Dra. Cléo Salustiano In this article
SummaryTypes of cracks and why they hurtDiagnosis, treatments and what to do until your visitFAQRead nextCracked Tooth: Symptoms, Why It Hurts When You Bite and What to Do
Quick summary of this article+
A cracked tooth usually causes sharp pain when biting, especially on releasing the bite, and sensitivity to cold, on and off and sometimes hard to pinpoint. The crack does not always show on X-rays, and diagnosis relies on clinical exam, bite tests, transillumination and magnification. Surface enamel lines usually need no treatment; deeper cracks may need a filling, crown, root canal or, if they reach the root, extraction. Large fillings, bruxism and hard foods increase the risk. An old fracture that starts hurting again deserves an assessment. In Mooca, Dr. Cléo Salustiano (CRO-SP 170844) sees patients every day, from 8 a.m. to 10 p.m.
The most typical sign of a cracked tooth is sharp, brief pain when biting, especially at the moment you release the bite, that comes and goes and does not always make it clear which tooth it is. Sensitivity to cold is also common. A crack often does not show on X-rays, and diagnosis relies on a careful clinical exam. Treatment varies with depth: from a filling or crown that protects the tooth to root canal treatment or, when the crack reaches the root, extraction.
In clinical practice, patients often spend weeks chewing "on the other side" without knowing why, or report that an old fracture has started hurting again. Cracks tend to progress over time, so an early assessment usually allows simpler treatment.
Dr. Cléo Salustiano (CRO-SP 170844), a dentist in Mooca, explains the types of cracks, the symptoms, how dentists investigate and what to do until your visit.
This article comes from Dr. Cléo Salustiano's dental office in Mooca, São Paulo (care in English, Portuguese and Spanish). See the general dentistry page to learn how the treatment is done here and book your assessment.
Types of cracks and why they hurt
Not all cracks are the same. Fine lines in the enamel (craze lines), common in adults and visible against the light on front teeth, stay on the surface and usually cause no pain or need treatment, except for appearance. A fractured cusp, a true cracked tooth, a split tooth and a vertical root fracture go deeper and can reach the dentin, pulp or root.
Pain happens because, when you bite, the parts separated by the crack move very slightly, and that movement stimulates the dentin and pulp. When you release, the parts return to position, which explains the typical twinge at that moment. Over time, bacteria can enter through the crack and inflame the pulp, causing longer-lasting pain.
Risk factors: large fillings that weaken the tooth, root-canal-treated teeth without a crown, grinding or clenching, chewing ice, pits or very hard foods, and trauma. That is why the article bruxism treatment is closely related.
Old fracture hurting again: a tooth that broke or cracked long ago and starts hurting may have a crack that progressed, leakage under a filling or pulp inflammation. It is no reason to panic, but it is a sign to have it assessed soon, before the crack grows.
| Type | What it is | Common path |
|---|---|---|
| Craze lines | Surface cracks in enamel only | Usually just monitor |
| Fractured cusp | A tooth cusp broke or cracked | Filling or crown |
| Cracked tooth | Crack from crown toward the root | Protective filling, crown; sometimes root canal |
| Split tooth | Crack that separated the tooth into parts | Assess keeping part of it or extracting |
| Vertical root fracture | Crack starting in the root | Usually extraction and replacement |
Diagnosis, treatments and what to do until your visit
The dentist investigates with questions about when the pain appears, an exam under magnification, bite tests on each cusp, cold sensitivity tests, transillumination with a strong light and X-rays to rule out other causes. Sometimes an old filling has to be removed to see the crack. Even so, in some cases the diagnosis is one of probability, and the dentist monitors the response to treatment.
Possible treatments: when the crack is shallow, a filling or piece that covers the cusps, or a crown, helps hold and protect the tooth; if the pulp is already affected, root canal treatment may be needed before the crown; when the crack runs down the root, the tooth may not be savable, and extraction followed by an implant or prosthesis is considered. See also porcelain crowns in Mooca and root canal treatment.
Until your visit, avoid chewing on the suspect side, do not bite hard foods, avoid temperature extremes and do not "test" the pain by biting on purpose. If there is swelling, fever or intense constant pain, seek care promptly; broken tooth: what to do covers visible fractures. Enamel lines on front teeth that bother you only for how they look can be assessed calmly; the composite veneers guide shows cosmetic options when the tooth is healthy.
This content is for information only and does not replace an exam. Consult a dentist if you feel pain when biting or releasing your bite. In Mooca, Dr. Cléo Salustiano sees patients every day, from 8 a.m. to 10 p.m., including Sundays and holidays, for general dentistry and dental emergencies.
What are the symptoms of a cracked tooth?
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The most typical is sharp, brief pain when biting, especially on releasing the bite, that comes and goes. Sensitivity to cold and difficulty knowing exactly which tooth hurts are also common. Some cracks cause no symptoms at first.
Does a cracked tooth show on an X-ray?
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Often not, especially when the crack runs in the same direction as the X-ray beam. That is why diagnosis also uses magnification, bite tests, sensitivity tests and transillumination with a strong light.
Can a cracked tooth be treated?
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It depends on the depth. Cracks confined to the crown are usually treated with a filling that protects the cusps or a crown; if the pulp is affected, a root canal may be needed. When the crack reaches the root, the tooth may not be savable.
An old fracture started hurting again. What should I do?
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Avoid chewing on that side and book an assessment. The pain may mean the crack has progressed, there is leakage under a filling or the pulp is inflamed. Swelling, fever or intense constant pain call for prompt care.
Are lines in the enamel of front teeth dangerous?
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Fine enamel lines visible against the light are common in adults and usually stay on the surface without pain. They are generally just monitored. If they bother you for how they look, the dentist can assess cosmetic options.
Can a crack in a tooth get worse?
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Yes. Every bite puts stress on the crack, which tends to progress and can let bacteria in. That is why an early assessment usually allows simpler treatment than waiting for the pain to increase.
Where can I have a cracked tooth assessed in Mooca?
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In Mooca, Dr. Cléo Salustiano (CRO-SP 170844) sees patients at Rua Hipódromo, 1141, near Bresser-Mooca station, Monday to Sunday, from 8 a.m. to 10 p.m., including holidays. Appointments via WhatsApp (11) 97409-7834, in Portuguese, English or Spanish.
