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:

• Cracked Tooth Syndrome