Cracked tooth syndrome (CTS)  is the result of a split or a crack in the tooth. Early diagnosis and treatment are important to prevent the crack from progressing through the tooth which can lead on to further complications. It is an increasingly common problem in dentistry and one of the most difficult problems to diagnose and treat.

In some instances CTS can occur as a result of large and extensive fillings that weaken the tooth. Other causes are less obvious, such as tooth grinding and in teeth that have suffered trauma. Symptoms can also vary considerably. Some patients may complain of mild sensitivity to temperature, while others pain on biting or even extreme pain that upsets sleep.

Diagnosis of CTS is often difficult as in most instances the crack cannot be seen visually or on x-rays. Often it is not until treatment has commenced that the full extent of the crack is realised.

Treating CTS depends on the diagnosis and the severity of the crack. A simple crack usually involves removing the weakened cusp(s) or parts of the tooth and placing a filling over the area to cover and protect it. Sometimes a stainless steel orthodontic band can be used as a temporary measure. By enclosing the tooth the band holds the tooth together and should ideally alleviate symptoms. It is then that the tooth can be restored with an overlay filling or crown. If symptoms continue this may indicate a more complicated problem.

A more complex crack has often progressed to the nerve of the tooth and root canal therapy is indicated. Often in such cases the tooth will continue to be painful after a filling is placed. In some instaces the split can be so deep that the tooth cannot be salvaged and extraction is the only option. It is therefore not only important that a cracked tooth is detected and treated early, but that if there are other teeth at risk these are also managed before they become an issue also.

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