Cracked Tooth Syndrome – Symptoms, Diagnosis, & Treatment

A syndrome is a collection of symptoms that come along with one single problem. In this case, it is a cracked tooth. Hence, you can call it a cracked tooth syndrome. Dentists also call it ‘Greenstick fracture’ or incomplete tooth fracture or split cusp syndrome.

The primary cause of this syndrome is an incomplete fracture mostly affecting your back teeth. Because of various presentations and a range of different symptoms, it is challenging to diagnose this problem.


The fracture is incomplete and the tooth will not split into half. The involvement of pulp and periodontal tissue may or may not be present. Depending upon the extent of the fracture, symptoms may vary.

The most typical sign is that you may feel pain when you release your bite. It means when you bite on the affected tooth, it doesn’t hurt.

Once the diagnosis is final, you can go ahead with the treatment. If you wish to salvage the tooth, you can go for a crown restoration of root canal therapy. Otherwise, you can always get the tooth extracted and replace it with an implant.

Let’s review some details about cracked tooth syndrome.

What is cracked tooth syndrome?

Cracked tooth syndrome typically shows sign like pain when releasing biting pressure on an object. When you bite with a cracked tooth, the biting reduces the pressure in the nerves in the dentin of the tooth and thus does not cause pain.

But when you release the biting force, the cracked segments of the tooth tend to move back together sharply and cause pain. Also, releasing the bite increases the pressure in the nerves of the tooth which cause pain.

The pain is often inconsistent, and hard to reproduce. If untreated, it can lead to severe pain, pulpal death, abscess, and even the loss of the tooth.

If the fracture extends into the pulp, dentists call it a complete fracture. Complete fracture leads to pulpitis and pulp death.

If the crack extends further into the root, a periodontal defect may occur, or even a vertical root fracture. (1)

What can cause a tooth to crack?

Cracked tooth syndrome initiates from a minor crack on your tooth which may occur due to –

  • Teeth grinding or Bruxism
  • Forced bite
  • Improper bite
  • Habits like tobacco chewing
  • Excessive restorative material filled in a tooth

Signs and Symptoms

The following are the chief symptoms that you can associate with cracked tooth syndrome –

Rebound pain

Sharp or fleeting pain arises while releasing a bite on a cracked tooth. The pain may increase or decrease on biting on the tooth depending upon the extent of the crack.

Sharp shooting Pain

You feel immense pain when grinding the teeth backward and forward and side to side. Acute pain may occur when drinking cold beverages or eating frozen foods, lack of discomfort with heat stimuli. (2)

Other types of stimuli initiated pain

These include –

  • Pain when eating or drinking sugary substances.
  • Tooth crack in the upper molar tooth is possible if you suffer from bruxism.

When the pain is localized, you can determine the exact tooth from which the symptoms are originating, but not always.

How to diagnose cracked tooth syndrome?

The diagnosis of cracked tooth syndrome is difficult even for skillful clinicians. The features are highly variable from case to case.

This syndrome may mimic sinusitis, temporomandibular disorders, headaches, ear pain, or atypical facial pain/atypical facial pain.

When diagnosing the cracked tooth syndrome, a dentist takes many factors into account. A bite-test is a conventional method to confirm the diagnosis. For this, you have to bite down on either a Q-tip, cotton roll, or an instrument called a Tooth Sloth.

Transillumination test is helpful to identify the extension of the crack. Also, methylene blue dyes may need a few days to show the trace of propagation of the crack. Dental radiographs are also an excellent aid to decipher a cracked tooth.

Treatment of cracked tooth syndrome

Once the diagnosis is complete and final, treating a cracked tooth is relatively simple. You can manage the pain initially at home and then reach out to your dentist for a permanent solution.

Immediate pain control measures at home

  • Apply ice packs on the affected tooth.
  • Place ice chips on the affected side.
  • Over the counter pain medicines like ibuprofen may help.

Ways to salvage the tooth

If you wish to save your tooth, you can go for the following treatment approach-

Root canal therapy

Root canal therapy will extirpate the ailing pulp and replace it with inert dental cement. All pain and symptoms of a cracked tooth will go as soon as the pulp is gone. (3)

Crown restoration

Your dentist can fill dental cement or metal restoration on the crack. Restoration is useful only when the crack is not far up into your pulp.

Tooth bonding

Crown restoration with bonding is by far the best solution for shallow cracks leading to cracked tooth syndrome.

Alternative treatment

If you don’t wish to save your tooth, you can go for extraction. After extraction, you can replace the cracked tooth with an implant or removable denture.

Final words

Pain from a cracked tooth can be unbearable. You may develop a habit of clenching your teeth because biting down feels better. This habit may put undue pressure on your jaw joints and create more trouble for you.

Swollen jaw joints and a more in-depth fracture on your tooth is what you may end up with when you ignore cracked tooth syndrome.


The syndrome comes with so much pain that it is hard to miss. Your dentist may have a hard time in diagnosing it because the symptoms overlap.

Once the diagnosis is complete and final treatment part is easy. You can go ahead and save your tooth with root canal therapy or crown bonding.

You may also choose to replace the ailing tooth with an implant or a partial denture. The final takeaway is that it is entirely treatable. Hence, if you see the symptoms of a cracked tooth reach out to your dentist.


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