J Am Dent Assoc. 2017 Feb 2. pii: S0002-8177(16)31011-X. doi: 10.1016/j.adaj.2016.12.023. [Epub ahead of print]
Abstract
BACKGROUND:
Cracked
teeth are ubiquitous in the adult dentition. The objective of this
study was to determine which patient traits and behaviors and external
tooth and crack characteristics correlate with cracked teeth being
symptomatic.
METHODS:
Dentists
in The National Dental Practice-Based Research Network enrolled a
convenience sample of patients each with a single, vital posterior tooth
with at least 1 observable external crack in this observational study;
they enrolled 2,975 cracked teeth from 209 practitioners. The authors
collected data at the patient level, tooth level, and crack level. They
used generalized estimating equations to obtain significant (P < .05)
independent odds ratios (OR) associated with teeth that were
symptomatic for a crack.
RESULTS:
Characteristics
positively associated with cracked tooth symptoms, after adjusting for
demographics, included patients who clenched, ground, or pressed their
teeth together (OR, 1.30; 95% confidence interval [CI], 1.12-1.50),
molars (OR, 1.58; 95% CI, 1.30-1.92), teeth with a wear facet through
enamel (OR, 1.22; 95% CI, 1.01-1.40), carious lesions (OR, 1.31; 95% CI,
1.07-1.60), cracks that were on the distal surface of the tooth (OR,
1.31; 95% CI, 1.13-1.52), and cracks that blocked transilluminated light
(OR, 1.31, 95% CI, 1.09-1.57). Teeth with stained cracks were
negatively associated with having cracked tooth symptoms (OR, 0.68; 95%
CI, 0.55-0.84).
CONCLUSIONS:
The
greatest likelihood of a cracked tooth being symptomatic was found when
patients reported clenching or grinding their teeth and had a molar
with a distal crack that blocked transilluminated light.
PRACTICAL IMPLICATIONS:
This information can help inform dentists in the decision-making process regarding the prognosis for a cracked tooth.
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