Fractured teeth are a very common dental problem. Cracks in teeth may occur for a variety of reasons such as trauma, teeth grinding (bruxism) or brittleness after root canal treatment. But, by far the most common cause for a cracked tooth is the expansion of an old silver filling in a tooth. Silver amalgam expands with age and like ice expanding in the sidewalk, causes the surrounding tooth to crack.

Cracks may show up as fine fracture lines in the tooth enamel emanating from the edges of the old silver filling. They are generally not visible on x-rays. Sometimes they are not visible at all to the naked eye making the diagnosis of a "cracked tooth" dependent on the patient’s description of symptoms. Typical symptoms include sensitivity to cold or sometimes hot foods, sporadic pain when chewing that seems to come and go, or pain when direct pressure is applied.

The treatment for a cracked tooth is removal of the old silver filling and construction of a crown ("cap") for the tooth. Although the crack or cracks may still remain in the tooth, the crown provides a rigid exterior shell which dissipates the chewing forces and eliminates the pain. The effect is like putting a picture frame around a puzzle. Pushing on the edge of the picture frame does not disturb the puzzle pieces inside. Sometimes the cracks propagate to the area between the roots of multi-rooted teeth. If this occurs pain will increase and the tooth must be removed. A crown will not relieve the pain. For this reason it is very important to treat cracked teeth before the fracture migrates and splits the tooth in half.

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