Cracked Teeth Clinical Guidelines - Chase Fibers When to Intervene

Cracked teeth — the diagnosis we all hate as Dentists!

How do you decide when to monitor and when to intervene?

What is the recommended intervention at different scenarios of cracks? Should we be chasing cracks and reinforcing with fibers; is there actually enough long-term data to support that approach?

Over the years, we’ve had some epic episodes on this topic — from Kreena Patel’s “I Hate Cracked Teeth” - PDP028 to Dr. Lane Ochi’s Masterclass on Diagnosis and Management.

But in this brand-new episode, Jaz is joined by Dr. Masoud Hassanzadeh (https://www.instagram. com/masoud.hassanzadeh.dds/?hl=en) to bring it all together — not just the diagnosis of cracks, but their management. They explore when to intervene, the role of fibers in preventing propagation, and even the fascinating possibility that cracks in teeth may have some ability to heal, just like bone!

This one’s a deep dive that will change how you talk to patients - and how you approach cracked teeth in your own practice.

Protrusive Dental Pearl - Your patient’s history predicts the future!

- Ask if past extractions were difficult → clues you into anatomical challenges.

- Ask how they lost other teeth → if cracks, be proactive with today’s cracks.

- History isn’t just background—it’s a clinical tool.

Key Takeaways

- Cracks in teeth can be diagnosed using magnification and high-quality imaging.

- Patient factors such as age and muscle strength play a significant role in crack prognosis.

- Symptomatic cracks should be treated to prevent further propagation.

- The healing mechanism of cracks in teeth is possible but varies between enamel and dentin.

- Fibers can be used to strengthen restorations and manage cracks effectively.

- Long-term studies are needed to assess the effectiveness of current crack management protocols.

- The use of fluorescence filters can help identify bacteria in cracks.

- Chasing cracks should be done cautiously to avoid pulp exposure.

- A comprehensive understanding of crack mechanics can improve treatment outcomes.

Highlights of this episode

00:00 Teaser

00:47 Intro

03:08 Protrusive Dental Pearl - The Importance of Dental History

07:18 Interview with Masoud Hassanzadeh

08:22 Diagnosing and Managing Cracks

21:13 When to Intervene on Cracks

25:50 Restoration Techniques and Materials

28:30 Chasing Cracks: Guidelines and Techniques

36:50 Mechanisms of Crack Healing in Teeth

45:11 Exploring the Use of Fibers in Dentistry

52:43 Introducing the Book on Cracked Teeth

54:57 Percussion-Based Diagnostics (QPD)

56:44 Key Takeaways

57:21 Conclusion and Final Thoughts

01:00:07 Outro

Dr. Masoud Hassanzadeh has written two essential books every dentist should own.