My Tooth Cracked Under a Crown: Your Ultimate Guide

Cracked teeth, especially those hidden beneath a crown, can be sneaky and difficult to spot.

Often, you might not notice the problem until it worsens and causes significant damage.

It’s even trickier if your tooth has had a root canal, as you may not feel any pain at all. But this doesn’t mean your tooth is safe from infections or other complications.

If you suspect your tooth has cracked under your crown, don’t worry! We’ll explain, in detail, everything you need to know.

Why Are Crowned Teeth More Prone to Cracking?

A crown is a dental restoration that caps and protects the entire visible part of a tooth. However, teeth with crowns aren’t immune to problems.

Sometimes, the natural tooth beneath the crown can crack or break, especially if it was already weak before treatment. Unfortunately, these injuries can be severe enough to cause tooth loss.

But why are crowned teeth more prone to cracking?
Often, the problem isn’t the crown itself but the condition of the tooth underneath.

Most teeth that need crowns have already been severely damaged by decay or infection, making them weak to start with.

Before placing the crown, the dentist trims the weakened tooth, which can make it even more brittle.

It's even worse if the tooth has had a root canal, in which case it becomes even more fragile.

Anything that puts too much pressure on these brittle teeth can cause them to crack or break. Common causes include:

• Biting down on hard objects like ice or nuts
• Grinding or clenching your teeth, especially during sleep
• Trauma or a blow to the mouth from a fall or accident

How Can a Crack Progress Under a Crown?

In its early stages, a crack under a crown can be difficult to detect. It often begins as a tiny, invisible line within the tooth structure. Since the damage is hidden beneath the crown, you might not notice anything unusual at first.

Much like a crack in a windshield, a tooth crack can slowly worsen over time. As it spreads, it may trap stains from foods, making the crack more noticeable.

Pain is rarely an early sign. These cracks often cause no symptoms initially, but can lead to serious problems like infections and abscesses over months or years.

Below is a breakdown of the typical patterns of cracked teeth:

1. Fractured cusp:

2. Cracked tooth syndrome:

3. Split tooth:

4. Vertical root fracture:

Can a Cracked Tooth Under a Dental Crown Be Saved?

If caught in its early stage, a cracked tooth can often be repaired and saved.

However, if the damage is severe and beyond repair, the tooth may need to be extracted.

The best way to assess the severity of the damage is by removing the crown. This allows your dentist to examine the tooth directly and determine if it can be repaired.

If the crack is limited to the visible top portion of your tooth and hasn’t reached the roots, there’s a good chance the tooth can be saved. Your dentist will clean and reshape the damaged area, then place a new crown to protect it.

However, if the crack extends into the roots below the gum line, the situation becomes more complex. In most cases, the tooth will need to be extracted because the roots cannot be restored. After extraction, you can consider tooth replacement options like a dental bridge or implant.

The image below shows a crowned tooth beginning to develop signs of infection.

When the tooth was removed, you can definitely see a large vertical crack in the root!

These vertical root fractures are tough to spot, making them tricky to diagnose. They are also one of the most common causes of tooth extraction. This is because they are not repairable and often lead to gum infections (3).

What are the symptoms to watch for?

Again, cracks in your teeth can be hard to notice at first. You may not feel any pain or discomfort. But that doesn't mean the fracture is not there. Some signs to look out for:

• Sharp pain when you bite down or chew on something
• Sensitivity to hot or cold foods and drinks
• Darkening of the tooth or the crown
• Swelling, tenderness, or bleeding of the gum around the tooth
• Loose or ill-fitting crown

If you notice any of these symptoms, don't wait to see your dentist. The sooner you get treatment, the better the chances of saving your tooth and preventing further damage.

The potential complication if a cracked tooth is left untreated:

A cracked tooth is an irreversible damage, meaning it cannot heal on its own. The only way to repair it and prevent further complications is to get treatment from your dentist.

If left untreated, the crack or fracture line becomes an open gateway for oral bacteria to enter the tooth’s nerves and the surrounding deep tissues.

Some potential complications include:

• Tooth decay: Bacteria can enter the crack and cause decay under your crown. If not caught early, this can lead to significant damage.


• Tooth infection: If the pulp (tooth nerves) becomes infected, you may experience severe throbbing pain, swelling, and sensitivity. The infection can spread to the bone and gum tissue, causing an abscess (a pus-filled pocket).


• Gum infection: Bacteria can infect the gums directly through the crack, leading to a gingival abscess. Symptoms may include swelling, bleeding, and pus leakage.


• Split tooth: If the crack runs vertically through the tooth, it can split the tooth completely into two parts.


• Tooth loss: Without timely treatment, the tooth may be lost entirely. In this case, it will need to be replaced with a dental implant to prevent bone loss and other complications.

How to prevent a crowned tooth from cracking or breaking off?

Here are some tips to prevent a crowned tooth from cracking or breaking off:

1. Avoid biting or chewing on hard foods, such as ice, candy, popcorn kernels, or bones. These can damage the crown and the underlying tooth structure.


2. Wear a mouthguard if you play contact sports or grind your teeth at night. This can protect your teeth and crowns from trauma and excessive wear.


3. Maintain good oral hygiene by brushing twice a day and flossing daily. This can prevent plaque and bacteria from building up around the crown and causing decay or infection.


4. Visit your dentist regularly for check-ups and cleanings. Your dentist can monitor the condition of your crown and detect any signs of damage or looseness. They can also repair or replace your crown if needed.