Crack tooth syndrome By Dr Rosalind Ho
Crack toothsyndrome is a painful condition of the tooth associated with some signs andsymptoms
History:
1 usually relatedto excessive occlusal or biting forces
2 patient bitsomething hard
3 patient grindsand /or clench teeth at night.
Typical Signs and Symptoms;
1 sharp pain onbiting and chewing
2 usually involvethe molars , non-vital teeth or root canal treated tooth even crownedones.
3 A deep bite and/or strong jaw muscles may be present.
4 Facets of wearmay be seen on the teeth.
Reason for the sharp pain
When the tooth iscracked, there is a micro movement of the separated parts. If the crack reachedthe pulp, there is sudden fluid movement and bacteria to the pulp resulting in thermalsensitivity. Untreated, the crack may propagate resulting in total crack andextraction. Or the tooth dies and needs further treatment.
How the dentist test:
1 trahsillumination
2 staining
3 pulp test
4 bite
5 probing
6 restoration removal to detect
7 use oral camera to magnify tooth
Differential Diagnosis
Crack and craze lines are different. Craze lines are restricted to enamel and are not cracks .
Management:
1 Root canaltreatment may or may not be needed depending on the diagnosis.
2 a temporary crownor band may be placed to test out the tooth with the understanding. If stillpain, to start root canal treatment followed by permanent crown.
3 Tackle predisposingfactors.
- Night guard is indicated for night grinders.
- Botox injections into their masseter and temporal muscles to reduce strong muscular action ( works for aperiod of time)
- Patient should avoid biting hard food like ice.