Molars and premolars have small natural furrows called “cracks”. Generally asymptomatic, they do not require special care, in addition to preventive care to reduce the risk of dental caries (see pit and fissure sealant).

However, sometimes the cracks in the teeth are more severe, and lead to complications if they are not treated. Also, it is possible for a crack to develop into a coronary or cuspid fracture (part of the cracked tooth eventually breaks), a vertical split (the crack may or may not reach the root and nerve), a vertical crack (a crack that divides the tooth) and a vertical fracture (the fracture extends from the root to the surface but can easily go undetected).

• Diffuse and sharp pain during chewing;
• Increased sensitivity to heat and cold.

• Bacteria in the mouth;
• The pressure exerted during chewing;
• A malocclusion;
• A shock;
• Food (hard or sticky foods);
• The habit of chewing on objects (pencils);
• Bruxism and clenching of teeth.

Cracks, splits and fractures cause enamel movements during chewing, which considerably damage the pulp of the tooth. The pain becomes more and more severe as the damage increases. If the tooth is not treated (usually through root canal treatment), it is possible for an infection to develop and reach the bone and the soft tissues that support the tooth.

• Infection of the dental pulp;
• Gum infection;
• Swelling or bump on the gums;
• Abscess;
• Loss of tooth.

It is advisable to make an appointment with an oral health professional as soon as the first symptoms appear.

The solutions considered to treat a crack depend on its evolution:

• Surface cracks: No treatment is required. However, it is advisable to adapt your hygiene habits accordingly, either by brushing your teeth 3 times a day and flossing. Regular follow-up with the dentist to monitor the progress of the crack is necessary;
• Coronary fracture without affecting the pulp: A crown can be made to restore and strengthen the affected tooth;
• Coronary fracture with pulp damage: Root canal treatment is required and a crown can also be placed;
• Vertical split that has not reached the root: A root canal treatment is required and a crown can also be placed;
• Vertical split that reaches the root: The tooth is extracted;
• Vertical crack: Depending on the depth of the crack, a root canal treatment can be performed and the tooth can be restored;
• Vertical root fracture: The tooth is extracted.

Certain measures can be taken to reduce the risk of dental cracks:

• Maintain good oral hygiene, including brushing and flossing 3 times a day, to eliminate bacteria that can weaken tooth enamel;
• Correct malocclusion problems (including orthodontic treatment) to better distribute chewing forces and avoid unnecessary pressure on the teeth;
• Correct some bad habits such as biting your nails and chewing on hard objects;
• Wear a custom-made occlusal plate to reduce bruxism damage;
• Make an appointment with the dentist twice a year for a complete examination and cleaning.