A cracked tooth can lead to a serious infection, requiring immediate professional attention. This type of fracture typically begins on the chewing surface and may extend vertically toward the root. Although the outer enamel is the hardest substance in the human body, a fracture compromises this defense, opening a direct entry point for oral bacteria. This breach of the tooth’s protective layers can quickly escalate to a widespread infection within the jawbone and surrounding tissues.
The Pathway from Crack to Infection
The danger of a cracked tooth lies in the direct access it provides to the dental pulp, the soft tissue at the tooth’s core. The pulp contains the tooth’s nerves, blood vessels, and connective tissue, normally sealed off by enamel and dentin. Once a crack extends through the dentin, abundant oral bacteria can infiltrate this sterile inner chamber.
This bacterial invasion causes inflammation of the pulp, known as pulpitis. The infection multiplies rapidly within the pulp chamber, leading to increased pressure and severe discomfort. If left untreated, the pulp tissue will eventually die, a process called pulp necrosis.
The infection travels through the root canals and exits at the tip of the tooth root. Bacteria and inflammatory cells accumulate there, forming a pocket of pus known as a periapical abscess. This abscess signals that the infection has spread beyond the tooth structure, involving the surrounding jawbone and gum tissue.
A simple crack may only cause intermittent pain when biting. However, an infected crack presents a greater health risk because the immune system cannot effectively fight the bacteria inside the tooth structure. Untreated abscesses will not resolve on their own and can spread into the facial muscles and tissues of the neck and face, presenting a potentially life-threatening situation.
Identifying Symptoms of a Severe Dental Infection
Recognizing the signs that a cracked tooth has progressed to an infection is crucial for timely treatment. The most common localized symptom is a severe, constant, and throbbing toothache that may radiate into the jawbone, ear, or neck. This pain is distinct from the intermittent discomfort experienced with a non-infected cracked tooth.
Sensitivity to extreme temperatures, particularly heat, that lingers after the stimulus is removed indicates irreversible pulp damage. Pain or discomfort persists when chewing or biting down, often feeling like pressure on the inflamed tissue. The presence of a small, pimple-like bump on the gums near the affected tooth, which may discharge pus, signals an active dental abscess.
Systemic symptoms indicate the infection is spreading beyond the immediate oral area. These signs include a fever, fatigue, and the presence of tender, swollen lymph nodes underneath the jaw or in the neck. A persistent foul taste or odor in the mouth can result from the abscess draining pus. If facial swelling occurs, especially if it leads to difficulty swallowing or breathing, this represents a medical emergency requiring immediate attention.
Necessary Dental Intervention and Treatment
Treatment for an infected cracked tooth begins with a thorough diagnosis to determine the extent of damage and infection. Dentists utilize X-rays, which can reveal bone loss around the root tip, and sensitivity testing to assess pulp vitality. Cone-beam computed tomography (CBCT) may also be used to get a detailed, three-dimensional view of the crack’s depth and spread.
Initial Management
Initial management focuses on controlling bacterial spread, often involving prescribing antibiotics, though medication alone is not a permanent solution. If an abscess is present, the dentist may drain the pocket of pus to relieve pressure and remove the accumulated infection. This step helps mitigate the immediate risk of the infection spreading further.
Permanent Solutions
The permanent solution requires addressing the source of the infection, which is the contaminated dental pulp. Root canal therapy is the standard procedure if the tooth is salvageable. This involves drilling into the tooth, removing the infected or necrotic pulp tissue from the chamber and canals, and then thoroughly cleaning and sealing the interior space. Following a root canal, a dental crown is typically placed over the tooth to restore its strength and protect the compromised structure from further fracture.
If the crack extends too far below the gum line or the damage to the tooth structure is too severe, extraction may be the only viable option. Removing the tooth eliminates the source of the infection, and the socket is cleaned to ensure no bacteria remain. Replacement options, such as a dental bridge or implant, can then be considered to restore function and maintain the alignment of the remaining teeth.