Vertical Tooth Fractures: Diagnosis, Treatment & Early Warning Signs — Insights from Dr. Mili Gupta (MDS, Prosthodontist & Implantologist)

Vertical fractures in teeth are one of the most challenging dental conditions I see at AMD Dental Clinic, Jaipur. They often present silently, without dramatic symptoms, but the damage they cause can be deep and progressive. Many patients come to me saying, “Doctor, the tooth looks normal, but I get sudden sharp pain while chewing.” This is usually the first red flag of a vertical fracture.

In this blog, I want to share my clinical experience, how we diagnose such cracks, and what treatment choices truly save the tooth.

What Exactly Is a Vertical Tooth Fracture?

A vertical fracture is a crack that begins from the chewing surface and extends downward toward the root. It may or may not split the tooth completely. These cracks are different from simple enamel cracks — they involve deeper tooth structures and sometimes even the root.

At my clinic in Jaipur, I regularly see such fractures caused by:

• Chewing hard foods (ice, nuts, paan masala, supari, bones)

• Old, large fillings that weaken tooth walls

• Previously root-canal treated teeth without crowns

• Heavy grinding or clenching (bruxism)

• Age-related changes in enamel

Common Symptoms Patients Experience

Even though vertical fractures often appear invisible, the underlying symptoms usually tell the story:

• Sharp pain while biting or releasing pressure

• Sensitivity to cold or sweet foods

• Localized gum swelling

• Discomfort while chewing on one side

• A visible line or shadow on the tooth

• Occasional pus discharge near the tooth (advanced stage)

If you experience these symptoms, visiting a dentist immediately can save the tooth. Many patients in Jaipur report months of mild discomfort before seeking help — and the delay often reduces the chances of saving the tooth.

How We Diagnose Vertical Fractures at AMD Dental Clinic, Jaipur

Vertical fractures are tricky to detect with a normal X-ray. That’s why at our clinic, we use advanced tools and techniques:

✔ High-resolution digital X-rays

Helps identify bone loss patterns around the cracked area.

✔ CBCT 3D Scanning

This is the most accurate way to detect root fractures.
My experience with CBCT confirms many early fractures that were missed in traditional radiographs.

✔ Clinical Evaluation

Using magnification loupes, dye tests, bite tests, and periodontal probing, we locate micro-fractures.

✔ Patient history & symptom analysis

Often, the way a patient describes their pain gives important clues.

Early and accurate diagnosis is the key — the sooner we catch the fracture, the better the prognosis.

Management of Vertical Tooth Fractures

Treatment depends entirely on the depth and location of the fracture.

1. Crack Limited to the Crown (Upper Part of the Tooth)

Treatment Options:

• Composite restoration

• Onlay or ceramic crown

• Reinforcement with fiber post (in selected cases)

If the fracture is superficial, placing a crown can prevent the crack from widening.

2. Fracture Extending Into the Pulp (Nerve Area)

Management:

• Root canal treatment

• Placement of fiber post

• Full coverage ceramic/zirconia crown

This approach stabilises the tooth and prevents further propagation.

3. Vertical Root Fracture

This is the most severe form and often not salvageable.

Recommended Treatment:

• Extraction of the affected tooth

• Replacement options: Dental implant, bridge, or denture

At AMD Dental Clinic, Jaipur, implant-based replacement is my first recommendation because it preserves bone and offers long-term stability.

Can Vertical Cracks Be Prevented?

Yes — with timely dental care and right habits.

✔ Always get a crown after root canal

It prevents 80% of post-RCT fractures.

✔ Avoid chewing hard items

Especially supari, ice, gur-gattas, or pens.

✔ Regular dental check-ups

Every 6 months for early detection.

✔ Night guard for grinding

I often prescribe customised night guards for patients with bruxism.

Why Choose AMD Dental Clinic for Cracked Tooth Treatment in Jaipur?

As a Prosthodontist and Implantologist, my focus is long-term tooth preservation. At our clinic, patients benefit from:

• Advanced CBCT-based diagnosis

• Expertise in crown, onlay, and implant treatments

• Modern microscopic dentistry

• Same-day emergency pain relief

• Personalised dental planning based on fracture pattern

Our goal is to save your natural tooth whenever possible.

FAQs on Vertical Tooth Fractures 

1. Can a vertically fractured tooth be saved?

If the fracture is limited to the crown or upper tooth structure, yes — crowns and RCT can save it.
Root-level vertical fractures usually require extraction.

2. How do I know if my tooth is cracked?

Pain on biting, sensitivity, and discomfort on chewing are early signs. CBCT is the most reliable method for confirmation.

3. Is extraction the only option for root fractures?

Yes, in most cases. A dental implant is the best replacement option after removing the fractured root.

4. Why do root canal treated teeth crack more often?

After RCT, tooth becomes brittle. Without a crown, it cannot tolerate chewing forces, increasing fracture risk.

5. Is a cracked tooth an emergency?

Yes. Ignoring it allows the crack to deepen, ultimately requiring extraction.

Final Word from Dr. Mili Gupta

Vertical fractures are silent but dangerous. Timely diagnosis can help save the tooth — and sometimes even save patients from painful emergencies. If you suspect a cracked tooth or are experiencing persistent chewing discomfort, visit AMD Dental Clinic, Jaipur for expert evaluation.