A cracked tooth can be very problematic for a patient.  Often there are twinges that the patient feels when they bite down on certain foods and the food presses in a certain direction that aggravates the cracked cusp.  These cracks are often not visible with the naked eye.  Dentists who use magnification and enhanced lighting during an examination will be more likely to detect them.  Sometimes patients describe the pain that comes from a cracked tooth as a sharp shooting pain often at the instant the pressure is released.  

Cracked teeth are often sensitive to pressure as well as cold temperatures.  The pulp (nerve) of the tooth gets inflamed and this inflammation can progress to ischemia and necrosis of the pulp if the crack worsens and travels deeper into the nerve chamber.  The crack in a tooth is a potential pathway for bacteria to enter the nerve chamber.  

A cracked tooth is at much higher risk of complete fracture and even being lost.  Teeth will suffer a complete fracture when a cusp has a vertical crack and a horizontal crack.   Often the vertical fracture occurs first and is followed by a horizontal fracture later on.  The risk of leaving the vertical fracture untreated is that the horizontal fracture that will likely develop with continued chewing is not in our control.  Such horizontal fractures sometimes develop on the root surfaces far below the surface of the gum tissue and this can result in the need for extraction.

A cracked tooth is at much higher risk of complete fracture and even being lost.  Teeth will suffer a complete fracture when a cusp has a vertical crack and a horizontal crack.   Often the vertical fracture occurs first and is followed by a horizontal fracture later on.  The risk of leaving the vertical fracture untreated is that the horizontal fracture that will likely develop with continued chewing is not in our control.  Such horizontal fractures sometimes develop on the root surfaces far below the surface of the gum tissue and this can result in the need for extraction.

Sometimes the pulps (nerves) in cracked teeth do not calm down even after a crown is placed and root canal treatment may need to be done. However, most of the time the crown solve the problem. It is advisable to address cracks sooner rather than later since the health of the nerve may be more likely to deteriorate the longer a crack remains.