The Epidemic of Cracked and Fracturing Teeth by Dr Clark
By Dr. David Clark | Dentistry Today, 2007
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Cracked and fractured teeth are now the third leading cause of tooth loss in industrialized countries. In this influential article, Dr. David Clark explores the contributing factors, the limitations of traditional diagnostic methods, and how modern techniques—including magnification and biomimetic restorations—can help prevent long-term damage.
Key Insights
Why Are Teeth Cracking More Than Ever?
- People are living longer—and teeth are exposed to more wear, clenching, and bruxism.
- Conventional cavity preparations using high-speed handpieces weaken natural tooth structure.
- Aggressive endodontic and full-coverage crown treatments make teeth more susceptible to fracture.
The Power of Magnification in Diagnosis
Many cracks are missed during routine exams. Dr. Clark recommends using 16x magnification microscopes to detect cracks early—before symptoms or visible damage occur. Early detection allows for more conservative treatment planning.
Understanding Crack Types
- Enamel Cracks: Often superficial but may indicate underlying stress.
- Dentinal Cracks: More serious and potentially progressive—require intervention.
- High-Risk Cracks: A sign of imminent tooth fracture if left untreated.
Modern Approaches to Prevention
- Minimally invasive cavity design that preserves strength and reduces flexure.
- Conservative endodontic access and shaping to protect structural integrity.
- Stronger restorative materials like gold and zirconia to reinforce weakened teeth.
- Focus on occlusion and parafunction to manage clenching forces.
Why It Matters
Fracture diagnosis and prevention should be at the forefront of modern dentistry. Dr. Clark’s approach—incorporating high-magnification tools and biomimetic principles—supports a new era of dentistry focused on preservation, prevention, and long-term success.