The Invisible Line

Rodney Baier, DDS
September 18, 2023

Do you have a cracked tooth? The possibility may be greater than you think.

If you are experiencing acute pain when you bite and then release, eat grainy tough foods, and/or when you apply cold food or drinks to the same area, you may be experiencing symptoms related to a cracked tooth.  Cracks or fractures are often found in teeth after the removal of an existing restoration.  Sometimes patients have been experiencing little to no symptoms.  Unknown to you, this silent situation continues until the disruption of enamel and dentin extends further and you eventually begin to experience pain.  For many years, the fracturing of teeth was not a thoroughly understood process and often went without diagnosis.  However, now that we have the knowledge and experience, we make it our goal to identify and manage the overall structural stability of the entire tooth.  We do this by locating the fracture and protecting it from the invasion of bacteria, regardless of whether or not you are already experiencing pain.

Cracked teeth was initially described in 2007 by David Clark in “Dentistry Today” as an “epidemic” and was recently described more prominently as an “epidemic” at the 2015 American Association of Endodontists (AAE). It is now recognized as the third leading cause of tooth loss and as such, it has led the AAE to recently form a “Special Committee on Methodology of Cracked Tooth Studies.”  – Spear Education


In order to properly see and diagnose cracks/fractures visually, we must use loupes of at least 3x along with intraoral cameras.  If necessary, we may also use methylene blue staining in addition to magnification to help with our identifying techniques.


The most common causes of cracked teeth are the result of too much stress on the tooth from ongoing grinding or clenching, acute trauma from an accident, and/or biting something too hard at the wrong angle.  Interestingly, cracked teeth are more common in females than males.


A crack in your tooth may be determined as a complete or incomplete fracture.  An incomplete fracture describes a crack that involves one marginal ridge of your tooth, while a complete fracture involves two marginal ridges.  This problem may be as simple as a craze line that only ventures into the enamel or as complex as a root fracture which you will most likely experience pain from.

Treatment plans for a cracked tooth will contain any of the following assessments: craze lines, fractured cusp, cracked tooth, split tooth, vertical root fracture, or fracture necrosis.


Our treatments are always customized to your individual situation.  This can depend on the size and location of the crack and the symptoms you may be experiencing.  Your treatment plan may include: watching and waiting, repairing the tooth with a filling, placing a crown to protect the tooth from any further damage, a root canal, and/or extraction.  To limit the severity of treatment and possibly the extent of the fracture, it is always best to see your Sandy Springs Dental Practice on a regular basis.  This allows us to diagnose and treat any fractures while they are in their earliest stages, and possibly prevent you from experiencing pain.

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