Cracked teeth: How hard foods and teeth grinding can take a toll on your smile

07 Apr 2026 | The Straits Times

SINGAPORE – Mr Stephen Neo used to like eating nuts, but the snack habit has taken a painful toll on his teeth.

He had an upper left molar removed after it developed a severe crack in 2016.

“When I bit anything hard or chewed meat, I could feel the spike of pain,” says Mr Neo, 58, a Grab driver. He admits he never saw the dentist regularly before getting the tooth removed.

Three years later, he had another crcked molar extracted at a private dental surgery, this time on the right side of his mouth.In 2020, his dentists at the National Dental Centre Singapore (NDCS) discovered two more cracked molars – which were saved – one with a crown and the other with a root canal treatment. But another cracked tooth a year later had to be extracted in 2022.His sixth and most recent cracked tooth episode occurred in 2023, when he bit on a bone in his chicken rice. He had to undergo root canal and crown treatments, and is now considering dental implants for his three missing molars.

Cases like Mr Neo’s are surprisingly common.

Cracked teeth are typically incomplete fractures of the tooth that are similar to hairline cracks, says Dr Wu Siwen, head and senior consultant from the endodontics unit in the department of restorative dentistry at NDCS.Cracked teeth are the third-most common dental problem – after tooth decay and gum disease – at the NDCS and make up 25 per cent of all cases seen by its endodontists, she adds.

Such dental specialists treat the inflamed or infected nerves of teeth through root canal treatments.“This 25 per cent figure likely represents just the tip of the iceberg. It refers to patients who are motivated to save their cracked teeth through root canal treatment. There is also likely a significant number of people with cracked teeth who have chosen extraction over treatment to retain their teeth.“Hence, the true prevalence of cracked teeth in the population is probably much higher than our data suggests,” Dr Wu explains.

Cracked teeth are also the second-most common reason for primary root canals after tooth decay at Smileworks Endodontic Lounge, says Dr Mandy Leung, a dental specialist in endodontics at the private clinic.

Smileworks is part of Royce Dental Group. The group’s six endodontists see one to two cases of cracked teeth for every 10 patients each day, says Dr Leung.

More than one cause

There are typically multiple reasons behind cracked teeth, experts say.

Biting on hard foods such as nuts, ice cubes and crab shells can be a contributing factor.

“Nuts, despite their nutritional value, are among the hardest foods we commonly eat, and repeated consumption can create the perfect storm for tooth fractures,” says Dr Wu.

The teeth at the back of the mouth – molars, in particular – are the most prone to developing cracks because they bear the load during chewing.

Cracked teeth can also occur because of the heavy loading on a patient’s remaining teeth after multiple extractions and anatomical factors such as teeth alignment and the steepness of tooth grooves, adds Dr Wu.

Grinding or clenching teeth during sleep, known as sleep bruxism, can also predispose one to cracked teeth, says Dr Valerie Tey, a dental specialist in prosthodontics at T32 Dental Group. A prosthodontist restores and maintains oral function, comfort, and appearance for patients with missing or damaged teeth.

Research shows that sleep bruxism is strongly associated with obstructive sleep apnoea (OSA), a sleep disorder where one stops breathing repeatedly because of a complete or partial blockage in the airway. It is estimated to affect one in three Singaporeans. Several studies have shown that effective treatment in individuals with OSA tends to lead to a reduction in sleep bruxism, Dr Tey adds.

At NDCS, cracked teeth tend to occur in patients aged 30 to 60, but Smileworks’ Dr Leung says she is now seeing patients in their 20s.

She attributes this to the increased psychological stress among those in their 20s to 40s, especially during the pandemic. This has been linked to patterns of unconscious muscle contraction such as bruxism. Delays in routine dental care during the Covid-19 years may also have allowed minor defects to progress to cracks that cause pain.

One of Dr Leung’s patients, a woman in her mid-30s, had five cracked teeth out of 28. One had recurring pus and swelling, another hurt when she bit down on it, and three were asymptomatic.

The first tooth was extracted and replaced with an implant, the second is pending a root canal treatment and a crown, and the others will be monitored for symptoms. Dr Leung also referred the patient, who has sleep bruxism, to her primary dentist for a nightguard.

At the same time, Dr Leung sees seniors becoming more aware of their oral health and seeking help to manage cracked teeth before they are completely lost. Ageing affects teeth, which become less resilient and more susceptible to damage.

Seek help early and save your teeth

Cracks in teeth are often difficult to diagnose – even with routine check-ups at general dental practitioners – because they tend to be very fine, Dr Wu says. A diagnosis usually requires a referral to an endodontist and additional clinical and radiographic tests.

One of the early symptoms is pain or sensitivity when a patient chews food or when he or she eats or drinks anything hot or cold.

Teeth with superficial cracks within the enamel – the outermost layer of the tooth – do not usually show symptoms and should be monitored closely, says endodontist Benny Goh from The Endodontic Office, a private dental clinic.

But tooth cracks that extend to the dentine layer below the enamel should be covered with a crown. This may prevent the crack from extending and reduce the risk of a fracture.

In some cases, patients may do an elective root canal treatment before placing the crown if there is a high risk of developing pulpitis, which is inflammation of the innermost layer of the tooth where blood vessels and connective tissue lie, he says.

Dr Wu says cracked teeth can be treated successfully if they are detected and managed early.

If left untreated, the cracks can deepen and bacteria can enter, resulting in severe toothache and swelling as the nerve tissue becomes infected. The teeth may split and have to be extracted.

How fast a crack progresses varies among patients and depends on the individual’s risk factors and lifestyle habits, Dr Wu adds.

A 60-year-old NDCS patient, who wanted to be known only as Mr J.C., says his cracked teeth have caused him much inconvenience.

Since 2020, the self-employed trader has had five cracked teeth because of sleep bruxism. Two of them were extracted and one was replaced with an implant. He also had three crown treatments. Most of the affected teeth were molars.

He recalls having to drink from one side of his mouth because hot or cold drinks would trigger pain in his cracked teeth. In two separate incidents, he had painful cracks in the molars on both sides of his mouth and had to eat soft foods for about six months using only his front teeth.

He also had to have an emergency root canal treatment a few years ago because of unbearable pain.

Mr J.C. has since given up his favourite snack of nuts in favour of other protein sources like meat and tofu.

After his bruxism diagnosis, he started wearing a mouth guard while sleeping. He also sees the Singapore General Hospital’s sleep clinic for OSA.

The experience has taught him not to take his teeth for granted.

“Once I have a problem with my teeth, I will work to get it resolved because you never know when it will happen again,” he says.