracks. These do not threaten tooth health and often need no treatment, though cosmetic improvements like veneers or bonding can reduce their appearance.
These affect only the visible crown of the tooth and do not reach below the gums. The damaged area may eventually break off. Since the pulp is untouched, pain is minimal.
These extend below the gum line and may reach the jawbone. When pieces fracture, they often stay attached until a dentist removes them. These cracks can be painful and may require a combination of periodontal procedures such as osseous surgery, gum grafting, or crown lengthening, along with endodontic treatment and the placement of a crown.
These occur when the roots begin to separate. Since the nerves are usually involved, root canal therapy combined with a crown can often save the tooth.
These cracks occur below the gum line and are not typically visible. Whether the tooth can be saved depends on how close the fracture is to the surface. Extraction is often necessary.
These occur at the tip of the root. Although the tooth doesn’t always need extraction, the pain may lead patients to choose removal. Root canal therapy may provide temporary relief.
Some cracked teeth can be identified only with X-rays, while others are clearly visible. When the tooth root or pulp is involved, root canal therapy is usually the best option. During this procedure, the pulp, nerves, and vessels are removed, and the root is filled with gutta-percha. A crown or filling is then placed to stabilize the tooth so it can continue to function.
If the broken tooth or broken teeth cannot be saved, extraction is necessary. After removal, several restorative options can rebuild function and appearance, including dental implants, bridges, dentures, and other prosthetic solutions often used in cosmetic dentistry.
Regular dental cleaning, teeth cleaning, and periodontal maintenance can help prevent cracks caused by gum disease or bone loss. Patients with grinding habits or TMJ disorder may also benefit from treatment to reduce pressure on the teeth.
