Cracked Teeth &
Vertical Root Fractures 

Why Do Teeth Crack?

Teeth are built to handle strong biting forces, but over time certain factors can weaken them, including:

• Bruxism (grinding or clenching): often stress-related, sometimes even during sleep.

• Biting down on hard foods or objects: such as ice, nuts, or pens.

• Large fillings or dental work: which can reduce the strength of the tooth.

• Poor bite alignment: which puts uneven stress on certain teeth.

• Accidents or injuries.
   

During the COVID-19 pandemic, dentists noticed a major increase in cracked teeth, likely linked to higher stress and more grinding.​

 

Types of Tooth Cracks and Fractures

Not all cracks are the same. Some are surface-level and harmless, while others can threaten the entire tooth. The American Association of Endodontists has defined several categories:

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• Craze lines (infractions): Tiny cracks limited to the outer enamel. These are common and usually harmless, though they may affect appearance.

• Cracked tooth: A deeper crack that extends into the dentin (the layer beneath enamel). This type often causes pain with biting or chewing and needs treatment.

• Fracture: A more severe break in enamel, dentin, and possibly the root surface. Fractures can range in severity but usually require professional care.

• Root fracture: A crack that extends into the root of the tooth.

  • Vertical root fracture: A crack that runs along the length of the root. These are often hard to detect and may cause localized gum problems or infection.

  • Split root: A severe fracture where the tooth separates into two parts.
     

Understanding which type of crack is present helps determine the best treatment plan.

 

Signs You May Have a Cracked Tooth

Cracks can be tricky to diagnose because symptoms may come and go.

 

Common warning signs include:

• Pain when biting or chewing (especially when releasing pressure).

• Sensitivity to cold or sweet foods.

• Swelling or a “pimple” on the gums near the tooth.

• A loose or fractured filling.

• Localized gum tenderness or deep periodontal pockets.
   

If you notice these symptoms, it’s important to see a dentist or endodontist as soon as possible.

 

Treatment Options

The right treatment depends on the type and severity of the crack.

• Craze lines: Usually don’t require treatment, though cosmetic options are available if desired.

• Cracked tooth: Most of these teeth can be saved if treated early. A crown is almost always recommended to protect the tooth. If the pulp (nerve) becomes inflamed or infected, root canal therapy may also be needed.

• Fractures extending into the root: Treatment may include root canal therapy, crown placement, or in severe cases, surgical procedures to remove the fractured portion.

• Vertical root fractures: Single-rooted teeth with this type of crack often cannot be saved and may need extraction. However, in multi-rooted teeth, removing the affected root and saving the rest of the tooth is sometimes possible.
   

The earlier a cracked tooth is treated, the better the long-term outlook. Studies show that when a crown is placed early, many cracked teeth remain healthy and functional for years to come.

 

Preserving Your Natural Teeth

Even when implants are an option, saving natural teeth—when possible—is often the best choice. Natural teeth help maintain bone, support chewing, and preserve your smile. In some cases, procedures like root resections or hemisections can extend the life of a compromised tooth for many years.

 

The Bottom Line

Cracked teeth are more common than ever, but they don’t always mean the end of a tooth. With today’s technology and treatment options, many cracked teeth can be preserved.

If you have symptoms of a cracked tooth—or if you grind your teeth, have large fillings, or are at risk—it’s best to schedule an evaluation. Early diagnosis and treatment can make all the difference in saving your natural teeth.