The teeth consist of the enamel, dentin, and pulp. Enamel is the outer layer, which protects the inner layers of the tooth. The second layer is called the dentin, and it consists of tubules that act as a buffer between the enamel and the tooth’s innermost layer. The pulp is the last layer of the tooth and contains nerves and blood vessels that keep each tooth alive.
Proper maintenance of teeth is essential for protecting the different teeth layers. Even minor untreated fractures can result in severe issues. A tooth fracture will damage the enamel and cause the other layers of the teeth to become increasingly susceptible to harm. Patients with a fractured tooth should contact us as quickly as possible to protect their oral health.
Oblique subgingival fractures extend below the gum line. The severity of the fracture depends on how far it has gone past the gum line. These fractures are usually painful as the fractured tooth usually remains in the gums after it breaks off. However, patients may have a subgingival fracture for years before feeling any pain.
This type of oblique fracture only affects the tooth’s crown and does not extend below the gum line. Usually, a supragingival fracture results in the affected part of the tooth breaking off. Patients typically experience little pain as the nerves and blood vessels of the pulp remain intact and undamaged. Although this fracture may not cause immediate pain, it can lead to infection or pain in the future without treatment.
Oblique root fractures do not usually affect the surface of the tooth at all. The damage occurs below the gum line, particularly under the bone. While this classification of fracture is not visible, it is very painful. Patients with oblique root fractures may require root canal treatment or extraction, depending on how close the fracture is to the tooth fracture.
Vertical apical fractures occur at the apex or tip of the tooth root. Many patients with vertical apical fractures ask for extraction because of the severe pain it causes. The severe pain is a result of tooth fragments placing pressure on the bone. Root canal therapy can help alleviate the pain, but some cases may require tooth extraction. Patients can discuss the best treatment option with our dentist.
When the roots of a tooth separate, a vertical furcation fracture occurs. This type of fracture almost always affects the tooth’s nerves. Patients affected by this fracture experience pain and difficulty with simple tasks like eating and speaking. Root canal therapy and a crown can usually save teeth affected by vertical furcation fractures as the tooth does not generally split completely.
A vertical root fracture happens when part of the tooth root breaks off. This type of damage is not common and usually occurs in teeth with endodontic treatment like root canal therapy. An apicoectomy may save the tooth if the vertical root fracture is short. Extraction is usually the common treatment; however, various studies have attempted to reunite fractured roots with varying success rates.
Cracked teeth are not completely preventable. However, certain precautions can reduce the chances of a fractured tooth. Avoid chewing hard objects and refrain from clenching or grinding teeth. People that play contact sports should also wear a mouthguard or protective mask.
Tooth fractures are more common in older adults as teeth wear down over time. Other factors that may increase the risk of dental root fractures include teeth with decay or damage, silver alloy restorations, or exposure to temperate extremes within a short time. People that chew on hard foods, play collision sports, or grind or clench their teeth also have a greater risk of fracturing their teeth.
Not all people with dental root fractures will experience symptoms. While some fractures will rarely cause problems, other fractures may expose the sensitive tooth pulp to debris and bacteria in the mouth. This exposure causes inflammation or infection, leading to pain while chewing, sensitivity to temperature or sweetness, and swollen gums around the affected tooth.
Fractures may be difficult to diagnose with the naked eye. We will ask patients about their symptoms and look for the fracture based on their feedback. We may also use dye staining, transillumination, periodontal probing, bite tests, or X-rays to locate the fracture and the extent of the damage.
Dental root fractures do not heal on their own. The goal of treatment is to protect the tooth and the pulp. Treatment options will depend on how severe the tooth damage is. Options include crowns, dental veneers, root canal treatment, tooth extraction, and removal of the tooth’s fractured portion. Patients can speak with our dentist about the best treatment option for their needs.