What are the signs of a cracked tooth, and can it be saved?

A cracked tooth often causes sharp, erratic pain when you bite down, especially as you release the bite, or discomfort with hot and cold food and drink, even when there is no visible chip. Unlike a broken bone, a crack in a tooth cannot heal on its own. Treatment ranges from smoothing or bonding a shallow crack to a root canal and a crown for a deeper one, and a crack that reaches below the gum line usually cannot be saved.

In short

• Sharp pain on biting, or just as you release the bite, is a classic sign of a cracked tooth, sometimes with sensitivity to hot or cold.
• A crack is not always visible. Pain alone, without an obvious chip, is still worth a dental check.
• A crack in a tooth cannot heal by itself, and it can deepen if it is left.
• Treatment ranges from bonding a shallow crack to a root canal and a crown for a deeper one.
• A crack that reaches below the gum line usually cannot be saved, and the tooth may need to be removed.

This article is part of the dental emergency guidance on this site.

What does a cracked tooth feel like?

A cracked tooth can be hard to pin down. Pain is often erratic: it comes and goes, is worse when chewing, and can be sharpest at the moment you release the bite rather than while you are biting down. Sensitivity to hot and cold is also common. Because the pain can move around and a crack is not always visible, even a dentist can sometimes have difficulty locating exactly which tooth, and which part of it, is causing the discomfort. This pattern is sometimes called cracked tooth syndrome.

How is a cracked tooth different from a chipped or broken tooth?

A chip or break usually removes a visible piece of tooth, which you may be able to see or feel with your tongue. A crack can run through the tooth as a fine line, with no piece missing and nothing obvious to see, which is part of why it is more easily missed. I have broken or chipped a tooth. Is it an emergency? covers what to do when a piece of tooth has actually come away.

How is a cracked tooth treated?

Treatment depends on the type, location and extent of the crack. A shallow crack confined to the outer enamel may only need smoothing or bonding. A crack that reaches the inner part of the tooth, where the nerve sits, usually needs a root canal followed by a crown to protect what remains of the tooth; see How long does a dental crown last? and the crowns and bridges page for more on this. If a crack extends below the gum line, the tooth is generally no longer treatable and cannot be saved. Early diagnosis and treatment give a cracked tooth the best chance, since a crack that is left can continue to deepen.

Will I need a root canal?

Not every cracked tooth needs a root canal. It depends on whether the crack has reached the nerve inside the tooth. Is a root canal painful? answers a common worry about this treatment, which is often less unpleasant than people expect.

What should I do if I think I have a cracked tooth?

Avoid chewing on the affected side, and avoid very hot, cold, or hard food until you have been seen. Over-the-counter pain relief such as paracetamol or ibuprofen can help, taken as the packet directs, and a cold compress against the outside of your face can ease any swelling. Contact a dentist to describe what you feel rather than waiting to see if it settles, since a crack does not heal on its own and early treatment matters.

When should I go to a hospital emergency unit instead of a dentist?

Go to a hospital emergency unit, not a dentist, if there is bleeding from the mouth that will not stop, if swelling is spreading towards your eye or neck, if you are struggling to breathe, swallow or speak, or if the crack happened together with a blow to the head. These need urgent medical attention rather than a routine dental appointment.

How do I reach Dr Davies?

To ask about a suspected crack, call Dr Davies directly on her own mobile, which is shown on this page. Dr Davies practises at BRS Dental on Strand Street in the Cape Town city centre. This page gives general information and cannot tell you whether your own tooth can be saved, since only an examination, and sometimes an X-ray, can confirm that.