Do you have occasional pain while chewing – especially on certain foods, or if you catch a tooth at a certain angle?
Do you have vague cold sensitivity not alleviated by other methods?
You may have a cracked tooth.
As people are living longer with their own teeth, these teeth are subject to stresses over a longer period of time. These stresses include sudden temperature changes, diet and habits. Chewing on ice, whole nuts, raw firm foods, like carrots and hard candy, can cause damage. Grinding and clenching habits, especially at night, may also play a role. This is creating an increase in the frequency of cracked teeth.
Just like a crack in a windshield, a crack in a tooth will start small and progress slowly. Unlike bones, cracked teeth cannot mend. Depending on the direction of crack propagation, as it gets larger, it may progress to the outside and a piece of tooth may break off, or the crack may go into the pulp, or nerve of the tooth, or it may split the tooth completely. Diagnosing a cracked tooth can be difficult. This may involve bite tests, removing existing fillings and staining the tooth underneath, and transillumination. Unfortunately, X-rays alone do not usually show a crack. Early treatment is important to improve the chances of saving the tooth. If a crack is suspected, steps should be taken immediately to confirm the presence of the crack, try to determine the type of crack, and decide on a treatment plan.
Treatment may involve a crown and root canal treatment if the tooth is temperature sensitive. Because it is impossible in most circumstances to determine the exact extent or depth of the crack, the long term success is more questionable in this situation. Treatment does not guarantee success.
Awareness of the causes of cracked teeth and what to look for, especially if you have already had one cracked tooth, is important for the prevention of early treatment of this very complicated problem.