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Dental Office Handbook

Craze vs. Crack vs. Fracture (From an Insurance Viewpoint)

Terminology and wording used in insurance claims can make a big difference in whether a procedure is or is not reimbursed.

Craze

  • Limited to enamel.
  • Superficial.
  • Shallow.
  • Tip of a dental explorer instrument cannot penetrate into a craze. Might be felt by explorer, but explorer would not stick in it.
  • Do not extend into dentin.
  • Do not necessarily weaken the tooth.
  • Do not necessarily get worse with time.
  • Do not necessarily lead to fractures.
  • Does not stop transilluminated light from shining all the way through the tooth.
  • Are found in most adult teeth.
  • Not visible on x-rays.
  • Long vertical craze lines are common on anterior teeth.
  • Can cross marginal ridges, and can extend along buccal and lingual surfaces.
  • Do not cause pain.
  • Can be considered inconsequential, and do not need to be restored except for possibly cosmetic purposes.

Crack

  • More than just a superficial craze line.
  • Can be thought of as an incomplete fracture.
  • Can be felt with the dental explorer.
  • Tip of dental explorer instrument can penetrate into a crack. An explorer would stick in the crack.
  • Might or might not extend into dentin.
  • Most commonly begin on the occlusal surface and extend apically.
  • If in dentin, crack stops transilluminated light from shining all the way through the tooth.
  • Usually not visible on x-rays unless large.
  • More common in posterior teeth than anterior teeth.
  • Can range in size from very small, to a large split tooth.
  • Can cause Cracked Tooth Syndrome.
  • Treatment needs range from nothing to filling to crown.

Fracture

  • A portion of the tooth is "displaced"; tooth structure is actually gone.
  • Can range in size from small chips, to entire cusp missing.
  • Visibility on x-rays depends on size of missing piece, and presence of other restorations.
  • Treatment often requires crown or onlay.

See also:

 
Written by Jacob Hodara

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