First, figure out what kind of crack you have
Not all cracks are equal. The key categories:
- Craze lines — tiny surface cracks in enamel only. Visible but painless. No treatment needed.
- Chipped tooth — a small piece broken off the edge or corner. Usually no pain unless deep. Cosmetic fix or small bonded filling.
- Cracked tooth (visible crack across the tooth) — the most variable. Pain when biting, sensitivity to cold or sweet. Needs evaluation soon.
- Split tooth — the crack has separated the tooth into pieces. Usually severe pain. Needs immediate care; may not be savable.
- Vertical root fracture — crack runs down into the root. Pain is variable. Usually requires extraction.
In the first hour
1. Save any tooth fragments. Rinse them gently in water and put them in a small container with milk, saliva, or saline. We may be able to bond a fragment back if it's a clean break and you act quickly (within 24 hours).
2. Rinse your mouth with warm salt water. A teaspoon of salt in a cup of warm water — gentle rinse, don't swish hard. This cleans the area and reduces bacteria.
3. Manage pain with ibuprofen. 600 mg every 6 hours works well for most dental pain (assuming you have no contraindications). Avoid aspirin if you're still bleeding.
4. Cold compress on the cheek — 15 minutes on, 15 off. Reduces swelling.
5. Avoid chewing on that side. Bite on the other side until you've been seen.
6. Call us. (719) 647-9433. We hold same-day emergency slots open every weekday.
When to skip the dentist and go to the ER
The ER, not a dentist, is the right call when:
- The crack is part of a larger jaw or facial trauma
- You can't close your mouth normally
- You're bleeding heavily and it won't stop with pressure
- You're having difficulty breathing or swallowing
- There's significant facial swelling spreading rapidly
- You hit your head and may have a concussion
The ER will stabilize you medically. Then we'll see you for the dental side after. For pure dental emergencies (cracked tooth, no other injury), the ER will only give you antibiotics and a referral — they don't do dental work.
What we'll do at the visit
Three steps: examine, X-ray, plan.
The exam tells us how deep the crack is, whether the nerve is involved, and whether the tooth is savable. X-rays show the root and any spread of damage below the gum line. Some cracks need a 3D scan (CBCT) to see clearly.
From there, treatment depends on what we find:
- Small chip or surface crack: Bonded filling or smoothing. Quick, often same visit. $150–$400.
- Crack into dentin (no nerve damage): Crown to hold the tooth together. Often a same-day CEREC crown. $1,000–$1,800.
- Crack reaching the nerve: Root canal followed by crown. ~$2,000–$3,200 total.
- Split or vertical root fracture: Extraction, usually followed by an implant. $4,000–$6,000 for the complete replacement.
Why some cracks heal and others don't
Tooth structure doesn't heal the way bone does. A crack in enamel won't close on its own. What can change is whether the crack stays small or spreads — and that depends on what you do next.
Cracks left untreated tend to grow. Each chew adds stress. Eventually the crack reaches the nerve (toothache), or the tooth splits in half (extraction). Catching cracks early — before they cause severe pain — is what gives you the best treatment options.
Even if the cracked tooth doesn't hurt much, get it looked at within a week. Pain isn't a reliable indicator of how serious a crack is.