Dr Wu Siwen, Consultant from the Endodontics Unit, Department of Restorative Dentistry at National Dental Centre Singapore (NDCS), answers your questions about cracked teeth.
The hard truths about cracked teeth.
Tooth enamel - the outermost surface of our teeth - is the hardest substance in the human body, which is even stronger than our bones. While tooth enamel can withstand a lot of wear and tear,
cracked teeth may develop if we subject our teeth to stresses.
Unlike broken bones, fractures in
cracked teeth will not heal, putting our smiles and chewing ability at risk if the teeth are eventually lost.
Symptoms of cracked teeth include:
Chewing can cause micro-movement of the affected fragments and changes to tooth structure, resulting in irritation to the pulp (nerve) of the tooth. This irritation can progress, resulting in injury to the pulp, giving rise to pain, sensitivity and a root canal infection.
Hence, it is critical to diagnose cracked teeth quickly so that the problem does not worsen.
In this ‘Ask the Specialist’ Q&A forum, don't miss this chance to ask Dr Wu about:
Steps to take to minimise developing cracked teeth
How can cracked teeth be saved?
Alternative options if cracked teeth can't be saved
About Dr Wu Siwen
Dr Wu Siwen graduated with a Bachelor of Dental Surgery from the National University of Singapore in 2007 and a Master in Dental Surgery (Endodontics) in 2013. She is an accredited Endodontist with the Singapore Dental Council and a teaching faculty staff with National University of Singapore (NUS).
Her clinical interests include management of cracked teeth and endodontic surgeries.
Questions and answers on cracked teeth
1. Question by Joanne
Hi Dr Wu,
Coincidentally I just came back from my dentist and was recommended to consult a root canal specialist as she did a cold test and the sensation was quite intense and long lasting as compared to the other tooth. It is the last molar. Given it is the last molar, what’s the advantage to do root canal vs a tooth implant?
Answer by Dr Wu Siwen
Dear Joanne,
Root canal treatment and tooth implant are two different procedures, and both have their own advantages and disadvantages. Here is a look at the pros and cons of each:
Root Canal treatment (+ crown after that)
Advantages:
Less invasive than a tooth implant
Better chance of saving a natural tooth
Typically less expensive than a tooth implant
Disadvantages:
Tooth Implant
Advantages:
Disadvantages:
While these 2 procedures share similar functional retention rates, other factors such as restorability of the tooth (dependent on the degree of tooth structure breakdown), quality of bone, aesthetic demands, cost-benefit ratio, and overall health should be taken into account when deciding whether to do a root canal treatment or extract and replace with a tooth implant.
Ultimately, the best way to decide which procedure is right for you is to talk to your dentist about your particular clinical condition, individual needs and preferences.
2. Question by SY Ang
Hi Dr Wu,
I have a chipped & cracked tooth. There is now a cavity in the tooth and food gets stuck.
It has been 3 months but the earliest dental appt at the polyclinic is at end Jun 2023. Had to endure occasional pain. Took paracetamol to alleviate the pain. My main concern is tooth decay.
My questions are:
What can be done? Can the tooth be repaired
What other things should I take note of until I see the polyclinic dentist?
I am 63yrs old & am undergoing treatment for medical Multimorbidity.
Answer by Dr Wu Siwen
Dear SY,
If you have a chipped or cracked tooth, it is important to see a dentist as soon as possible. The dentist will be able to assess the severity of the damage (X- rays may be required for this) and recommend the best course of treatment.
In some cases, the dentist may be able to repair the tooth with a filling. However, if the damage is more extensive, a root canal treatment and/or crown may be needed.
If you are able to, do consider seeing a general dentist in a private clinic for an earlier consult, in case it is a problem where time is of the essence.
In the meantime, there are a few things you can do to help prevent food from getting stuck in your chipped or cracked tooth.
First, make sure you are brushing and flossing your teeth twice a day.
Second, avoid eating sticky or hard foods such as nuts.
Finally, if you do get food stuck in your tooth, try to remove it with a toothbrush.
3. Question by Julie
Dear Dr Wu,
I read your article on cracked teeth and I thought I’m experiencing all the symptoms mentioned therein. Pain when chewing and very sensitive to hot and cold foods.
Having said that, does it mean that there’s an urgent need for me to see a dentist for treatment? I’ve been trying hard to book a dental appointment at the Polyclinic but I was told that there’s no slot all the way until 2024. Kindly advise what is the worst that can happen if the treatment is delayed.
Your advice, please.
Answer by Dr Wu Siwen
Dear Julie,
It is difficult to diagnose your condition and treatment needs solely based on the information you have provided. If you have dental decay or gum disease (periodontitis), you may experience similar symptoms.
As a dental examination is needed for diagnosis, I would encourage you to seek a dental consultation early to get the problem diagnosed and treated early. You may consider booking an appointment with NDCS using the SingHealth Health Buddy app, or seeing a general dentist in a private clinic for a consult in case it is a problem where time is of the essence.
4. Question by Tuck Seng
Dear Dr Wu,
I have a dental phobia and fear of pain and gagging when something is inserted into my mouth. Also, a most recent example is when taking an x-ray of my cracked tooth when I feel nausea and throwing out.
For my case, I have not much confidence in going through a root canal treatment as it may need over an hour. On the other hand, I feel it is an irreversible decision should I remove the tooth. I’m in a dilemma. Please kindly advise. Thank you.
Answer by Dr Wu Siwen
Dear Tuck Seng,
Let me assure you that you are not alone in this. If you do really require a root canal treatment, and yet are fearful of it, speak to your root canal specialist about this. There is a possibility of undergoing root canal treatment under sedation means, so that the treatment can be performed comfortably for you.
I encourage you to get in touch with your dentist, or NDCS through an appointment request on the SingHealth
Health Buddy app, so that the above option can be discussed sooner rather than later.
5. Question by Bernard
Hi Doctor,
I was confirmed by the private dentist that my lower molar tooth is cracked resulting to sharp pain occurs whenever I chew on nuts or sometimes at chilli seeds. I was advised to take a referral letter from polyclinic to apply for subsidies in hospitals. May I know the solution to my problem and will it be rectified? Please advise.
Answer by Dr Wu Siwen
Dear Bernard,
If your tooth is indeed cracked, whether it can be salvaged depends on the location, extent and severity of the crack. Usually, there will be a need to stabilise or splint the tooth with a band to prevent further progression of the cracks. Some cracked teeth may only require a crown while others require both a root canal treatment and a crown.
Root canal treatment is required in cases when there is pulpal involvement arising from the crack. Root canal treatment will help relieve pain and aid in resolving pulpal inflammation and infection. The placement of a crown provides maximum protection, retards the progression of the cracks but does not guarantee success in all cases. The severe cases may not be salvageable and may warrant an extraction.
Time is of a critical essence in the management of cracked teeth, hence do book an early appointment with your dentist to get it treated!
6. Question by Phillip
Dear Doctor,
What can be done to save cracked teeth or to reduce pain in the tooth?
Answer by Dr Wu Siwen
Dear Philip,
Whether a cracked tooth can be salvaged depends on the location, extent and severity of the crack. Usually, there will be a need to stabilise or splint the tooth with a band to prevent further progression of the cracks. Some cracked teeth may only require a crown while others require both a root canal treatment and a crown.
Root canal treatment is required in cases when there is pulpal involvement arising from the crack. Root canal treatment will help relieve pain and aid in resolving pulpal inflammation and infection. The placement of a crown provides maximum protection, retards the progression of the cracks but does not guarantee success in all cases. The severe cases may not be salvageable and may warrant an extraction.
In the meantime, you may be prescribed painkillers if you encounter spontaneous episodes of pains. Try to avoid chewing using the affected side if possible. Book an early appointment with your dentist to get your problem fixed!
7. Question by Kee
Dear Dr Wu,
Hi, I am a staff in SGH. During my root canal treatment for my tooth, I noticed that the tooth that near to it is very sensitive.
The doctor checked the tooth actually did not see anything, so she suspected maybe the tooth is crack need further investigation.
After the treatment, I did have a bit of sensitive to hot and cold drinks, however no pain on biting or chewing. After a while, this sensation seems better now.
Do I need to do anything on it? Please advise. Thank you very much.
Answer by Dr Wu Siwen
Dear Kee,
It sounds like your sensitivity to hot and cold drinks is gradually improving. However, if your problem were to return, I would encourage you to go back and seek dental help from your previous dentist who will know your condition the best and able to give you the best advice on further investigation (if needed), to be done.
8. Question by Sebastian
Hi Dr Wu,
I initially had no issues/symptoms with my right side of my teeth but was told by my dentist that there was a crack. After her treatment which was painful, my right side began to become very sensitive to even water, and painful upon biting.
Why did this happen when I had no symptoms of pain before the 'fix'?
Despite repeated visits to 'fill' the crack, the issue comes and go. Is there anything that can done to save my cracked teeth? What alternative options if they can't be saved?
Thank you for your advice!
Answer by Dr Wu Siwen
Dear Sebastian,
Sorry to hear about your experience. It is difficult to evaluate and conclude based on your symptoms described, as a dental examination is needed to diagnose the issue you are experiencing.
You can book an appointment to see an Endodontist at NDCS using the SingHealth Health Buddy app, and we can help you diagnose and manage the problem.
9. Question by regina
Hi Dr,
Is it alright to leave a cracked tooth alone if it doesn't give problems?
Is it necessary to do crowning or some other procedure before the tooth gets worse?
Thanks in advance.
Answer by Dr Wu Siwen
Dear Regina,
If your tooth is already diagnosed as cracked tooth and treatment has been recommended by your dentist, I would encourage you to treat it early. Time is of a critical essence in management of cracked teeth and when treated early, cracked teeth tend to have better outcomes.
The placement of a crown provides maximum protection and retards the progression of the cracks. In some cases, when there is pulpal involvement arising from the crack, root canal treatment may be necessary to relieve the pain and resolve pulpal inflammation and infection. Once again, remember to seek dental attention early.
10. Question by Peggy
Hi Dr Wu,
I broke my two front teeth in 2018 while jogging. Due to the impact and the trauma caused, I was on follow up with Singapore Dental Centre for about 4-5 years. I underwent root canal treatment, teeth extraction fillings n much more. Now I had to be very careful when eating. I wonder how long my fillings can last? How do I let the dentist know about my injuries when they can’t access the dental records.
Hopefully you can assist me. Thank you.
Answer by Dr Wu Siwen
Dear Peggy,
The lifespan of fillings is variable depending on size and location of your fillings and the care afforded to them. Do get your teeth checked by a dentist every six months to ensure that the fillings are in good condition and that there are no other problems with your teeth.
If you are seen at NDCS, we will have access to your previous dental records. If you are seen at any other clinic that has no access to NDCS dental records, rest assured the fillings and crowns that were done previously should be obvious to any trained eye. Any tooth that has been root canal treated, however, will usually be obvious only on your dental X-rays.
Usually, a verbal history to your dentist (any previous trauma/ extractions/ root canal treatments done) will be sufficient, and your dentist will inform you if X-rays are required thereafter.
11. Question by Ee Huat
Hi Dr Wu,
I had a cracked tooth and had seen NDCS in May 2023. As mentioned in your article that cracked tooth may result in pain when consuming cold and hot stuff. For my case, I do not feel the pain and what is the possible reason?
In addition, while awaiting to see an Endodontist (in NDCS) for root canal and crowning treatment in August 2023 (3 months wait), will my cracked tooth be able to withstand till that time keeping in mind that it will several visits before the complete treatment.
Lastly what's the alternative to root canal treatment and crowning apart from extraction of tooth? Thank you.
Answer by Dr Wu Siwen
Dear Ee Huat,
One possibility why you may not be feeling pain when consuming cold and hot stuff, even though you have a cracked tooth, could be because the pulp of the tooth, which is the soft tissue inside the tooth that contains the nerves and blood vessels, is already dead.
It is important to see an endodontist to get the infected pulp treated. Even if you are not experiencing any pain now, the crack could worsen over time. While it may be possible that your cracked tooth will be able to withstand the wait until your appointment with the endodontist, it is also difficult to say for certain without a proper dental examination. Avoid chewing on hard foods for the time being. If you experience discomfort or pain in the interim, you could walk into NDCS. Our dentist can help render any emergency treatment if necessary.
If there is pulpal involvement arising from the crack, there are only 2 options: root canal treatment followed by crown, or extraction. Whether your cracked tooth can be salvaged depends on the location, extent and severity of the crack. The severe cases may not be salvageable and may warrant an extraction.
Your endodontist can help you decide which option is best for you.
12. Question by Joanna
Hi Dr Wu,
I'm approaching 67 years old and according to my dentists in NUH, most of my teeth especially the front lower ones have fine cracks but I do not have major issues apart from sensitive teeth molar region when eating cold things like ice cream.
What can I do to help myself? I dun want the cracks to get worse.
Appreciate your advice.
Answer by Dr Wu Siwen
Dear Joanna,
Here are some things you can do to help prevent the cracks in your teeth from getting worse:
Avoid chewing on hard foods. This includes things like ice, popcorn kernels, and hard candy.
Don't clench or grind your teeth. If you do this, you may need to wear a mouthguard at night.
Get regular dental check- ups. Your dentist can look out for any signs of problems and recommend treatment if necessary.
If you are experiencing sensitivity in your teeth, you can try using a desensitising toothpaste. This type of toothpaste contains ingredients that help to block the nerve endings in your teeth, which can reduce the pain.
13. Question by Shel. Scully
Dear Dr Wu,
I have a question – Does eating nuts and other ‘hard’ foods often increase the chances of teeth getting cracked or weakened over time? (I heard this from a few people!)
Answer by Dr Wu Siwen
Dear Shel. Scully,
Yes, eating hard foods like nuts can increase the chances of teeth getting cracked or weakened over time. Even though tooth enamel -the outermost surface of our teeth- is the hardest substance in the human body, it is still susceptible to stresses like chewing on hard foods, grinding and clenching.
When we bite down on a hard food, cracks can develop and allow for bacteria ingress leading to infection of our dental pulp. This gives rise to pain, sensitivity, and even tooth loss. By watching your diet carefully, you can help to keep your teeth healthy and strong for years to come.
14. Question by Mdm Tan
Hi Doctor,
How do I save my tooth altho it’s cracked n painful at times?
Answer by Dr Wu Siwen
Dear Eileen,
If you have a cracked tooth, it is important to see a dentist as soon as possible. The dentist will be able to assess the severity of the crack and recommend the best course of treatment.
Usually, there will be a need to stabilise or splint the tooth with a band to prevent further progression of the cracks. Some cracked teeth may only require a crown while others require root canal treatment and a crown.
Root canal treatment is required in those cases when there is pulpal involvement arising from the crack. Root canal treatment will help relieve pain and resolve pulpal inflammation and infection. The placement of a crown provides maximum protection, retards the progression of the cracks but does not guarantee success in all cases. In severe cases, the tooth may not be salvageable and may warrant an extraction.
Meantime, you can take some painkillers to relieve the pain. Time is of a vital essence in the management of cracked teeth, hence book an early appointment with your dentist to get it treated. The earlier it is treated, the better the outcome.
15. Question by WL Lin
Dear Dr Wu,
Recent months I've pain at my lower left side and I had it checked at a private dental clinic. The first dentist asked me to bite and release, I felt some pain. As no decay was observed, it was suspected that it was a cracked tooth.
However, I did not proceed to take X-ray then since the pain comes and goes. As the pain continued on and off, I went to another dentist and this time, X-ray was taken but no cracks or decay were observed. The second dentist advised that I go to a specialist through polyclinic.
However, I would like to know if this is still possible to be a cracked tooth since X-ray did not pick it up. If yes, since X-ray did not pick it up, is it ok that I do not treat it at this point, the crack could be so fine.
Answer by Dr Wu Siwen
Dear WL,
It is still possible that you have a cracked tooth, even if the X-ray did not show it. This is because cracks can be very small and difficult to see on X-rays.
If you are experiencing pain in your tooth, it is important to see a dentist to get a proper diagnosis and treatment. Time is of a critical element in the management of cracked tooth. It is not recommended to wait to see if the crack gets worse. This is because the crack could propagate and cause more damage to the tooth. The earlier your cracked tooth is treated, the better the outcome!
You can book an appointment to see an Endodontist at NDCS using the SingHealth Health Buddy app, and we can help you diagnose and manage the problem.
16. Question by Peach
Hi Doctor, I am a 54 years old female.
a) How to tell if my pain is due to cracked teeth or sensitive gums? Also, last year, my right bottom molar and premolar area hurts and I went to the polyclinic to check, they took an X-ray on my tooth and they could not determine if it’s cracked. Through the x-ray, they still couldn’t determine because it could be a hair-line crack and so they use a very cold object to touch my tooth to see my reaction and finally said that it was probably sensitive gums.
Is there a better and confirmed way to determine cracked teeth? Also, do hair-line cracks on teeth get worse over time if untreated?
b) What is the treatment for hair-line cracks and big cracks on tooth/teeth?
c) My kid grinds her teeth when she sleeps, will that cause crack teeth now or in the future? Does she need to sleep with a teeth guard to prevent cracked teeth?
Thanks very much.
Answer by Dr Wu Siwen
Dear Peach,
It is difficult to tell if your pain is due to cracked tooth or sensitive gums without a proper dental examination. It is possible that the cracks in your teeth are too small to be seen on an X-ray. There are other investigations we could do to better diagnose cracked teeth and these include bite tests, transillumination and examination under a dental operating microscope. Hair-line cracks could possibly worsen with time, if left untreated, especially if you continue eating hard foods or have other parafunctional habits like grinding or clenching.
Usually, there will be a need to stabilise or splint the cracked tooth with a band to prevent further progression of the cracks. Some cracked teeth may only require a crown while others require root canal treatment and a crown.
Root canal treatment is required in those cases when there is pulpal involvement arising from the crack. Root canal treatment will help relieve pain and resolve pulpal inflammation and infection. The placement of a crown provides maximum protection, retards the progression of the cracks but does not guarantee success in all cases. The severe cases may not be salvageable and may require an extraction. Whether it can be salvaged depends on the location, extent and severity of the crack.
You can book an appointment to see an Endodontist at NDCS using the SingHealth Health Buddy app, and we can help you diagnose and manage the problem.
If your child grinds her teeth when she sleeps, there is a possibility that she may crack her teeth with time. I would encourage her to see a dentist and get a nightguard fabricated to prevent the grinding stresses from cracking her teeth.
17. Question by Philip
Dear Dr,
I have this crack tooth many years back and the advice was to cover it with a crown, which I did.
Recently I went to the dentist on sensitivity coming from the tooth that was covered. No pain but feeling of sensitivity when taking hot and cold drinks.
What is your advice? The root is still inside.
a) To do a root canal and replace the crown or,
b) to extract it?
Will the tooth fall apart when the crown is removed? Thanks.
Answer by Dr Wu Siwen
Dear Philip,
Your sensitivity to hot and cold drinks on the tooth that was crowned couldsuggest that the crack is getting worse.
In some cases, when there is pulpal involvement arising from the crack, root canal treatment may be necessary to relieve the pain and resolve pulpal inflammation and infection.
The decision of whether to have a root canal treatment or tooth extraction will depend on the location, extent and severity of the crack. Other factors such as restorability of the tooth (dependent on the degree of tooth structure breakdown), quality of bone, aesthetic demands, cost-benefit ratio, and overall health should be considered when deciding whether to do a root canal treatment or extract and replace with a tooth implant. Ultimately, the best way to decide which procedure is right for you is to talk to your dentist about your specific clinical condition, personal needs and preferences.
There is a possibility that the tooth may become unsalvageable after the removal of the crown, especially if the crack has progressed further. It is difficult to ascertain unless the crown is removed and assessed.
18. Question by Ic yee
Hi Dr, I have a question relating to cracked teeth and would like to know what can be done.
My dentist told me that she suspected hairline crack in my molar as the X-ray did not show any sign of decay but my tooth was very sensitive to the cold when she tested it with something cold. She said nothing could be done and there is no certainty that crowning is effective if the hairline crack is deep down.
May I have a second opinion from you on what are my options if the tooth can be saved, and what if it cannot be saved? Thank you.
Answer by Dr Wu Siwen
Dear lc yee,
It is difficult to diagnose your condition and treatment needs solely based on the information you have provided. A dental examination is needed. You can book an appointment to see an Endodontist at NDCS using the SingHealth Health Buddy app, and we can help you diagnose and manage the problem.
19. Question by Rachel
Hi Dr Wu,
Would like to ask what are the precautionary measures/dos and don’ts for previously cracked teeth which have been restored?
My husband previously chipped his centre left front tooth from a fall and was wondering what to look out for to ensure its intact. He goes for annual dental check. Thanks!
Answer by Dr Wu Siwen
Dear Rachel,
Here are some precautionary measures/dos and don’ts for previously cracked teeth which have been restored:
Dos:
Brush and floss regularly. This is essential for keeping your teeth clean and healthy, and it can help to prevent further damage to the restored tooth.
See your dentist for regular check-ups and cleanings, ideally once every 6 months as opposed to an annual checkup. This is important for detecting any problems early on, when they are easier to treat.
Don’ts:
Don't ignore any pain or sensitivity in the restored tooth. If you experience any pain or sensitivity, see your dentist right away.
Avoid excessive sugar intake. This can contribute to tooth decay.
Avoid chewing on hard objects. This can put stress on the restored tooth and cause it to crack further.
By following these tips, you can help to keep your restored tooth healthy and intact.
If your husband is concerned about the condition of his chipped tooth, he can schedule an appointment with his dentist for a check-up. The dentist can examine the tooth and advise any treatment if necessary.
20. Question by Eileen
Hi Dr Wu,
I would like to know whether there is any way to save cracked teeth? Possible by root canal of the tooth? Is it possible to avert extraction?
Answer by Dr Wu Siwen
Dear Eileen,
If your tooth is indeed cracked, whether it can be salvaged depends on the location, extent and severity of the crack. Usually, there will be a need to stabilise or splint the tooth with a band to prevent further progression of the cracks. Some cracked teeth may only require a crown while others require root canal treatment and a crown.
Root canal treatment is required in those cases when there is pulpal involvement arising from the crack. Root canal treatment will help relieve pain and resolve pulpal inflammation and infection. The placement of a crown provides maximum protection, retards the progression of the cracks but does not guarantee success in all cases. The severe cases may not be salvageable and may require an extraction.
Time is of a critical essence in the management of cracked teeth, hence I would encourage you to book an early appointment with your dentist to get it treated!
21. Question by Pansy
Hi Dr Wu,
I think I have several cracked teeth. I saw several dentists and had X-ray taken. The dentists told me they cannot see any crackled lines and treated them as sensitive teeth. In fact, one of the tooth fell off while I was eating.
Please advise if there is any treatment to save my teeth. Thank you.
Answer by Dr Wu Siwen
Dear Pansy,
Sorry to hear of your plight.
It is possible that the cracks in your teeth are too small to be seen on an X-ray. If you are indeed having a cracked tooth, there will be a need to stabilise or splint the tooth with a band to prevent further progression of the cracks. Some cracked teeth may only require a crown while others require root canal treatment and a crown.
Root canal treatment is required in those cases when there is pulpal involvement arising from the crack. Root canal treatment will help relieve pain and resolve pulpal inflammation and infection. The placement of a crown provides maximum protection, retards the progression of the cracks but does not guarantee success in all cases. The severe cases may not be salvageable and may require an extraction.
If you are experiencing pain or sensitivity in your teeth, it is definitely important to see a dentist to get it diagnosed and treated early. You can book an appointment to see an Endodontist at NDCS using the SingHealth Health Buddy app, and we can help you diagnose and manage the problem.
22. Question by Chay Bee
Dear Dr. Wu,
I was advised by my dentist that I have a potential crack tooth (a line was seen when she shone light on the surface of the tooth). She suggested that I put a cap on the tooth to prevent the crack from happening.
Please advise if putting a cap is my only option? Thank you.
Answer by Dr Wu Siwen
Dear Chay Bee,
The placement of a crown for a cracked tooth helps to provide maximum protection, retards the progression of the cracks but does not guarantee success in all cases. If your tooth is indeed cracked, an early placement of crown will ensure a better outcome.
23. Question by Mr Ng
Dear Dr Wu,
I have a patched molar with fillings.
The top of the tooth is sensitive to the touch, does it mean I will need to extract tooth eventually?
How can I stop the sensitivity and save the tooth? Thank you.
Answer by Dr Wu Siwen
Dear Mr Ng,
There can be many reasons for why your tooth is sensitive to touch. I would encourage you to return to your dentist and see how he can help you manage this problem.
24. Question by Jessica
Hi Dr Wu,
My son complained about tooth pain and he went to consult a dentist. The dentist checked and said the teeth cracked and that he is unable to do anything to help him so nothing was done.
What I would like to know if it is true that nothing can be done to save the cracked teeth?
I read online that bonding/filling can be done but I suspect the dentist is unwillingly to do it as he never elaborated further on it.
I would also like to know how a teeth cracked and what options do we have if the cracked teeth cannot be saved?
Thanks for your advice.
Answer by Dr Wu Siwen
Dear Jessica,
Cracked tooth could occur as a result of biting on hard foods (which include nuts and ice) or other parafunctional habits such as grinding and clenching.
Whether a cracked tooth can be salvaged depends on the location, extent and severity of the crack. Usually, there will be a need to stabilise or splint the tooth with a band to prevent further progression of the cracks. Some cracked teeth may only require a crown while others require root canal treatment and a crown.
Root canal treatment is required in those cases when there is pulpal involvement arising from the crack. Root canal treatment will help relieve pain and resolve pulpal inflammation and infection. The placement of a crown provides maximum protection, retards the progression of the cracks but does not guarantee success in all cases. The severe cases may not be salvageable and may warrant an extraction.
You can book an appointment to see an Endodontist at NDCS using the SingHealth Health Buddy app, and we can help your son diagnose and manage the problem. I encourage you to do so sooner rather than later, as time is of the essence when treating/ managing cracked teeth.
25. Question by May Ying
Dear Doctor Wu,
Thank you for your time. Would greatly appreciate if you can address my following concerns:
Are the symptoms for exposed roots and cracked tooth the same? If so, how do we tell which is the cause of our sensitivity feeling when taking cold food?
Is putting filling at the exposed part of the tooth root area a resolution to exposed root issue?
How long can the filling last? Is there an alternative solution for receding gums?
Thank you.
Answer by Dr Wu Siwen
Dear May Ying,
The symptoms of exposed roots and cracked teeth can be similar, both conditions can cause sensitivity to cold or hot foods. It is difficult to tell the cause based purely on description of the symptom. Hence it is important to see a dentist to have the problem diagnosed and treated.
The treatment for exposed roots depends on the severity of the gum recession. In mild cases, the dentist may be able to treat the exposed roots with a filling or bonding. In more severe cases, the dentist may need to perform gum grafting. The best treatment for receding gums depends on the severity of the recession and the patient's overall health. It is important to consult with a dentist to determine the best course of treatment.
The lifespan of a filling depends on various factors, including the type and location of the filling and the patient's oral hygiene habits. Most importantly, do get your teeth checked by a dentist every six months to ensure that the fillings are in good condition and that there are no other problems with your teeth.
26. Question by Mdm Wong MC
Dear Dr Wu,
I have a molar tooth that has undergone root canal treatment 10 years ago.
Lately, it is shaky with slight discomfort upon pressing on it. Upon x-ray it shows a crack on the same spot 10 years ago and it has now gone beyond the metal crown, deep into the root of the tooth.
Other than extracting the tooth, is there any way to fill the crack to save the tooth. If no way, it is alright to keep it till it drops or decay?
Thank you very much for your time to reply to my query.
Answer by Dr Wu Siwen
Dear Mdm Wong,
Unfortunately, when the crack extends deep into the root, the prognosis is poor and the tooth requires an extraction. There is no technology or material to-date that can predictably seal these extremely deep cracks. I would not advise to leave the tooth alone as it is currently already giving you discomfort and this pain could also potentially escalate. Before the problem starts giving you severe pain, I encourage you to get in touch with your dentist to discuss extraction and replacement options sooner rather than later.
27. Question by Aishah
Dear Dr. Wu,
I have a canine tooth that grows over the neighbouring tooth (first premolar). That area is sensitive to cold food and sharp pain.
A few years ago, a dentist tried to insert a filling in the gap between the two teeth, which was small, and for a while the sensitivity was gone. I am not sure what happened later - maybe the filling fell out - but I felt the gap to be wider and the sensitivity to return.
Another dentist I saw afterwards said the gap was too small for them to fill, so it was left just like that.
Should I see a different dentist who can put in a dental filling there, or is the sensitivity due to reasons other than the closeness of the two teeth such as cracked teeth, or are there other solutions?
Thank you very much Dr. Wu.
Answer by Dr Wu Siwen
Dear Aishah,
It is difficult to diagnose for certain the cause of your sensitivity based on your description.
If there is a decay or cavity, this can be the contributing cause of the sensitivity. If there is overcrowding of teeth that results in the difficulty to fill the tooth cavity properly, you may consider orthodontic treatment. This will involve moving the canine tooth into the correct position using braces. This allows the dentist greater ease to fill up the cavity and also easier for you to maintain the oral hygiene in this region. This may be time consuming and expensive but may serve a more permanent solution.
You would require a proper dental examination to have a proper diagnosis and only with that, we could advise on possible solutions. I would recommend that you see a dentist to discuss your options.
28 Question by Mun Chiew
Dear Dr Wu,
I have this pain when biting or chewing, but not always. Sensitivity to hot or cold foods. Previously I had consult the polyclinic and taken x-rays, but they could not detect any cracks. I was referred to NDCS, x-rays also done, no cracks was detected too. I was called to go to polytechnic to do some good cleaning, this was done too.
The pain seems to disappear for a while but it comes back again once in a while nowadays when I accidentally bite hard things.
Is this a sign of crack teeth somewhere that is difficult to detect. I think I had also done a dye test too previously. I have a root-canal done previously on a different tooth. What would be your advice for me, Dr Wu?
Answer by Dr Wu Siwen
Hi Mun Chiew,
I'm sorry to hear that you are experiencing pain when biting or chewing. It sounds like you've already seen a few dentists and had some tests done, but the cause of the pain is still unclear.
It is possible that you have a crack in one of your teeth that is difficult to detect on an x-ray. If this symptom persists, I would recommend that you see your dentist again and discuss your symptoms. We may need to carry out further examination/ investigation to help diagnose and manage your problem. If you are an existing patient with NDCS, you can schedule for an appointment with us for a review.
In the meantime, there are a few things you can do to help relieve the pain. Avoid biting on hard foods, and try to eat soft foods that are easy to chew.
Ref: I23
