Cracks in teeth often manifest as the so-called
“cracked tooth syndrome.” This syndrome is
characterized by acute pain on mastication
(pressure or release) of grainy, tough foods and sharp, brief pain with cold.
These findings are also related to cusp fracture. However, cracked teeth may
present with a variety of symptoms ranging from slight to very severe
spontaneous pain consistent with irreversible pulpitis, pulp necrosis or apical
periodontitis. Even an acute apical abscess, with or without swelling or a
draining sinus tract, may be present if the pulp has undergone necrosis. In other
words, once the fracture has extended to and exposed the pulp, severe pulp
and/or periapical pathosis will likely be present. This explains the variation in
signs and symptoms, and therefore, should not be termed a syndrome.