The process
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Diagnosis · Microscope and CBCT
Cracked teeth, found and fixed
A cracked tooth typically causes sharp pain on biting or on release, and sensitivity to cold that comes and goes. Cracks rarely show on X-rays, so we diagnose them under the dental operating microscope, with CBCT 3D imaging where indicated. Treatment depends on how deep the crack runs, and often means a bonded onlay or crown, made the same day where suitable. Assessment £125.
Assessment
£125
Diagnosis
Operating microscope, CBCT where indicated
Protection
Same-day crown from £1,250
Clinical lead
Dr Spencer Richman
Who it is for
Signs of a cracked tooth
Sharp pain on biting
A brief, sharp pain when you bite on something firm, or as you release the bite, is the classic sign. It often happens with one particular food or at one particular angle.
Sensitivity to cold
A crack lets cold reach the nerve more quickly. A short, sharp response to cold drinks or cold air on one tooth, with no visible cavity, is common.
Pain that is hard to locate
People often cannot say which tooth it is, or even whether it is upper or lower. The pain comes and goes, which makes it easy to put off.
A heavily filled back tooth
Cracks are most common in back teeth with large fillings, and in people who clench or grind. A weakened cusp can flex for months before it gives way.
The difference
Why diagnosis decides the outcome
X-rays often miss cracks
Most cracks run in a direction that a standard X-ray cannot show. A normal X-ray does not rule a crack out, which is why the history and the testing matter.
The operating microscope
Under high magnification and strong light, fine crack lines become visible. We can follow a crack across the tooth and judge whether it stops in the crown or heads towards the root.
Light, dye and bite tests
Transillumination shines light through the tooth, and a crack blocks it. A staining dye highlights the line. Biting on a small tester, cusp by cusp, finds the one that hurts.
CBCT where it adds information
A 3D scan does not usually show the crack itself. It can show changes in the bone beside a root that suggest how deep a crack runs, so we use it selectively.
01
Assess and test
We listen to the history, test the tooth and its neighbours and examine it under the microscope. An old filling sometimes needs to be removed to see the crack beneath it.
02
Surface lines: monitor
Fine lines confined to the enamel, known as craze lines, are common and usually harmless. They need no treatment, only a record and a check at future visits.
03
Cracks into the tooth: hold it together
A bonded ceramic onlay or crown covers the cusps and stops the crack from flexing. Where suitable, it is made with CEREC on site and fitted the same day.
04
Cracks reaching the nerve: root canal treatment
If the nerve is inflamed or infected, root canal treatment removes it and the tooth is then covered with a crown. Dr Spencer Richman carries this out under the microscope.
05
Cracks below the bone: replace the tooth
When a crack runs down the root below bone level, the tooth usually cannot be saved reliably. Extraction, followed by a dental implant, is then the more dependable option.
Afterwards
Aftercare
Until the tooth is protected, chew on the other side and avoid hard or sticky food. After an onlay or crown, biting pain usually settles over a few weeks, though some cracked teeth go on to need root canal treatment later. We review the tooth and tell you what to expect. If you grind your teeth, a night guard helps protect it.
Guide fees
Assessment (new patient or emergency appointment)£125
CBCT 3D X-ray, where indicatedfrom £195
Same-day CEREC crownfrom £1,250
Root canal treatmentfrom £1,200
Guide fees. You receive a written plan with exact costs before treatment starts. See all fees
Common questions
Questions, answered
What does a cracked tooth feel like?+
Usually a sharp, brief pain when you bite on something firm or as you let go, often with sensitivity to cold. It tends to come and go, and it can be hard to tell which tooth is responsible. A constant, throbbing ache suggests the nerve is now involved.
Can a cracked tooth heal on its own?+
No. Unlike bone, a tooth cannot knit back together. Cracks tend to spread with continued biting, so a crack that could be held with a crown today may reach the nerve or the root later. Early assessment keeps more options open.
Why did my X-ray not show a crack?+
A standard X-ray only shows a crack if the beam happens to pass directly along it, which is uncommon. Most cracks are found by examining the tooth under magnification, with light, dye and bite tests. A clear X-ray with typical symptoms still deserves a closer look.
How much does cracked tooth treatment cost?+
Assessment is £125, through a new patient or emergency appointment, and a CBCT scan, if indicated, is from £195. A same-day ceramic crown is from £1,250. Root canal treatment, if the nerve is involved, is from £1,200. You receive a written plan with exact fees first.
Does treatment for a cracked tooth hurt?+
Testing may briefly reproduce the pain, which is how we confirm the tooth. Treatment itself is carried out under local anaesthetic, so you should feel pressure but not pain. A same-day crown takes around two to three hours in a single visit.
Can a cracked tooth be saved?+
Often, yes, particularly when it is caught early. A crack confined to the crown of the tooth can usually be held with an onlay or crown, with root canal treatment if the nerve is affected. If the crack extends below the bone, extraction is usually advised and an implant can replace the tooth.
Is a cracked tooth an emergency?+
In most cases it is urgent but not an emergency. Book promptly, because cracks spread. If you have severe pain or swelling, or part of the tooth has broken away, call or WhatsApp 07497 573 936 and we will find the earliest slot, often the same day.