Your teeth go through a lot. Like any machine, wear and tear needs to be considered. Imagine the stress that chewing muscles alone (for decades!) put on your teeth! Generally, we put anywhere between 16 and 34 lbs of force on our teeth when chewing our food. Some people can apply up to 160 lbs of force (1). Imagine then how much force we apply when grinding or clenching. Studies have recorded forces nearing 275 lbs with a single clench. Could you imagine having to offer a warranty for this machine? How in the world do our teeth withstand these forces without failing? The answer: sometimes they don’t… 

Teeth have a makeup that is similar to bone, and as far too many of you have learned, like bone, teeth can fracture. Sometimes this happens without warning, but the good news is that regular checkups will allow your dentist to notice small cracks that can be nipped in the bud before they become devastating fractures. 

Unless you experience serious trauma, fractures in teeth most often begin as small cracks. These are usually in teeth that have been restored with large fillings in the past. A tooth with a filling will, of course, be made up of less natural tooth structure than one that hasn’t been restored. Then why is the filling there in the first place? Because the tooth initially had a cavity that needed to be addressed with a restoration.  

Here are some examples of the types of fractures we see in our office. These pictures were taken with our intraoral camera, an invaluable tool in patient education. In figure 1 you are looking at the cheek side of a molar. Note the crack that runs along the entire side of the tooth from top to bottom. That same tooth is seen in Figure 2. Here we see the large silver filling in the chewing surface and a second crack is seen in the top of the frame. These types of radial fractures are ones that often result in the loss of an entire quadrant of the tooth. If the fracture propagates too far below the gum line the result is may lead to extraction due to an unrestorable tooth. Figure 3 shows a tooth with a fracture that goes right through a small filling on the side of the tooth. Note that there is a crater where a previous filling has been lost. 

Figure 1

Figure 2

Figure 3

So, what is the treatment for this type of problem? Your dentist may suggest any number of options. We often cannot tell the depth of the fracture. The first line treatment is to remove the crack and follow it to see how deep it goes. Sometimes that tooth can be restored with a simple filling, but more often a crown or onlay made of ceramic is required for the strongest, longest term outcome. The dentists at CrossKeys Dental with discuss your options and obtain your feedback to arrive at the solution that makes the most sense for you.  

Sources:
1) Crispian Scully, (2002) Oxford Handbook of Applied Dental Sciences, Oxford University Press –ISBN978-0-19-851096-3P156

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CrossKeys Dental is located at 110 CrossKeys Office Park in Fairport. Dr. DuPre՛ and Dr. Badali provide comprehensive family dentistry and are always welcoming new patients. Visit us at www.CrossKeysDentalFairport.com for more information. 

        © 2017 CrossKeys Dental in Fairport, NY by Vince Badali, DDS

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