• CTS is defined as symptomatic incomplete fractures in teeth that are difficult to diagnose by conventional methods. Excessive pressure on teeth is the main cause of this condition.
  • Common symptoms of CTS include sensitivity to pressure and heat, and intermittent severe pain, similar to tooth decay.
  • Doctors diagnose CTS with dental explorers, detection solutions and X-rays taken from different angles.
  • Need help with cracked tooth syndrome? Use Authority Dental to find 24-hour emergency dental services near you.

Do you suspect you may have CTS? Here's everything you need to know.

Causes of cracked tooth syndrome

Any excessive pressure on teeth can lead to fractures. The force, impact, frequency, and the previous condition of the tooth can determine the severity and type of fractures. It is common for several microscopic cracks to occur over time and eventually lead to CTS. 

Common causes of crack teeth include:

  • blunt force trauma

  • biting on hard foods

  • grinding and clenching 

  • improper teeth alignment (i.e. malocclusion)

Other causes of CTS include oral piercings such as tongue piercings and teeth with prior dental procedures such as root canal treatment and large fillings. 

Symptoms of Cracked Teeth Syndrome

Common symptoms of CTS include pressure and thermal sensitivity and intermittent severe pain. Symptoms are similar to tooth decay.

CTS rarely causes throbbing pain, unless the crack has reached the pulp tissue.

If the crack extends below the gum line, bacteria can be introduced through the crack and eventually lead to decay and/or abscess. 

How is CTS diagnosed?

CTS is difficult to diagnose using only traditional methods such as radiographs and intraoral photographs. Dental radiographs only detect between 25% and 34% of fracture lines.

Your dentist may conduct several examination methods to diagnose CTS. Instruments such as dental explorers and tooth sleuths are utilized to isolate and detect cracks. Disclosing solutions stain and highlight cracks which help with making the cracks more visible. Occasionally, radiographs taken in different angles can help with diagnosis. 

Identification and treatment of a fracture may involve removing a prior crown or restoration.

Can a CT scan detect a cracked tooth?

The cone beam CT (CBCT) can create accurate three-dimensional imaging of hard tissue structures. Depending on the type of crack, a CBCT scan can detect up to 70% of such damage. Even with this technology, some fractures are difficult to identify.

Modern dentistry is looking for more techniques for CTS detection. Some of the promising methods include swept-source optical coherence tomography or SS-OCT, and near-infrared imaging.

Which tooth most often exhibits cracked tooth syndrome?

Lower second and first molars are the most susceptible to cracked teeth syndrome, followed by upper premolars. 

Molar teeth are the most vulnerable teeth to CTS because teeth in the back withstand shear force the most. Molars are also susceptible to decay which compromise their strength and integrity because molars are in the back of mouth and many people have difficulty maintaining proper hygiene due to their location. 

Treatment of cracked teeth syndrome

Superficial cracks can be treated with bonding by using composite resin material.

Deeper cracks require more invasive treatment options such as crowns, overlays, onlays, and root canal treatments. Root canal treatment removes the pulp, nerves and blood supply to the tooth which treat the symptoms of CTS. Most teeth receiving a root canal treatment require a dental crown for long-term protection. 

Teeth with extensive cracks which make them untreatable will need to be extracted.  In many cases, the missing tooth may be replaced by a dental implant and implant-crown.


What problems can the cracked teeth syndrome cause?

Sensitivity to hot and cold temperatures is the first problem that can occur. The consequence of cracked teeth is the gradual development of extensive tooth decay. This, in turn, leads to sharp pain and extreme tissue damage. Eventually, you will have to deal with a broken tooth. It is also important to find the cause of your CTS. If you suffer from bruxism or misaligned teeth, you will also need to treat these conditions to reduce pressure on other teeth. Avoid the habit of biting on hard foods.

Is cracked teeth syndrome painful?

In most cases, CTS is painful. However, the degree of pain can vary: You may suffer from occasional symptoms of tooth sensitivity or develop constant pain in your teeth and gums. Your sensations will depend on the severity and location of the cracks.