If your tooth hurts when biting down you may have cracked tooth syndrome. There are other reasons but cracked tooth syndrome is becoming more prevalent as we are keeping our teeth for longer and subjecting them to more wear and tear. Commonly occurring in molars and premolars and sometimes in front teeth, cracks may be simple, affecting only the superficial enamel or more complex, affecting down to the nerve in the tooth and into the root of the tooth which is then unable to be saved.

Other reasons can include infection under the tooth, sinus problems with the top teeth or clenching and grinding your teeth.  Sinus problems will resolve with time and the pain will go.  Tender teeth due to clenching and grinding often do settle, but sometimes require protections with dental splints.  Infection under a tooth can mean the need for root canal treatment or removal of the tooth.

Some common reasons for cracked tooth syndrome include:

  • Grinding and clenching which subjects the teeth to excessive forces
  • Heavily filled teeth are more likely to develop cracks particularly under cusps surrounding the filling, as these teeth are weakened.
  • Chewing on hard foods such as nuts, ice, hard lollies.
  • Trauma to the teeth due to impact injuries particularly when the lower teeth impact against the upper teeth.

Symptoms you may feel when biting on a cracked tooth:

Cracks can occur with or without pain or symptoms but often the tooth hurts when biting down. Typically a cracked tooth will be described as feeling sensitive to hot or cold with a short sharp pain on biting hard foods such as multigrain bread. It can be difficult to identify which tooth is causing the symptoms, with the pain often referred between top and bottom teeth. But we can perform a number of test to help identify which tooth hurts when biting down. Some people feel the pain on release of the pressure, when they let go of biting.


Simple cracks can be easily removed and replaced with a large filling which can re-build and overlay the tops of the tooth. As cracks become more extensive, they cannot be easily removed and in these situations a crown is the only effective treatment option. A crown will completely cover the tooth to hold it together. More complex cracks that pass deeper and reach the nerve of the tooth will unfortunately allow bacteria in. The bacteria then cause inflammation of the nerve and can even kill the nerve. The tooth will then require a root canal treatment or if the crack is extensive the tooth is unable to be saved. An alternative replacement may then be required, such as a denture, implant or bridge. The options are many and varied, so pop in for a chat about what may suit your teeth.

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