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Cracked Molar

When you have cracked molar, it does not refer to the fact that your molar is broken and needs to be filled or crowned. It means that you may be suffering from Cracked Teeth Syndrome, a condition which is very painful, and also very difficult to diagnose. This condition causes pain to radiate from several parts of the teeth, making it hard to pinpoint which tooth, or molar, is the source of the pain. The cracks in the tooth, or molar, are too small to be seen by the naked eye. The pain that comes from the cracked molar is caused by the momentary exposure of the dentine, when you are biting down and pressure is put on the tooth. The exposure of the dentine causes a change in the hydrostatic pressure in the dentinal tubules, and this causes the pain. The mandibular molars are the most susceptible to having cracks wince they exert the highest pressure when chewing down on food.

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Symptoms

A lot of pain when you bite down or release the bite; you may not be able to pinpoint which tooth is causing the pain

Diagnosis of cracked molar

Dentists and patients are usually frustrated at the way the pain radiates and cannot be attributed to a particular tooth. This is why the diagnosis of cracked molar, or cracked tooth syndrome is very important to understand.

In the past, diagnosis of this condition was very difficult, given the ambiguous origin of the pain. Although a patient would say the pain comes from the left, it was hard to tell which tooth was actually affected. Taking radiographs and vitality testing would not yield good results. Here are some of the techniques that are used in finding the cracks in molars and other teeth:

  • Fiber-optic wand – this is an instrument that has a fiber-optic light at the end. It is held up against the gingival sulcus in a dimly lit room. The cracks in the teeth will become visible and the dentists can recommend a treatment in good time.
  • Methylene blue dye – this is a dye that is applied to the surface of the tooth using a cotton bud. The patient will then be asked to bite down, and shake his head in all direction, so as t spread the dye throughout the teeth and into the cracks. After this, the extra dye is washed off with alcohol, and the dye in the cracks will reveal where the problem is.
  • The bite stick or CrackFinder – this is a stick which is placed on the surface of each tooth. The patient is then asked to bite down. The teeth that do not have cracks will not experience pain. When the patient bites with the cracked tooth, he or she will feel the pain and the tooth will be identified.
  • The dental microscope – this is perhaps the most important development in finding cracked teeth or molars. The teeth are methodically examined using the microscope, which even helps in finding the cracks when they are in their initial stages. This way, they can be treated conservatively, and therefore prevent painful symptoms, when the crack widens.

Causes

When you get into the habit of clenching your teeth, eating ice, or grinding your teeth, you may end up having cracked teeth syndrome. However, the cracks can also come from an isolated incident, such as biting on a piece of bone during one meal. The mandibular molars are the ones most susceptible to developing these cracks. Another cause is the poor restoration of teeth during a prior dental procedure.

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Treatment of cracked molar

The treatment of this condition will depend on the extent of the crack and also how much of the pulp has been affected.

  • The cracks which can be seen but have not yet started causing pain should be treated using a crown, or other complete covering of the cusp. This treatment stops the spread of the crack; it will not get any bigger with time.
  • The cracks which have already started to cause intense pain indicate that the pulp and nerves have been exposed to bacteria. In this case, root canal treatment should be done before a crown is placed on the tooth. Before root canal and crowning is recommended, the extent of the crack has to be determined under a microscope. Those teeth where the crack is limited to the crown port of the tooth can be restored using root canal and crowning method. However, for those that extend below the osseous crest, or have a narrow and deep pocket, complete extraction of the tooth is recommended.

Patients who have more than one cracked molar or tooth will need proper treatment and counseling to avoid getting cracks in the other teeth; bad habits such as clenching, grinding and biting on hard or extremely cold items should be discouraged.

 

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