A dental crown functions as a cap placed over a damaged tooth, restoring its shape, size, strength, and appearance. When properly fitted, a crown should feel like a natural part of your bite. However, pain when chewing with a crowned tooth is a common concern. This discomfort is often a treatable issue that warrants professional dental attention.
Common Reasons for Crown Pain
Decay can develop beneath or around an existing dental crown. This decay can progress, reaching the sensitive inner layers of the tooth and irritating the nerve, leading to pain when pressure is applied during chewing. Addressing this decay often requires crown removal and replacement.
The natural tooth structure underneath a crown can develop a crack, known as cracked tooth syndrome. This often causes sharp, sudden pain when biting down or releasing pressure. These cracks may be microscopic, requiring professional evaluation for diagnosis.
A crown that does not fit properly or is too high can create an uneven bite, leading to excessive pressure on the crowned tooth. This imbalance can cause pain during chewing as forces are not distributed evenly. Adjustments to the crown’s height are often necessary to alleviate this issue.
Gum tissue around the crown can become inflamed (gingivitis) or recede. Inflammation makes gums tender and sensitive to pressure during chewing. Recession can expose the tooth’s root surface, which lacks enamel protection and is highly sensitive.
Deep decay, traumatic injury, or previous dental work can lead to inflammation or infection of the tooth’s pulp, which contains nerves and blood vessels. This condition, pulpitis, can cause persistent pain that intensifies with chewing or sensitivity to temperature changes. If the pulp is irreversibly damaged, root canal therapy becomes necessary.
Sometimes, pain in a crowned tooth may originate from an adjacent tooth, the sinuses, or temporomandibular joint (TMJ) issues. This is called referred pain. A thorough dental examination helps differentiate the actual source of the pain.
When to See Your Dentist
Any persistent or worsening pain in a crowned tooth warrants immediate dental evaluation. Prompt assessment helps identify the underlying cause and prevents the condition from advancing.
Sharp, acute pain when biting down on food indicates a need for professional attention. This pain often suggests a tooth crack or crown fit issue. Prolonged sensitivity to hot or cold temperatures, especially if it lingers, signals potential nerve irritation.
Swelling or redness around the crowned tooth or gum tissue can indicate infection or inflammation. These visible signs require prompt assessment. If a dental crown feels loose, shifts when chewing, or completely falls off, it indicates a mechanical failure requiring immediate professional intervention.
Diagnosis and Treatment Approaches
A thorough clinical examination is the initial step in diagnosing crown pain. The dentist will visually inspect the crown and surrounding gum tissue, gently tap on the tooth to assess sensitivity, and evaluate gum health. This assessment helps pinpoint visible issues or tenderness.
Dental X-rays are a diagnostic tool, providing images that can reveal decay underneath the crown, bone loss, or an abscess at the tooth’s root. X-rays also help identify crown fit issues or underlying structural problems. A bite analysis, using articulating paper, helps identify “high spots” on the crown receiving excessive pressure during chewing.
Pulp vitality testing involves applying cold or electric stimuli to assess the tooth’s nerve health. This helps determine if the nerve is inflamed or infected, guiding decisions on root canal therapy. These diagnostic methods provide a comprehensive picture of the crowned tooth’s condition.
Simple Adjustments
Once the cause of pain is identified, treatment can begin. If the crown is too high, a bite adjustment can be performed by carefully grinding down small areas of the crown’s surface to restore a balanced bite. This often provides relief from pain caused by uneven pressure during chewing.
Crown Repair or Replacement
If the crown is loose or decay is found underneath, the dentist may attempt to re-cement the existing crown. However, if decay is extensive or the crown is significantly damaged, replacement becomes necessary. A new crown ensures a proper seal and protects the tooth.
Root Canal Therapy and Other Treatments
When the tooth’s nerve is irreversibly inflamed or infected, root canal therapy is performed. This procedure involves removing the infected pulp, cleaning the inside of the tooth, and sealing it. After root canal therapy, a new crown is often placed to protect the tooth. For gum inflammation or periodontal issues, scaling and root planing are performed to restore gum health and reduce sensitivity. In severe cases where the tooth is extensively damaged, extraction may be necessary.
Caring for Your Dental Crown
Maintaining excellent oral hygiene prevents pain and preserves your dental crown’s longevity. Brush twice daily with fluoride toothpaste and floss daily. Pay special attention to flossing around the crown margin to remove plaque and food debris.
Regular dental check-ups and professional cleanings are important for your crowned tooth’s ongoing care. During these visits, the dentist monitors the crown’s integrity, checks for decay or gum issues, and professionally cleans areas. These routine examinations help detect potential problems early.
Avoid hard foods like ice, hard candies, or tough nuts, as they can damage the crown and underlying tooth. Chewing on excessively hard items can cause the crown to chip, crack, or dislodge. Protecting your dental restoration requires mindful chewing.
For individuals who grind or clench their teeth (bruxism), addressing this habit is important. Teeth grinding places excessive stress on dental crowns, leading to pain, cracks, or wear. A custom-fitted nightguard worn during sleep can protect the crown and natural teeth from grinding forces.