Vertical Root Fracture | SHL

Although they might seem as strong and durable as metal, our teeth are prone to damage due to everyday wear and tear. Most of that damage comes in the form of cracks, and you can find more info on them at any given time.

Dental classifications recognize five different types of tooth cracks. They include:

  • Vertical root fractures
  • Cracked tooth
  • Craze lines
  • Fractured Cusp
  • Split root

To take the best possible care of our teeth, it’s key to identify what type of crack is causing the damage. It can help indicate what type of action the dentist should take (if any at all).

Luckily, there are solutions to all types of cracks and fractures, including the one we’re here to talk about – vertical root fracture.

What Is a Vertical Root Fracture?

This type of tooth damage is fairly easy to describe. Just imagine a tooth with a straight crack line starting at the bottom and heading upward. It can be complete, but it’s not always the case. Thus, it can extend across the whole root or just a segment of it.

In some cases, people with such fractures aren’t even aware of them. They simply show up unannounced during X-ray checkups.

So, the main problem with this type of tooth damage is that it’s sneaky, and we become aware of it suddenly.

Unfortunately, vertical root fractures don’t show any symptoms in the beginning. Yet, over time, they tend to cause major issues if untreated. They can cause an infection that spreads both onto the bone and gum line that surrounds the cracked tooth.

How Does Vertical Root Fracture Occur?

To better understand vertical root fractures, it’s essential to understand why they occur. In essence, there are two main reasons why someone might suffer from vertical root fracture. The first one is if you chew on hard foods (ice, hard candy, unpopped corn, etc.).

Applying force like this generally causes damage to your teeth, and it usually manifests in a crack that starts from the bottom. That is regardless of whether you do or don’t have healthy teeth.

Unfortunately, people who had previous dental interventions like root canal treatment or crown placements frequently fall victim to this type of cracked teeth too.

Root canal treatment often undermines the tooth’s structure due to extensive filling pressure. And in case the tooth is in dire condition and in need of posts, the chances of root fractures skyrocket.

A common sign of vertical root damage during root canal therapy is a sudden jolt of pain. Yet, that’s not all. It can also manifest in a popping sound that will make both the dentist and their patient shiver.

Additionally, another sign of a vertical root crack is bleeding inside the canal. That happens due to gum tissue rubbing against sharp fractures.

The Symptoms

Like with most other health issues, the symptoms of vertical root fracture are various. As such, it can sometimes be more than difficult for dentists and endodontists to diagnose it. Nevertheless, some signs are more common than others.

Vertically fractured tooth root symptoms include the following:

  • Moderate to more severe pain when chewing or biting;
  • Increased sensitivity to hot and cold;
  • A visible crack that extends from the bottom upwards that’s only visible with dye or special light;
  • An ulcer-like tract besides the tooth that suggests an infection extending below the gum line;
  • A pocket of space between the fractured tooth and the gum.

During dental procedures like root canal filling, it’s possible for dentists to diagnose vertical root fractures.

However, if the fracture occurs after the procedure, they might need the help of X-rays. With this dental procedure, it’s possible to identify the fracture, as it usually appears in the form of the letter J.

Additionally, another dental method of identifying a vertical root fracture is what we know as transillumination. It involves shining a light through the tooth to spot fracture lines.

Transillumination will force the light to move its way through the substance until it reaches a surface from which it reflects backward, thus signaling a crack.

Is There a Way to Treat Vertical Root Fracture?

Fortunately for anyone suffering from this type of tooth damage, it’s possible to treat it successfully. In fact, there is more than one way of beating vertical root fractures.

A popular solution is to go for special cement that can prevent further fracture propagation. Yet, even if it sounds painless and clean, it’s not always a possibility.

The most common way of treating vertical root fracture is tooth extraction. Although it might seem like an overreaction to some, it’s more than necessary.

As we said, tooth fractures often lead to serious infections. And if you wait for the extraction for too long, the infected tooth can spread damage to the surrounding bone, eating it out dry.

As such, it might be impossible to insert a tooth implant later on if there’s too much damage to the jawline.

Prevention Is Always Better Than Cure

Preventing tooth degradation is always better than treating it. Regardless of how good your dentist or the endodontic procedure is, some issues are just too severe to be taken care of.

However, there are ways you can make sure you don’t suffer from vertical root fractures in the first place.

Here’s all you need to know:

  • To save a tooth from this type of crack, it’s key not to take it through a root canal treatment. Instead, you should regularly visit your dentist and allow them the opportunity to spot problems early on. If you prevent cavities from occurring on time, the likelihood of vertical root cracks — or any other for that matter — will be next to impossible.
  • If root canal treatment is simply unavoidable, you can discuss it with your dentist in more detail. Since not all techniques are the same, the chance of vertical root fractures occurring will vary. Therefore, we suggest avoiding post-placement, as it can greatly increase the chance of fractures appearing.

About The Author:

Gilbert D. Curtis, DDS, is an associate professor at the University of Connecticut School of Dental Medicine. He teaches both in the undergraduate Doctor of Dental Medicine curriculum and the Advanced Education General Dentistry Residency.

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