Dealing With A Fractured Cusp: What Patients Need To Know

19 June 2015
 Categories: Dentist, Articles


Damaged teeth can quickly cause more serious health issues. If an infection develops inside the tooth, an abscess may form, which could lead to painful side effects and even tooth loss. Dentists deal with various types of tooth damage, and many patients have treatment for a fractured cusp. Learn more about the symptoms of this type of tooth damage, and find out what a dentist will do to repair the problem.

Where you will find cusps

The teeth in your mouth serve different purposes. For example, the canine teeth in your upper jaw are longer and more pointed, so you find it easier to hold food when you tear it with your mouth. As part of this design, some of your teeth have one or more elevated protrusions called cusps.

The canine teeth each have a single cusp. Your premolars have two cusps, which is where the name bicuspid comes from. Molar teeth have either four or five cusps. The first molars (also called maxillary molars) sometimes have a fifth cusp known to dentists as the Cusp of Carabelli.

How people fracture their cusps

Fractured cusps are relatively common, particularly in certain groups of people. One study found that African-American people had twice the rate of cusp fracture as other participants in the research.

A fractured cusp can occur for several reasons. Common causes include:

  • Extreme tooth grinding or bruxism
  • A problem with a large dental filling
  • Accidentally biting something hard (like a piece of grit or a fruit stone)
  • Trauma from a sports injury or blow to the mouth

In some cases, sudden temperature changes can also cause this problem. For example, if you eat ice cream and then a hot drink, a cusp may fracture, particularly if the tooth is already vulnerable.

You may not feel any pain from a fractured cusp straight away because you may not damage the pulp inside the tooth. That aside, over time, you may start to develop pain if the problem worsens.

Cusp fractures are more common when you already have a filling. Damage can occur because the filling weakens the area around the cusp. It doesn't really matter what type of filling you have. Studies show that amalgam and resin-based composite fillings show the same prevalence of cusp fracture.

Diagnosing the problem

It isn't always easy to detect a problem with a fractured cusp, and a normal dental check-up may not spot the issue if the damage is minor. Dentists use a variety of methods to isolate problems with damaged teeth, including fractured cusps.

In many cases, you will need several tests. The dentist will combine the results of these tests to diagnose the problem. For example, the dentist may use a special light to shine through the tooth, as well as a biting test. The first test can help spot irregularities, while the second diagnostic can isolate a particular cusp.

Treating a fractured cusp

Many patients ignore or overlook a fractured cusp, particularly if a small piece of the tooth breaks off. Nonetheless, early treatment is important, as this can help prevent more serious problems, including tooth loss and dental abscesses.

In many cases, people with a fractured cusp don't need a root canal treatment because the damage doesn't extend into the pulp inside the tooth. If the fracture is more severe, your dentist will need to extract the damaged pulp from the root canal and fill the cavity with a special material called gutta-percha.

Even if the dentist doesn't need to carry out a root canal, he or she will still need to restore the occlusal surface of the tooth. If you lose a cusp, you may damage other teeth when you bite or chew, or you may start to suffer worse symptoms of tooth grinding. To avoid these issues, your dentist may use a new filling and or a dental crown.

Many people with tooth damage suffer from a fractured cusp. If you think you have a problem with one of your teeth, contact a clinic like Maplewood Dental Associates, PA for more advice.