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Question: “My lower right molars are sensitive to cold and chewing hard foods. My dentist thinks that my symptoms are a result of cracked tooth syndrome. What do you think I should do about it?”

Answer: Cracked tooth syndrome is a common condition for American adults. Sometimes these cracks are superficial and are of minor concern. Some cracks are internal and can’t be seen until a filling has been removed, and some cracks are deeper and can cause sensitivity or pain. Some deep cracks may not elicit any symptoms.

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Teeth withstand tremendous forces every day from chewing. Additionally, many people clench or grind their teeth, which can create even more pressure on the teeth. This heavy pressure can lead to cracks within teeth. Often cracks will occur around fillings, especially large, old fillings. These cracks often cause part of the tooth to break away.

The most common symptoms associated with “cracked tooth syndrome” are pressure and temperature sensitivity. This type of sensitivity can be of varying intensity, and it may occur constantly or sporadically. Interestingly, the symptoms will often go away after the cracked portion of the tooth breaks away.

There are several possible consequences of cracked teeth. Often these teeth require a new filling, onlay, or crown. The nature of the needed restoration is largely dependent upon the depth and location of the crack, the size of the existing filling (if any), and the forces being applied to the tooth (or teeth) in question. In severe cases, the tooth can split vertically into the root area, which can necessitate extraction (tooth removal) or root canal therapy.

Even cracked teeth that are asymptomatic (symptom-free) will often require treatment in order to prevent a more serious problem. To prevent the tooth from breaking and to seal out bacteria that could cause infection, a restoration that covers the entire tooth (usually a crown or onlay) is used for added strength.

Since your dentist is more familiar with the specifics of your situation, I would encourage you to follow his or her recommendations regarding how to proceed.