When a dental crown hurts upon pressure, it signals an underlying issue requiring professional attention. A dental crown, often called a cap, covers the entire visible portion of a tooth, restoring its shape, size, and strength. While the crown itself is inert and cannot feel pain, the natural tooth structure, nerves, and surrounding tissues beneath it remain vulnerable to problems. The discomfort you feel originates from these living components reacting to a mechanical, inflammatory, or infectious issue.
Structural Problems with the Crown
Pain felt when biting or pushing can sometimes be traced to the physical integrity or fit of the restoration. A dental crown is bonded to the underlying tooth using specialized cement to create a tight seal. If this cement washes out, the crown can become loose or develop micro-gaps at the margin where the crown meets the tooth structure.
This lack of a tight seal allows external forces, such as pressure, to cause slight movement of the crown against the tooth, irritating the sensitive tissue underneath. A crack or fracture in the crown itself, which can occur from trauma or biting on a hard object, compromises the structure’s ability to protect the tooth. When pressure is applied, the fractured pieces may flex, causing sharp, localized pain. An ill-fitting crown may also leave an opening, allowing bacteria to penetrate and cause underlying problems exacerbated by chewing forces.
Issues Originating in the Tooth Pulp or Root
The most common reasons for pressure pain involve the nerve tissue inside the tooth, known as the dental pulp, or infection at the root tip. Recurrent decay beneath the crown is a frequent culprit, where bacteria leak through a compromised margin and dissolve the remaining tooth structure. As decay progresses, it gets closer to the pulp chamber, causing inflammation of the nerve, a condition called pulpitis.
Pressure on the crown transmits force directly to the inflamed pulp, resulting in acute pain. If the nerve damage is severe and the inflammation becomes irreversible, the pulp tissue begins to die. This can lead to a periapical abscess, a pocket of pus forming at the root tip. Pressing on the crown in this scenario pushes the tooth down, compressing the sensitive, infected tissue and bone surrounding the root, causing a severe, throbbing ache. The pain from an abscess may also radiate to the jaw or ear, signaling a deep bacterial infection that requires immediate treatment.
Pain from Surrounding Tissue
Sometimes, the source of pressure-related pain is external to the tooth itself, involving the bite or the gum tissue. A crown that is slightly too tall interferes with the way the upper and lower teeth meet, a problem known as occlusal trauma. When you bite down, this high point receives excessive force, which overloads the periodontal ligament and bone supporting the tooth, leading to soreness and discomfort. Your dentist can often fix this with a simple adjustment to reshape the crown’s surface.
Localized gum inflammation, or gingivitis, around the crown margin can also cause tenderness when pressure is applied. This may be due to poor oral hygiene allowing plaque buildup, or because an ill-fitting crown margin physically irritates the gingiva. A more chronic issue like teeth grinding or clenching, known as bruxism, applies constant, excessive force to the crowned tooth and its supporting structures. This chronic overload can cause the tooth to become tender, making it painful to chew or push on.
What to Do Until You See the Dentist
Since pain upon pressure indicates an active problem, scheduling an appointment with your dentist is the most important step. In the meantime, you can manage the discomfort with over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, which help reduce inflammation around the tooth and surrounding tissues. Always follow the dosage instructions.
Adjusting your diet and chewing habits can also provide temporary relief. Avoid chewing hard, sticky, or crunchy foods, and try to chew exclusively on the opposite side of your mouth to minimize force on the painful crown. You should also watch for specific signs that signal a potentially spreading infection requiring emergency care. These red flags include facial swelling, a fever, or difficulty swallowing or breathing; seek immediate professional attention if any of these symptoms develop.