It can be a concerning moment when you discover you’ve got a cracked tooth. Questions race through your mind, with one looming large: “Does a cracked tooth need to be pulled?”

While the fear of losing a tooth is natural, it’s essential to understand that not all cracked teeth require extraction. Modern dentistry offers a range of treatments that can often save a cracked tooth and preserve your smile.

This comprehensive guide will explore the world of cracked teeth, from causes and symptoms to treatment options and prevention. So, let’s start by addressing that crucial question.

Does a Cracked Tooth Always Need to Be Pulled?

The short answer is no; a cracked tooth doesn’t always need to be pulled. The necessity of extracting a cracked tooth depends on several factors, including the type and severity of the crack, the tooth’s location, and your overall oral health. Dentists always aim to save a natural tooth when possible, as it offers the best function and aesthetics. Here are some key considerations:

1. Types of Cracked Teeth

  • does a cracked tooth need to be pulled kidsCraze lines: Tiny cracks appear on the tooth’s enamel. While they may cause concern, craze lines are typically superficial and don’t require extraction.
  • Fractured cusp: When a cusp (the pointed chewing surface of a tooth) fractures, it can cause discomfort but doesn’t always necessitate extraction. Treatment options like dental fillings or crowns can often restore the tooth’s function.
  • Vertical root fractures: Vertical cracks that start at the tooth’s root and extend upward are more challenging to treat. Extraction is often the only option, as these fractures can’t be effectively repaired.
  • Split tooth: A split tooth with a crack that vertically extends from the chewing surface down towards the root may need to be extracted if the crack has progressed significantly. However, early intervention can sometimes save a split tooth.

2. Severity of the Crack

The extent of the crack plays a critical role in determining the appropriate treatment. Dental fillings or crowns may address superficial craze lines and minor fractures. In contrast, deeper cracks that extend into the tooth’s pulp (the innermost part) often require more invasive treatment, such as root canal therapy (also known as RCT).

3. Location of the Crack

The location of the crack within the tooth is also crucial. If the crack extends into the pulp, it can lead to infection and severe pain. In such cases, root canal treatment may be recommended to remove the damaged pulp and save the tooth. Cracks that start at the root or extend under the gums may indicate extensive damage, making extraction more likely.

4. Tooth’s Overall Health

The general health and condition of the tooth play a significant role when deciding the treatment. If the tooth is otherwise healthy and the crack can be effectively treated, preservation may be possible.

5. Treatment Options

Advances in dentistry, such as root canal therapy and dental crowns, can often save cracked teeth. Extraction may be unnecessary if the crack can be repaired and the tooth’s structural integrity restored.

6. Patient’s Preference

Patient preference and their willingness to undergo dental procedures also influence the decision. Some patients may prefer to save the natural tooth whenever possible, while others may opt for extracting and replacing the chipped tooth with a dental implant or bridge.

What Are the Parts That Crack in a Tooth?



A tooth can crack in various parts, and the location of the crack can influence the severity of the condition and the treatment required. Here are the main parts of a tooth where cracks can occur:

  • Enamel: This is the outermost layer of your teeth. Cracks that are limited to the enamel are often referred to as “craze lines.” These cracks are usually superficial and do not typically cause pain. They are primarily a cosmetic concern.
  • Dentin: Beneath the enamel lies a layer called dentin. Cracks that extend into the dentin can be more concerning. They may cause tooth sensitivity or pain, especially when exposed to hot or cold temperatures.
  • Pulp: The innermost part of your tooth is what we call the pulp, which contains nerves and blood vessels. When a crack reaches the pulp, it can be extremely painful as it becomes exposed to bacteria and irritants. Root canal treatment is essential in removing the damaged pulp to save the tooth.
  • Root: In some cases, cracks can extend into the tooth’s root vertically or horizontally. Vertical root fractures are particularly problematic, often leading to tooth extraction.
  • Crown: Cracks can occur in the crown of the tooth, which is visible above the gum line. These cracks can vary in severity and may involve the chewing surface or extend to the sides of the crown.
  • Root surface: Cracks can also affect the surface of the tooth root. These cracks are often associated with gum recession and can be challenging to diagnose.
  • Marginal ridge: The marginal ridge is a raised area on the chewing surface of a tooth. Cracks in this region can affect the tooth’s chewing stability and function.
  • Biting surface: Cracks can commonly develop on teeth-biting or chewing surfaces, especially if subjected to excessive force, such as grinding or clenching.

The specific location and extent of the crack will determine the appropriate treatment. Some cracks may only require minor repairs, while others may necessitate more complex dental procedures, such as dental crowns, root canals, or tooth extraction.

What Is It Exactly That Makes Teeth Crack?

A fractured or cracked tooth can result from various causes, and the severity of the fracture can vary. Here are some common causes of fractured teeth:

  • Trauma: A significant blow to the face or mouth, such as during a sports injury, accident, or fall, can lead to a cracked tooth. Trauma can cause immediate fractures or weaken teeth over time, making them more susceptible to cracking.
  • Chewing on hard objects: Habitually biting or chewing on objects, including ice, pens, pencils, or fingernails, can exert excessive force on teeth, leading to fractures.
  • Grinding and clenching: Bruxism or teeth grinding and clenching, can place immense pressure on teeth. Over time, this pressure can lead to cracks or fractures, especially in molars and premolars.
  • Large fillings: Teeth with large amalgam or composite fillings are more prone to cracking. These fillings can weaken the tooth’s structure, making it more susceptible to fractures.
  • Temperature changes: Rapid and extreme temperature changes, such as consuming very hot food or beverages immediately followed by cold ones, can cause teeth to expand and contract, potentially leading to cracks.
  • Age: As people age, their teeth can become more prone to fractures due to natural wear and tear.
  • Tooth decay: Untreated tooth decay can weaken its structure, making it more vulnerable to fractures, particularly when biting or chewing.
  • Weakened enamel: Teeth with weakened enamel are more likely to develop cracks. Enamel erosion can occur due to acidic foods, beverages, or certain medical conditions.
  • Orthodontic treatment: Braces or orthodontic appliances can pressure teeth, especially when initially adjusted or tightened. Dental treatments like orthodontics can occasionally result in small cracks.
  • Biting hard foods: Biting into hard, crunchy foods like popcorn kernels, candies, or nuts can cause a tooth to crack if sufficient force is applied.
  • Existing dental work: Previous dental work, such as crowns or bridges, can create stress points on adjacent teeth, potentially leading to fractures.
  • Genetics: Some individuals may inherit a predisposition to weaker teeth, making them more susceptible to cracks and fractures.

When Tooth Extraction Becomes Necessary

Extraction becomes necessary for a fractured tooth when the damage is so severe that it can’t be effectively treated or restored. Fractured teeth can vary in severity, and not all require extraction. Here are some situations where extracting teeth may become necessary for tooth fracture:

  • Vertical root fracture: When a vertical crack extends from the affected tooth’s root and moves vertically towards the crown, it can be challenging to treat. These fractures often result in infection and significant pain. Extraction may be the only option to alleviate the discomfort and prevent further oral health issues.
  • Extensive cracks: If the crack in the tooth is deep and involves a significant portion of the tooth structure, it may weaken the tooth to the point where it can’t support restoration, such as a dental crown or filling. In such cases, extraction may be necessary.
  • Cracks that extend under the gum line: Cracks that start at the tooth’s biting surface and extend beneath the gum line can be particularly problematic. They’re challenging to treat and can lead to infections and gum disease. Having an extracted tooth should become the optimal solution.
  • Infection and Abscess: If a cracked tooth becomes infected, it might develop into an abscess, a painful condition affecting the surrounding tissues and bone. In cases of severe infection, extraction may be the best course of action to prevent the spread of infection.
  • Intense Pain: When a cracked tooth causes severe and unmanageable pain, it can significantly impact a person’s quality of life. If other treatment options are ineffective in relieving the pain, extraction may be considered to provide immediate relief.

The decision to extract a cracked or chipped tooth is typically made after a thorough evaluation by an emergency dentist, who will consider the crack’s type, location, and severity, as well as the patient’s overall oral health.

How Your Dentist Can Help

Does A Cracked Tooth Need To Be Pulled treatmentEarly diagnosis and treatment are key in saving a cracked tooth. If you experience sharp pain while biting or chewing, suffer sensitivity to hot or cold temperatures, or notice a crack in your tooth, you must pursue dental care immediately. Timely intervention can prevent the crack from worsening and increase the chances of saving the tooth.

Some of the ways that your dentist can help you out are:

Accurate diagnosis. Dentists are experts in diagnosing dental problems, including identifying the type, location, and severity of cracks in teeth. They use advanced diagnostic tools, such as digital X-rays and magnification, to detect even tiny cracks that may not be visible to the naked eye.

Prevention of tooth loss. The primary goal of your dentist is to save your natural tooth whenever possible. Addressing cracks early and providing appropriate care can help prevent the need for pulling out your tooth.


Frequently Asked Questions

1. Can I prevent cracked teeth?

Preventing cracked teeth involves avoiding habits like teeth grinding, using a mouthguard or a protective mask when playing contact sports, and seeking treatment for underlying issues like gum disease.

3. How can I tell if I have a cracked tooth?

Common signs of a cracked tooth include sharp pain whenever biting or chewing, sensitivity to hot and cold temperatures, and discomfort when releasing biting pressure.

4. Do X-rays show cracks and fractures in teeth?

Cracks in teeth are sometimes challenging to detect on dental X-rays for several reasons, such as the X-ray angle, size of cracks and their position, technology of the X-ray device, and stage of the crack.

Treating Your Cracked Teeth

Understanding the options for treating a cracked tooth is vital, as early treatment can often prevent the need for extraction. Your natural teeth are valuable, and preserving them should always be the priority. Dental professionals have various tools and treatments to save your chipped teeth, even those with cracks.

If you’re experiencing any symptoms of a cracked tooth or have concerns about oral health, seeking treatment as soon as possible is crucial. Don’t hesitate to contact us at Gordon Family Dental, Gordon, NSW; our expert team will provide emergency relief. Call us at (02) 9159 6163 today!

Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.


Cadman, Bethany. How Do You Know if You Have a Cracked Tooth? 2 June 2018,

“Cracked Teeth.” Oral Health Foundation,

“Cracked Teeth – Australian Dental Association.”

Professional, Cleveland Clinic Medical. “Fractured Tooth (Cracked Tooth).” Cleveland Clinic,

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