smile dental logo

Fractured Cusp – Solutions, Preventions, Treatments

Excerpt: Trauma, tooth decay, and teeth grinding (bruxism), can all be potential reasons for breaking the cusp (point) of a tooth.
Table of Contents

A fracture is the crack or separation of the enamel on the crown of a tooth caused by an impact such as tooth decay, tooth injury, or chewing with the front teeth on hard foods. Fractured tooth cusps can cause significant problems such as: difficulty chewing, pain when swallowing, and tooth loss. The good news is that cusp fractures usually heal completely with proper treatment. However, if you do not detect the fracture early on and it becomes bigger or more complicated, then you will need to see a dentist for a consultation and possible treatment. Follow this blog to learn everything you need to know about preventing tooth fractures and managing them when they do occur!

What Is A Fractured Cusp?

Cusps are the main points of impact for your teeth since they stand out on the surface of the tooth. Molars have the most cusps (usually 4 or even 5), and they do the most work, if you do break a cusp, it is usually a molar. Injuries or tooth decay are the primary reasons for breaking cusps. Sometimes it does not have to be a significant impact, you may even have accidentally bit down too hard, or around your teeth, which can result in a fracture. 

How can you identify if you have a cusp fracture?

If you’re like most people, you love to go out and have a good time. But what happens when the good times turn bad? For many people, that’s when cusp fractures happen – fractured bone at the cusp of the tooth. Cusp fractures are typically the result of a fall or sudden acceleration/deceleration. If you suspect you may have fractured your cusp bone, don’t wait – go to the ER ASAP! Cusp fractures are usually diagnosed by the presence of a fracture edge on X-ray images. If you do experience a fall and suspect you may have fractured your cusp bone, seek emergency medical attention as soon as possible! Prevention is key – always wear your protective gear when playing sports or participating in activities that could cause falls. Knowing the signs and symptoms of cusp fracture can help you avoid them in the first place.

If you do experience a fractured cusp, you will want to make an appointment right away. The fracture will most likely produce a sharp edge that can cut your tongue or cheeks and it may be prone to an even greater facture. 

Other Types of Tooth Fractures

Tooth fractures can occur at any stage of tooth development and may be caused by a variety of factors. If left untreated, fractured cusp teeth may lead to tooth loss and other dental problems. Here are some of the most common types of tooth fracture: 

  1. A crack or fracture in the enamel surface of a tooth crown (front, central or root). 
  2. A fracture in the dentin layer below the enamel that usually affects teeth with pulp inside them like molars and premolars (below 40% pulp content). 
  3. Fractures involving less vital tissues like gum lines or fillings around teeth have a much lower chance for causing serious damage but still require prompt treatment to prevent further dental problems from developing.

Why Do Cusps Fracture (Break)?

There are some common reasons as to why the points on your teeth break, here are the most prevalent:

Severe Decay

The best offense is a good defense. If you have great oral care you will prevent a significant amount of damage and other ailments that can impact your oral health. A decayed tooth can be prone to breaks as cavities will erode enamel, causing them to weaken over time. 

Teeth Grinding And Jaw Clenching

Teeth grinding (bruxism) and jaw clenching can often happen in times of stress, or as a coping mechanism if the body is experiencing pain. Sometimes it can even happen without your knowledge. Nighttime bruxism can be diagnosed by the dentist, as they will see the impacts of it on your teeth. If you are prone to bruxism as a stress-coping mechanism, you should take care of the stressful aspects of your life so you do not injure yourself. If it happens to be nighttime bruxism, you may want to sleep with a custom mouthguard. 

Trauma (Injury)

Sometimes trauma is out of our control, natural disasters, car crashes, falls, etc. However, if you are involved in physical sports, or activities that can cause injuries fairly easily like skateboarding, dirt biking, weightlifting, etc. wearing a custom mouthguard is definitely recommended as these activities can cause you to wreck, or even lose your teeth.

Significant Restorative Work

If a dentist has to do a lot of work on a tooth, they may recommend a crown, root canals for example can make a tooth vulnerable, even though they are needed to heal it. If a tooth isn’t reinforced and protected after the dental work, you may fracture it accidentally.

Biting Into Tough Or Sticky Food

Eating hard sugary candies, nuts, or other foods like this can cause breaks because they are tough to chew through. You can also break your teeth if you happen to bite into the bone too hard when eating meat. If you do eat these foods, you will want to be careful and chew with teeth that you know are healthy. If you have teeth with cavities or serious dental restorations, you may want to avoid using these teeth or those foods entirely.
adrian swancar roCfgvkBLVY unsplash 1

Is A Broken Tooth Painful?

Breaking a tooth can be incredibly painful, and it can make the nerves incredibly sensitive depending on which tooth you broke. If you break one of the teeth located at or near the front of the mouth, you are much more likely to experience pain, as they are smaller teeth and have less protection. If you break a molar, you may not feel the initial fracture at all due to the teeth being bigger and having more enamel. However, you will most likely feel the difference in the tooth afterward as any change in our mouth is usually quite noticeable, no matter how small. 

You may also feel like you are chewing on gravel or sand, this is the enamel that broke off. Anytime you break a tooth, you will want to get it fixed immediately. A broken tooth is much more likely to break even more in the future. The sharp edge after the break can also cause cuts in your mouth. These cuts are not only painful but may leave you vulnerable to infection.

When should you consult a dentist about cusp fractures?

Cusp fractures are a common dental complication that can be quite troublesome. If left untreated, cusp fractures can lead to tooth loss and other dental problems. So, when should you consult a dentist about cusp fractures? The answer is, that it will largely depend on the severity of the fracture. However, most cusp fractures will require antibiotics or surgery to stabilize the tooth. If you experience a cusp fracture, consult your dentist for treatment immediately! By doing so, you can ensure the best possible outcome for your teeth and cusp fracture. Prevention is key – make sure you don’t experience any cusp fractures in the first place. So, brush and floss regularly, eat a balanced diet, and visit your dentist for routine dental check-ups.


A fractured tooth cusp is a dental problem that can cause toothache and discomfort. In some cases, the fracture can lead to the tooth being removable. To prevent tooth fracture, take the following precautions: brush and floss your teeth regularly, avoid chewing hard foods, and use a dental dam when gargling. If you experience toothache or discomfort due to a fractured tooth cusp, consult your dentist as soon as possible.
Tell Your Friends

Book Your Appointment

Step 1 of 3