Pain when biting down on a dental crown can be an uncomfortable experience. A dental crown, a cap placed over a damaged tooth, restores its shape, size, strength, and appearance. Pain when chewing or biting signals an underlying issue that warrants attention.
Why Your Crown Might Hurt When You Bite Down
One common reason for discomfort is a high bite or occlusion issue, meaning the crown is slightly too tall. This causes it to make contact with the opposing tooth before other teeth, leading to excessive pressure on the crowned tooth during biting. This imbalance can result in soreness and jaw pain.
A cracked tooth underneath the crown or a fractured crown itself can also cause pain. Hairline fractures in the natural tooth structure beneath the crown or in the crown material can lead to sensitivity to temperature and sharp pain when biting. This can happen from biting on hard foods, teeth grinding, or wear over time.
Gum issues, such as inflammation or recession around the crown, may contribute to pain. Inflammation, known as gingivitis, can occur due to plaque buildup or an ill-fitting crown that irritates the gum tissue. Gum recession can expose the sensitive root surface, leading to discomfort and increased vulnerability to plaque.
New tooth decay forming underneath the crown is another potential cause. Even with a crown, the natural tooth structure beneath remains susceptible to cavities, particularly at the margin where the crown meets the tooth. Decay can lead to sensitivity, persistent discomfort, and a foul taste or odor.
Pulp inflammation or infection, medically termed pulpitis, occurs when the nerve inside the tooth reacts to trauma, decay, or the crowning procedure itself. This can manifest as throbbing pain, sensitivity to temperature, and swelling, potentially leading to an abscess if untreated. An infection can also result from bacteria leaking from old fillings under the crown.
A loose crown can also cause pain and sensitivity. If the cement holding the crown in place fails, the crown can shift slightly, allowing movement and irritation to the underlying tooth. This looseness can permit bacteria to enter, leading to decay or infection.
Habitual teeth grinding or clenching, known as bruxism, places excessive force on the teeth, including crowned ones. This constant pressure can cause soreness in the crowned tooth, jaw pain, and even damage the crown or the tooth underneath. A dentist may recommend a night guard to alleviate pressure.
What to Do When Your Crown Hurts
Avoid biting down on the affected side. Shifting chewing to the opposite side can reduce pressure and discomfort.
Maintaining good oral hygiene around the crown, even if painful, helps remove food debris and plaque. Be gentle to avoid aggravating discomfort.
Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can help manage the pain. These medications can reduce inflammation and provide relief while you await professional dental evaluation. Always follow the dosage instructions.
Rinsing your mouth with warm salt water can help reduce inflammation and soothe the affected area. Mix about half a teaspoon of salt in a glass of warm water and swish for 30 seconds multiple times a day.
Observe other symptoms, such as swelling, sensitivity to hot or cold temperatures, or persistent throbbing, as these details provide valuable information for your dentist. Never attempt to fix or remove the crown yourself, as this could lead to further damage or complications.
When Professional Dental Care is Needed
Persistent pain in a crowned tooth warrants professional dental attention. Seek immediate care if pain is severe, or accompanied by swelling, fever, pus, or a foul taste. Even mild pain lasting more than a few days should be evaluated to identify the cause.
A dentist will typically use several methods to diagnose the issue. This may include a visual inspection of the crown and surrounding gums, bite tests to check for occlusal imbalances, and dental X-rays to look for decay underneath the crown, cracks in the tooth, or signs of infection in the bone. Cold or hot tests might also be used to assess nerve vitality.
Treatment approaches vary depending on the diagnosis. If the crown is too high, a simple bite adjustment can often relieve the pressure. For a loose crown, re-cementing it might be an option if the crown and underlying tooth are healthy.
If decay is present underneath the crown, the dentist may need to remove the crown, treat the decay, and then place a new crown or re-cement the old one if suitable. In cases of significant pulp inflammation or infection, root canal therapy might be necessary to remove the infected tissue and save the tooth. In extreme cases where the tooth is severely damaged or infected and cannot be saved, extraction might be the only option.