Last updated: April 2026. Information sourced from NHS.uk, NHSBSA, NHS England, Gov.uk, Gov.wales, NHS Inform (Scotland), HSCNI Business Services Organisation, the British Dental Association (BDA), the American Association of Endodontists (AAE), and peer-reviewed clinical research. NHS dental charges verified from 1 April 2026.
A cracked tooth is not the same as a chipped tooth, and the difference matters. A chip takes a piece off the outer enamel and is usually cosmetic. A crack is a fracture that can travel through the tooth toward the root, irritate the pulp, and, if left alone, split the tooth or force an extraction. Most cracks need a dentist within days, not weeks.
This guide covers the five clinical types of cracked teeth, how to recognise the symptoms, what to do in the first 24 hours, when to call NHS 111, the 2026 NHS and private treatment costs, what recovery looks like, and how to stop it happening again.
If your tooth is cracked and painful right now:
- Stop chewing on that side and rinse with warm water
- Take paracetamol or ibuprofen at the doses printed on the packet
- Call your dentist, or call NHS 111 (free, 24/7) if you do not have one or the practice is closed
- If your face is swelling, you cannot swallow, or you cannot breathe comfortably, call 999 or go to A&E
What Is a Cracked Tooth? (And How It Differs From a Chip)
The NHS groups chipped, broken, and cracked teeth on the same advice page because the first-aid steps overlap, but clinically they are three different problems.
"A cracked tooth means a crack extends from the chewing surface of your tooth vertically toward the root."
-- American Association of Endodontists, Cracked Teeth
A chipped tooth loses a fragment of enamel, the hard outer shell. A crack is a fracture line running through the tooth, and it can extend into the inner layers (dentine and pulp) without taking any visible piece away. This is why a tooth can be cracked and still look completely normal.
Two facts explain why cracks are more serious than chips:
- Cracks do not heal. The AAE is explicit: "Unlike a broken bone, the fracture in a cracked tooth will not heal." Each bite can work a crack wider.
- Cracks move toward the nerve. As the fracture propagates, it exposes dentine and eventually the pulp chamber, triggering pain, infection, or both.
For the practical first-aid steps that overlap with a chipped tooth, see our chipped tooth repair guide.
The 5 Types of Cracked Teeth
Dentists classify tooth cracks into five types, using a framework set out by the American Association of Endodontists and used in UK clinical literature including the British Dental Journal. The type determines the treatment and the prognosis.
| Crack type | Depth | Typical symptoms | Usual treatment | Can the tooth be saved? |
|---|---|---|---|---|
| Craze lines | Enamel only | None | None needed | Yes (no threat) |
| Fractured cusp | Through a cusp, above gum | Mild, localised | Filling or crown | Almost always |
| Cracked tooth (CTS) | Biting surface toward root | Intermittent sharp pain | Crown, possibly root canal | Usually if caught early |
| Split tooth | Fully through tooth | Severe pain, mobility | Extraction or hemisection | Sometimes (part of tooth) |
| Vertical root fracture | Root upward | Vague ache, swelling | Extraction | Rarely |
Craze Lines (Enamel Only)
Craze lines are hairline cracks in the outer enamel. They are very common in adult teeth, especially from middle age onward, and they do not cause pain. Your dentist may point them out at a routine check-up. They can pick up surface staining over time but they do not threaten the tooth. No treatment is needed.
Fractured Cusp
A fractured cusp is when one of the pointed biting corners (cusps) of a back tooth breaks off, usually around the edge of an existing filling. The break tends to stay above the gum line. Because the pulp is rarely exposed, pain is mild or limited to sensitivity. A new filling or a crown restores the chewing surface. Root canal treatment is unusual unless the fracture is deep.
Cracked Tooth (Cracked Tooth Syndrome)
This is the middle type, the one most people have in mind when they ask about a cracked tooth. The crack runs vertically from the biting surface down toward (but not yet into) the root, while the tooth remains in one piece. It is the hardest type to diagnose because:
- Pain comes and goes, often triggered by biting down and released when pressure lifts
- Cold and sweet food can cause a brief wince of pain
- Standard X-rays often cannot see the crack
Cracked tooth syndrome responds well to prompt treatment. Research published in the peer-reviewed literature shows teeth restored with a crown after root canal treatment have a two-year survival rate of 94%, compared with only 20% if the crown step is skipped.
Split Tooth
A split tooth is a cracked tooth that has been left too long. The fracture has now travelled the full depth and depth of the tooth, separating it into two segments that can move independently. The split often extends below the gum line. In most cases the whole tooth needs to come out, though in multi-rooted molars a dentist may be able to save one root through a procedure called hemisection.
Vertical Root Fracture
Vertical root fractures start in the root and travel upward. They are most common in teeth that have already had root canal treatment, because removing the pulp reduces the tooth's internal moisture and flexibility. Symptoms are often subtle: a dull ache, a gum swelling or "pimple" (sinus tract) over the affected root, occasional tenderness. Standard dental X-rays frequently miss them because the crack runs in the same direction as the X-ray beam. CBCT (cone-beam computed tomography) scans detect them more reliably, but even CBCT can miss very narrow fractures. Treatment is almost always extraction.
Cracked Tooth Symptoms: How to Tell if Your Tooth Is Cracked
A cracked tooth does not always look cracked. Symptoms, not appearance, are the main clue.
"Cracked teeth show a variety of symptoms, including erratic pain when chewing, possibly with the release of biting pressure, or pain when your tooth is exposed to temperature extremes."
-- American Association of Endodontists, Cracked Teeth
Sharp Pain on Biting (Especially on Release)
The classic sign of cracked tooth syndrome is a short, sharp pain as you bite down on something firm. Many patients notice the pain actually lands when they stop biting and the pressure lifts, because that is the moment the crack closes back onto the irritated pulp. This "release pain" is one of the few signs a dentist treats as virtually diagnostic.
Sensitivity to Cold, Hot, or Sweet
A quick stab of pain from a cold drink, a hot cup of tea, or a biscuit that disappears within a few seconds is a common early sign. It happens because dentine, which sits below the enamel, is sensitive to temperature and sugar when it is exposed by a crack.
Intermittent, Hard-to-Locate Pain
Cracked tooth pain tends to come and go, and most people struggle to point to the exact tooth. You may find yourself unconsciously chewing on the other side of your mouth. That shift is worth mentioning at your appointment because it helps the dentist narrow down which tooth to test.
When There Are No Symptoms at All
Not every crack causes pain. Craze lines never do. Early cracked tooth syndrome can stay quiet for months. Vertical root fractures are often silent until an infection sets in. This is one of the reasons regular dental check-ups matter: your dentist can spot cracks you have not yet felt.
Signs That Suggest the Nerve Is Involved (More Urgent)
- Pain that lingers for 30 seconds or more after cold or hot stimulus
- A constant dull ache, especially one that wakes you at night
- Tenderness when you press along the gum line
- A gum "pimple" or swelling over a single tooth
- A persistent bad taste near the affected tooth
What to Do Right Now: First Aid for a Cracked Tooth
The First 60 Minutes
Working through this short list will protect the tooth and settle the pain until you can be seen.
- Stop chewing on that side. Each bite opens the crack further.
- Rinse with warm water. Do not use hot or ice-cold water, and do not probe with your tongue.
- Check for pieces. If a fragment of the tooth has broken away, keep it in a clean container of milk or saliva and take it with you to the dentist.
- Cover a sharp edge. A small piece of sugar-free chewing gum (not chewed) or a dental wax can smooth a jagged edge so it does not cut your tongue or cheek.
- Call your dentist or NHS 111. See the emergency section below for the full triage.
For the wider triage of what to do when no NHS appointment is available, see our dental emergency guide.
Safe Pain Relief (NHS Guidance)
Both paracetamol and ibuprofen are appropriate for cracked tooth pain in adults.
Paracetamol (adult dosing per NHS.uk): 1 or 2 x 500mg tablets up to four times in 24 hours, with at least four hours between doses. Do not exceed 8 tablets in 24 hours.
"Do not take or use paracetamol for more than 3 days unless a doctor tells you to."
-- NHS.uk, Paracetamol for Adults
Ibuprofen (adult dosing per NHS.uk): 1 or 2 x 200mg tablets up to three times a day (maximum 6 x 200mg tablets in 24 hours), or 1 x 400mg tablet up to three times a day, always with or after food. Do not use ibuprofen for more than 10 days without medical advice.
Adults can take paracetamol and ibuprofen together if one alone is not enough. If you have asthma, a stomach ulcer, kidney or heart problems, or you are pregnant, speak to a pharmacist before taking ibuprofen. For more on nighttime pain management, see our toothache at night guide.
What Not to Do
- Do not put aspirin directly on the gum. It will cause a chemical burn.
- Do not use superglue or household adhesive on the tooth. It is toxic, prevents proper repair, and can bond soft tissue.
- Do not ignore it. A crack does not heal, and a week of "wait and see" can be the difference between a filling and an extraction.
When Is a Cracked Tooth a Dental Emergency?
NHS England uses a three-tier clinical triage: emergency (60 minutes), urgent (24 hours), and non-urgent (7 days).
Call 999 or go to A&E if:
- Your face is swelling, especially toward your eye or under your jaw
- You cannot breathe, swallow, or speak comfortably
- You have had a significant facial injury alongside the cracked tooth
"Call 999 or go to A&E if you: are finding it hard to breathe, speak or swallow."
-- NHS.uk, Dental Abscess (applies to any dental swelling that compromises the airway)
Seek urgent dental care (within 24 hours) if:
- Pain is severe and not controlled by paracetamol and ibuprofen at the doses above
- You have facial swelling that is not spreading
- You have a fever alongside the dental pain
- You cannot open your mouth fully
Book a routine urgent appointment (within 7 days) if:
- You have intermittent biting pain but no swelling or uncontrolled pain
- Your tooth is sensitive to temperature but settles quickly
- A small piece of the tooth has broken off but you are comfortable
"You should be offered urgent dental treatment within 24 hours or 7 days, depending on your symptoms."
-- NHS.uk, Find an NHS Dentist in an Emergency
For a wider view of urgent access, see our emergency dentist UK guide.
How Dentists Diagnose a Cracked Tooth
Because standard X-rays often miss cracks, dentists use several hands-on tests:
- Bite test (Tooth Slooth or FractFinder): you bite down on a small plastic device cusp by cusp. A sharp pain on release, rather than on biting, strongly suggests cracked tooth syndrome.
- Transillumination: a fine bright light shone through the tooth. A crack that reaches the dentine blocks light and shows as a dark line.
- Dye staining: methylene blue or gentian violet painted on the tooth. The dye seeps into a crack and makes it visible, sometimes over 2 to 5 days.
- Intraoral camera: a pen-sized camera that lets your dentist photograph and magnify the suspected crack.
- Periodontal probing: a narrow, deep pocket next to a tooth can indicate the crack extends below the gum.
- Standard X-ray (periapical): limited for seeing the crack itself, but useful for checking bone around the root and ruling out abscess.
- CBCT scan: a 3D scan used when a vertical root fracture is suspected and other tests are inconclusive.
Peer-reviewed research confirms the X-ray limitation:
"The cracked tooth fracture extends in the mesiodistal direction, it is not visible on periapical radiographs."
-- PMC review of cracked tooth diagnosis, PMC3467890
NHS Treatment Routes and Charges (April 2026)
How to Access Urgent Dental Care on the NHS
If you have a registered dentist, call them first. Many practices keep a small number of emergency slots for existing patients. If you do not have a dentist, or your practice is closed, call NHS 111 (free, 24/7) or use 111.nhs.uk. NHS 111 can triage your symptoms and book you into an urgent dental service.
NHS 111 is now able to directly book urgent dental appointments in a growing number of areas in England, a pilot that has delivered close to 10,000 urgent dental bookings since May 2024.
NHS Dental Charges in England (from 1 April 2026)
Cracked tooth treatment falls under the standard NHS dental bands. You pay the single highest band charge per course of treatment, even if the course takes multiple appointments.
| Band | Charge | Cracked tooth treatments included |
|---|---|---|
| Band 1 | £27.90 | Examination, X-rays, diagnosis |
| Band 2 | £76.60 | Filling, composite bonding, root canal, extraction |
| Band 3 | £332.10 | Crown, onlay, bridge |
| Urgent | £27.90 | Emergency assessment, temporary filling, pain relief |
Source: NHS.uk dental costs and NHSBSA, both confirmed for April 2026.
The 12-month NHS guarantee. Crowns, fillings, root fillings, inlays, onlays, and veneers are guaranteed for 12 months. If the same treatment fails within that period and you return to the same practice, the repair or replacement is free.
Free NHS Dental Treatment
You pay nothing for NHS dental treatment in England if you are:
- Under 18, or under 19 and in full-time education
- Pregnant or within 12 months of giving birth
- Receiving Income Support, income-based Jobseeker's Allowance, income-related Employment and Support Allowance, or Pension Credit Guarantee Credit
- Named on a valid NHS tax credit exemption certificate or HC2 certificate (full help) or HC3 certificate (partial help)
NHS Charges Across the UK
| Nation | Exam | Crown (patient charge) | Root canal (patient charge) |
|---|---|---|---|
| England | £27.90 (Band 1) | £332.10 (Band 3) | £76.60 (Band 2) |
| Wales | £27.21 new patient / £25.00 recall | £140.44 | £91.18 (front) to £182.72 (back) |
| Scotland | Free for everyone | 80% of cost, capped £384 | 80% of cost, capped £384 |
| Northern Ireland | 80% of cost, capped £384 | 80% of cost, capped £384 | 80% of cost, capped £384 |
Sources: Gov.wales, NHS Inform Scotland, HSCNI BSO. Scotland offers free dental examinations to all and free treatment to everyone under 26. Wales uses a per-item charge model with a £384 cap.
The NHS Access Reality
It is important to be honest about access. According to the British Dental Association, 13 million adults in England (around 28% of the adult population) are unable to access NHS dentistry.
"NHS dentistry has effectively ceased to exist for millions across this country."
-- Shawn Charlwood, Chair of the General Dental Practice Committee, British Dental Association
The government pledged 700,000 extra urgent dental appointments for 2025-26 and reports that 1.8 million additional courses of treatment were delivered in the first seven months of that year. A reformed dental contract is expected from April 2026. In the meantime, urgent triage through NHS 111 is the fastest route for most people without a registered dentist.
Private Treatment Options and Costs (2026)
Private emergency dentists typically offer same-day or next-day appointments. Expect to pay a consultation fee of £50 to £150 before any treatment. The treatment cost depends on the crack type and the material chosen.
Typical UK Private Prices
| Treatment | Typical UK range | London premium |
|---|---|---|
| Composite bonding (minor crack) | £200 to £500 per tooth | £250 to £600 |
| Porcelain-fused-to-metal crown | £500 to £800 | £700 to £1,100 |
| All-ceramic or porcelain crown | £600 to £900 | £800 to £1,200 |
| Zirconia crown | £600 to £950 | £800 to £1,300 |
| E.max (lithium disilicate) crown | £650 to £1,000 | £900 to £1,400 |
| Root canal (front tooth) | £400 to £700 | £500 to £800 |
| Root canal (premolar) | £500 to £800 | £600 to £900 |
| Root canal (molar) | £700 to £1,100 | £900 to £1,300 |
| Simple extraction | £100 to £250 | £150 to £350 |
| Single implant (after extraction) | £1,800 to £4,500 | £2,500 to £5,500 |
These are market-aggregated ranges verified across UK private practice price lists in April 2026. Individual practice quotes can vary. Central London clinics typically sit 20% to 30% above the national average.
For a full crown price breakdown, see our dental crowns cost UK guide. For root canal specifics, see the root canal treatment UK cost guide. If extraction is needed, our tooth extraction cost UK guide covers both NHS and private options, and our missing tooth replacement options guide compares implants, bridges, and dentures.
Treatment by Crack Type: What Your Dentist Will Recommend
The treatment that works depends on where the crack is and how deep it goes.
- Craze lines: no treatment. Whitening can reduce the staining some craze lines collect.
- Fractured cusp: composite filling if the break is small, or a full crown if a large share of the cusp has gone. Pulp involvement is rare.
- Cracked tooth syndrome (early): a full-coverage crown to hold the tooth together and stop the crack progressing. Your dentist may first fit a temporary orthodontic band or a provisional crown for a few weeks to test whether the pulp settles.
- Cracked tooth syndrome (pulp involved): root canal treatment followed by a crown. Without the crown, survival drops sharply.
- Split tooth: extraction in most cases. For multi-rooted molars, hemisection followed by a crown on the remaining portion is sometimes possible.
- Vertical root fracture: extraction is almost always the only option. Endodontic surgery to remove the fractured root section is rare and case-dependent.
Recovery: What to Expect After Treatment
- Composite bonding or filling: one appointment, fully functional immediately. Mild temperature sensitivity for a few days.
- Crown (no root canal): usually two appointments about two weeks apart, with a temporary crown in between. Mild temperature sensitivity for the first few weeks is normal. A well-made NHS crown is expected to last around 8 to 10 years.
- Root canal treatment: one to two appointments of 1 to 2 hours each. The NHS notes the treated area "may feel swollen and sore but it should get better in a couple of weeks." Paracetamol or ibuprofen at standard doses is appropriate for post-procedure soreness.
- Extraction: local anaesthetic, usually under 30 minutes. Swelling and soreness for 2 to 3 days. Avoid smoking, vigorous rinsing, and strenuous exercise for the first 24 hours.
Can a Cracked Tooth Heal Itself?
No. Enamel and dentine do not regenerate in the way bone does. Superficial craze lines stay stable without treatment, but a true crack will propagate over time with every bite. Even a crack that seems painless today can widen into a split, expose the pulp, or reach the root.
The practical implication: if you have been told by a dentist that you have a cracked tooth, book the recommended treatment. Delay usually means a bigger, costlier repair later.
How to Prevent Tooth Cracks
Not every crack is avoidable (age and genetics play a part), but several everyday factors are well documented.
- Treat teeth grinding. Bruxism puts sustained excess force on teeth overnight. A custom-made night guard from your dentist is the single most effective protection if you clench or grind. The NHS describes bruxism as causing "worn-down or broken teeth, which can cause increased sensitivity, and loss of teeth and fillings."
- Wear a mouthguard for contact sports. A custom-fitted mouthguard from your dentist fits better, protects more, and lasts longer than a boil-and-bite from the sports shop.
- Stop chewing ice, boiled sweets, and pen lids. Ice cubes in particular are a common cause of cusp fractures.
- Keep existing fillings under review. A large old filling weakens the surrounding tooth and raises fracture risk significantly. Peer-reviewed research from 2022 reports that restorative procedures can "increase the risk of cracked teeth by almost 29 times" compared with unrestored teeth. If your dentist recommends replacing a very large filling with an onlay or a crown to protect the tooth, it is worth doing.
- Attend regular check-ups. Your dentist can spot a crack at the enamel stage, well before it causes pain.
- Keep the tooth clean at the margin. Brush twice daily with fluoride toothpaste and clean between the teeth. For technique, see our guide on how to floss and use interdental brushes.
Frequently Asked Questions
Can a cracked tooth heal on its own?
No. Tooth enamel does not regenerate, and a true crack will widen over time with ordinary chewing. The American Association of Endodontists states: "Unlike a broken bone, the fracture in a cracked tooth will not heal." Craze lines (enamel-only) stay stable without treatment, but every other crack type needs dental care.
How much does it cost to fix a cracked tooth on the NHS?
In England from April 2026, a filling for a cracked tooth costs £76.60 (Band 2). A crown, with or without root canal treatment in the same course, costs £332.10 (Band 3). An urgent emergency assessment alone is £27.90. Wales, Scotland, and Northern Ireland have different charging structures, summarised in the table earlier in this guide. Many patients qualify for free NHS dental treatment.
What does a cracked tooth feel like?
The classic sign is a sharp, short pain when biting on something firm, often landing as you release the bite rather than as you press down. You may also feel quick stabs of pain from cold drinks or sweet food that disappear within seconds. The pain is typically intermittent and hard to place, which is why cracked teeth can take weeks to diagnose.
Is a cracked tooth a dental emergency?
Not always. A cracked tooth with no pain or swelling is usually urgent within a week. A cracked tooth with severe pain that is not controlled by paracetamol and ibuprofen, or with facial swelling or fever, needs urgent care within 24 hours through your dentist or NHS 111. If the swelling is spreading to your neck, or you cannot breathe or swallow, call 999 or go to A&E.
Can I get a cracked tooth treated the same day?
Often, yes. If you have a registered NHS dentist, call the practice first as most hold a small number of emergency slots. If not, call NHS 111 for a triage appointment, or book a private emergency dentist, which typically offers same-day availability at a consultation fee of £50 to £150 plus treatment.
Does a cracked tooth always need a crown?
No. Craze lines need no treatment. A fractured cusp often needs only a filling. Early cracked tooth syndrome can sometimes be managed with composite bonding. Once the crack is sizeable, or the pulp is involved and root canal treatment is needed, a full-coverage crown is the standard recommendation because it dramatically improves survival. Research shows cracked teeth restored with a crown after root canal treatment have a 94% 2-year survival rate, compared with only 20% without the crown.
Can my dentist see a cracked tooth on an X-ray?
Often not. Standard dental X-rays miss most cracks in the crown of the tooth because the fracture runs in the same direction as the X-ray beam. Dentists use a bite test with a Tooth Slooth, transillumination, dye staining, and an intraoral camera to identify cracks. A CBCT (3D) scan is used when a vertical root fracture is suspected and the other tests are inconclusive.
Can teeth crack from grinding?
Yes. Bruxism is one of the most commonly identified causes of cracked teeth, alongside large old fillings and age-related wear. A custom-fitted night guard, prescribed by a dentist, is the most effective protection. For a full guide to bruxism management and NHS options, see our teeth grinding treatment guide.
A crack you catch early is a crown. A crack you ignore is often an extraction. If you think you have a cracked tooth, do not wait for the pain to get worse.
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