The experience of having a cracked tooth is daunting, full of uncertainties, and — hopefully — something you don’t experience often.

The important question — "Does this cracked tooth need to be pulled?" — often arises. Fortunately, not all cracked teeth are hopeless. The fate of a cracked tooth depends on the type, location, and extent of the crack.

Types of Cracks and Their Implications

Cracks in teeth vary widely and each type has different implications for treatment:

  • Cuspal cracks: These are cracks that involve the cusps of the tooth (the pointed parts on top). Often, these are savable with a large filling or crown.

  • Cracks not extending to bone level: If the crack doesn't extend down to the bone level, it can often be saved with a crown.

  • Craze lines: These are tiny "micro-cracks" that may look worrisome but typically do not cause significant issues.

Unfortunately, some types of cracks mean the tooth cannot be saved:

  • Vertical root fractures: These are cracks that extend far below the gums, usually down to (and beyond) the bone level. These aren't savable, and thus will need to be extracted.

  • Split teeth: If a tooth is split, the prognosis is almost always hopeless and will need to be extracted.

Challenges in Diagnosing Cracked Teeth

Diagnosing a cracked tooth can be a significant challenge.

Although patients may clearly notice symptoms such as severe pain or sensitivity, especially when chewing or biting, these cracks may not always be readily identifiable to the dentist.

Even with special tools and lights, dentists often can't definitively identify the crack, and it may not be visible on an X-ray either.

Thus, a patient's reported symptoms and an educated guess from the dentist often guide the provisional diagnosis.

When Does a Cracked Tooth Need to Be Pulled?

Cracked teeth that can't be restored due to a vertical fracture or split, or those that have become infected due to the crack, need to be extracted.

In other cases, small cracks might be fixed with crowns or large fillings, while more extensive cracks might require a root canal and crown.

If the tooth cannot be saved, don't worry. Replacement options including bridges, implants, and partial dentures are available.

Prevention and Management of Cracked Teeth

To prevent cracks in your teeth:

  • Avoid trauma

  • Refrain from using your teeth as tools (such as biting open packaging or fishing line)

  • Avoid chewing on especially hard foods

Maintain all of your back teeth, as losing some can put more pressure on the remaining teeth, potentially leading to cracks. Depending on your situation, your dentist might recommend a night guard.

Remember, a cracked tooth will never heal on its own, so it's crucial to see your dentist if you suspect you have one. Even if a cracked tooth doesn't cause pain, it's at a higher risk of getting infected or becoming painful, so don't delay seeking dental advice.

Final Thoughts

Navigating the experience of a cracked tooth can feel overwhelming, but remember that not all cracked teeth have a hopeless outlook. Consult with your dentist promptly if you suspect a cracked tooth to maximize your treatment options, minimize discomfort, and preserve your oral health.

Even in worst-case scenarios, where extraction is the only option, there are effective tooth replacement methods that can restore your smile and functionality.

FAQs

What happens if you don't remove a cracked tooth?

If a cracked tooth isn't removed, it can lead to several complications, including severe pain, infection, and potentially systemic health issues if the infection spreads.

Is it OK to live with a cracked tooth?

It depends on the severity and type of the crack. Minor cracks, such as craze lines, typically don't cause problems. However, more serious cracks can lead to pain or infection if left untreated, and should be addressed as soon as possible.

How long can you wait to pull a cracked tooth?

The urgency of tooth extraction depends on the type and severity of the crack. If a tooth is severely cracked and causing pain or infection, it should be removed as soon as possible. However, always consult with a dentist to understand the best course of action for your individual case.

How do they remove a cracked tooth?

Tooth extraction involves numbing the area with local anesthesia, then using dental tools to gently move the tooth back and forth until it detaches from periodontal ligaments and comes loose. If the tooth is severely cracked, it might need to be removed in pieces (don’t worry, this is normal and perfectly fine!). After extraction, your dentist will discuss replacement options like implants, bridges, or partial dentures.

How long can a fractured tooth go untreated?

This greatly depends on the extent of the fracture and its symptoms. If you're experiencing pain or sensitivity, it's best to seek dental care immediately. Leaving a fractured tooth untreated could lead to complications such as pain or infection.

* Though the author of this post is a licensed dentist in the state of Kansas, this information is provided for informational and educational purposes only. Please use your best judgment and contact emergency medical services in the event of an emergency.