Cracked tooth syndrome (CTS) occurs when a tooth (usually a molar) develops a crack in it that is difficult to identify, even on X-rays. Oftentimes, that means that the crack has developed under the gumline, underneath a previous tooth restoration (such as a crown or a filling), or is simply too small to see using traditional diagnosis methods.


CTS can be caused by a number of different things, including:

  • Chewing on hard foods and other items like ice, unpopped popcorn kernels, nuts, and pens
  • Grinding or clenching teeth
  • Accidents involving a blow to the mouth
  • Root canals
  • Teeth that have large fillings

Signs and Symptoms

The symptoms of cracked tooth syndrome are similar to a host of other dental problems. You may experience brief, sharp pain when chewing certain foods, though the pain won’t be constant, as with a cavity. Individuals with CTS often experience sensitivity to hot and cold temperatures and occasionally sensitivity to sweet, sour, or sticky foods. However, some people experience no pain at all.

Detection and Diagnosis

CTS is notoriously difficult to diagnose for a number of reasons. First, it often presents like other dental problems, such as a cavity or TMJ (temporomandibular) disorder. Additionally, the cracks in the teeth can be virtually impossible to see with the naked eye or even with X-rays. For this reason, people suffering from CTS can often go months or even longer before being properly diagnosed.

Some common ways dentists diagnose CTS include:

  • Bite tests, where the patient is asked to bite down on various items such as a toothpick, cotton roll, gauze pad, and wooden tongue depressor in order to identify the affected tooth.
  • Staining tests, where the dentist applies a temporary stain to the teeth (often with methylene blue). The staining may make small cracks easier to see.
  • Fiber-optic transillumination, a procedure in which the dentist shines a small, high-intensity light through the tooth to search for cracks that are not normally visible to the naked eye.
  • High-magnification cameras allow dentists to view teeth at a much more magnified level, which often makes tiny cracks in the tooth surface easier to see.

Treatment Options

Because CTS is caused by a variety of different things and it affects different people in different ways, treatment options can vary significantly. Your treatment plan should be customized specifically to your teeth and your needs.

Some of the more common treatments prescribed for CTS include:

  • Repairing the tooth with a filling or other similar restorative treatment
  • Removing affected dentin and impacted pulp via a root canal procedure
  • Placing a crown to protect the tooth from further damage
  • Endodontic surgery to remove or repair the damaged portion of the tooth
  • Tooth extraction, though this is usually necessary only in extreme cases.

Getting Help for Cracked Tooth Syndrome

If you suspect that you may have CTS, the best thing you can do is set up an appointment with your dentist as soon as possible to discuss your concerns. At McDonough Center for Family Dentistry, our talented and compassionate team of dentists can work with you to diagnose your CTS and develop a customized treatment plan. To set up an appointment, call us at (678) 432-0209 or fill out this short online contact form.

We look forward to getting to know you and your family!