The first sign of cracked tooth syndrome may be when a part of a tooth actually falls away such as with a broken cusp. This may be a precursor to, or a hint of other unseen fractures within the tooth.

On the other hand, a tooth with a "green stick" fracture may never break apart. Instead they may have symptoms of pain upon biting. This often is a sharp, quick pain that is not easy to reproduce at will. It may be felt only occasionally when the patient chews just a certain way. Or a cracked tooth may be tender to all pressure or even sensitive to other stimuli. Sometimes it is hard for the patient and the dentist to be sure which tooth is affected.

Sometimes a routine dental procedure will "bring to light" or exacerbate an existing "cracked tooth syndrome".

A bonded resin restoration often solves cracked tooth syndrome. A crown (cap) usually solves it. Sometimes a crown does not solve it because the dental pulp is irreversibly inflamed and root canal therapy will be necessary. This can be done after a crown is placed by drilling through it. A patient may opt to have root canal therapy before trying a crown to avoid disturbing the crown, "just in case".

Once in awhile, this syndrome results in recurring problems at the neck of the tooth or in the root of the tooth even after a crown has been placed or root canal therapy performed. These problems include breakage, leakage or other failures. There can even be a vertical root fracture that eventually necessitates removal of the tooth itself.

It is heartening, however, to know that most teeth with cracked tooth syndrome can be managed with just a bonded restoration or, more likely, a crown.

It has been postulated that cracked tooth syndrome is more common in recent years due to an increase in clenching and grinding, resulting from modern day stress. Dentists can fabricate night guards to help protect teeth from such a habit.