Dental crowns are tooth-shaped caps that are fitted over damaged or decayed teeth to help restore their shape and function. When appropriately placed, they can improve appearance and chewing ability. In restorative dentistry, they are commonly used after procedures such as large fillings or root canal treatment.
While dental crowns are widely used and generally successful, complications may still occur. Some people experience discomfort, wear, or changes in bite. Understanding these potential issues is important before proceeding with any dental procedure.
With regular dental care and attention to any early signs, many crown-related problems can be addressed promptly, preventing the situation from worsening. This blog shares useful information to help patients understand and manage possible complications of a crown. Learning about these challenges can help you feel more confident in discussing options with a dental professional.
Content Navigation
- 1 Summary of The Content
- 2 Types of Dental Crowns
- 3 Common Complications After Getting a Dental Crown
- 4 Long-Term Complications of Dental Crowns
- 5 Preventing Dental Crown Complications
- 6 When to Seek Professional Help
- 7 Modern Crown Technologies and Reduced Complications Associated with Dental Crowns
- 8 Final Thoughts
Summary of The Content
- Dental crowns are made from materials like porcelain, metal, porcelain-fused-to-metal, and zirconia, each with different strengths and disadvantages.
- Common complications after receiving a crown include discomfort, sensitivity, fit issues, allergic reactions, and damage like chips or fractures.
- Sensitivity is often temporary, but sharp or prolonged pain may signal an issue needing prompt attention from a dentist.
- Poor crown fit may cause bite problems, jaw discomfort, or flossing difficulty, but these concerns are often managed with minor adjustments.
- Although rare, allergic reactions to metallic crowns can occur and may present as inflammation, rash, or an unusual taste.
- Long-term problems may involve loosening, decay beneath the crown, gum recession, or gradual wear, which can develop over time.
- Maintaining good oral hygiene, attending regular check-ups, and modifying habits can greatly reduce the risk of crown-related issues.
- Advances in materials and digital technology have improved crown durability and fit, lowering the likelihood of complications.
Types of Dental Crowns
Dental crowns are made from different materials, each offering specific benefits and considerations. While all are designed to protect and restore damaged teeth, the material used can influence comfort, function, and the potential for certain complications.
Porcelain Crowns
Porcelain crowns are commonly used in restoring front teeth due to their natural tooth colour and translucency, which helps them blend well with surrounding teeth. However, they may be more prone to chipping or cracking, especially when exposed to strong biting forces. Their strength is generally sufficient for lower-stress areas in the mouth, making them a suitable option for restoring weak or damaged teeth in visible areas.
Metal Crowns
Metal crowns, which are usually made from gold or other metal alloys, are highly durable and less likely to wear down over time. While generally well-tolerated, the metallic colour of the crown tends to limit the application of metal crowns. These crowns are often used on molars, where the ability to withstand strong biting forces is essential.
Porcelain-fused-to-metal (PFM) Crowns
Porcelain-fused-to-metal crowns combine a metal substructure with a porcelain coating to balance strength and aesthetics. Over time, the metal edge may become visible near the gum line, especially if gum recession occurs. In some cases, the porcelain surface can wear or chip with extended use.
Zirconia Crowns
Zirconia crowns are made from a strong ceramic material that is both durable and tooth-coloured. Although less likely to fracture, their hardness can sometimes contribute to wear on opposing teeth. They are increasingly used for both front and back teeth due to their strength and appearance.
The choice of crown material depends on several factors, including the tooth’s location, bite forces, and the individual’s oral health. Each dental crown material comes with potential complications, which should be considered during treatment planning.
Common Complications After Getting a Dental Crown
While dental crowns are generally reliable and widely used in restorative dentistry, certain issues can sometimes occur. Recognising potential concerns early can help prevent more complex problems and support long-term crown success. Below are some of the more common complications of a crown that patients may experience after placement:
Sensitivity and Discomfort
It’s common to feel some tooth sensitivity after the dental crown process, especially when consuming hot or cold foods like coffee or ice cream. This type of sensitivity is usually mild and should begin to settle within the first few days. In some cases, it may take up to two weeks for the tooth and surrounding tissues to fully adjust.
However, if the discomfort continues beyond two weeks or becomes more intense, it may indicate a problem. Sharp pain when biting down or persistent sensitivity to heat or cold may indicate an issue with the crown’s fit or the tooth nerve. If symptoms persist, your dentist may need to adjust the crown or, in some cases, replace it. This helps keep the tooth protected and reduces the risk of further complications.
Crown Fit Issues
An improperly fitted crown can cause pain when biting, a feeling that the tooth sits too high, or difficulty flossing around the crown. These symptoms may indicate the crown isn’t aligning properly with the surrounding or opposing teeth. This can interfere with eating and everyday oral care.
Over time, a poor fit may lead to uneven bite pressure, jaw muscle strain, or discomfort in the jaw or temporomandibular joint (TMJ). It may also contribute to headaches or excessive wear on surrounding teeth. These concerns are often addressed through minor adjustments during a follow-up dental appointment.
Allergic Reactions
Allergic reactions to dental crown materials are uncommon but can occur. Symptoms may include localised inflammation, a rash near the crown, or an unusual taste in the mouth. These reactions are rare and often mild, but they should be assessed if they arise.
Patients with known allergies or sensitivities should mention this during their consultation so that alternative materials can be considered. Zirconia or all-ceramic crowns are options in such cases. Recognising the low risk of true allergic reactions helps patients feel more at ease and approach their treatment options with confidence.
Crown Damage
Dental crowns can develop chips, cracks, or fractures, especially after biting hard foods, grinding teeth, or experiencing trauma to the mouth. While they are built for strength, some materials may be more prone to wear or surface damage over time.
A dentist will examine the crown to decide whether it can be smoothed, restored, or needs to be replaced entirely. Minor damage may be managed with adjustments or bonding techniques. However, more serious fractures often require a new crown to restore strength and protect the tooth underneath.
Cement Washout
Cement washout occurs when the material holding the crown in place begins to dissolve or wear away over time. This may happen due to saliva exposure, acidic foods, or gradual breakdown from natural chewing forces.
When cement weakens, it may result in a loose dental crown, causing slight movement during chewing. It may also lead to a strange taste or mild sensitivity near the gum line. When addressed early, the crown can often be re-cemented without further complications. Delaying care allows bacteria to enter and affect the tooth underneath, leading to recurrent decay that may require root canal treatment.
Long-Term Complications of Dental Crowns
Over time, changes in the mouth or wear to the crown may lead to certain complications. These issues often develop gradually and may not cause immediate discomfort. Being aware of what to look for can support long-term oral health and help maintain the function of your crown.
Crown Loosening or Falling Off
Crowns are designed to remain securely attached to the tooth, but in some cases, they can loosen or fall off. This may occur suddenly or develop gradually without obvious symptoms.
Common Causes of Crown Loosening or Detachment:
- Cement Washout:
Over time, the dental cement holding the crown in place may weaken or dissolve, reducing its ability to keep the crown secure. - Tooth Decay Beneath the Crown:
Decay around the edges of the crown can compromise the tooth structure and affect how well the crown stays in place. - Physical Trauma:
A fall, blow to the mouth, or biting into something hard can result in a loose crown or cause it to come off. - Grinding or Clenching:
Excessive pressure from grinding or clenching, especially at night, can detach an ill-fitting crown or cause it to loosen over time.
If you encounter dental crown problems like these, taking prompt action can reduce the risk of further damage and improve the chances of reattachment.
What to Do if a Crown Comes Loose or Falls Off:
- Remove and Store the Crown:
Take the crown out of your mouth to prevent swallowing it, and place it in a clean, secure container. - Rinse the Crown Gently:
Rinse the crown under lukewarm water to remove any debris, but avoid scrubbing or using strong chemicals. - Avoid Chewing on That Side:
Eat soft foods like yoghurt and smoothies, and avoid chewing on the side of the mouth where the crown came off.
While not always painful, a loose or missing crown should be addressed promptly to protect the tooth underneath and avoid further complications. Consult your dentist as soon as possible to arrange an appointment and discuss whether the crown can be reattached.
Decay Under the Crown
Even with a crown in place, decay can still form where the crown meets your natural tooth. This occurs when patients fail to brush and floss regularly. Changes in the crown’s fit may also create small gaps that allow bacteria to enter.
Signs That Decay May Be Present Under a Crown:
- Increased Sensitivity:
You may notice heightened sensitivity to hot, cold, or sweet foods. - Persistent Discomfort or Pain:
Persistent discomfort that doesn’t improve may indicate decay beneath the crown. - Darkening Near the Gum Line:
A grey or brown line at the edge of the crown may be a sign of decay at the margin. - Bad Taste or Odour:
Bacterial buildup under the crown may cause an unpleasant taste or smell that doesn’t go away with brushing.
Regular dental check-ups play a key role in identifying decay early, often before symptoms become noticeable. During these visits, your dentist can assess the integrity of the crown, examine the surrounding tooth structure, and recommend appropriate care if changes are detected.
Gum Recession Around Crowns
Gum recession can occur around natural teeth as well as crowned teeth. It often develops gradually and may be influenced by several contributing factors.
Common Causes of Gum Recession Around Crowns:
- Natural Ageing:
Gum tissue naturally recedes with age, exposing more of the tooth or crown and increasing the risk of gum disease. - Improper Brushing Technique:
Brushing too hard or using a stiff-bristled toothbrush can cause the gums to recede over time. - Plaque and Inflammation:
Plaque buildup near the gum line can lead to inflammation, which may eventually cause the gum tissue to recede. - Poorly Fitting Crown Margins:
If the edge of a crown sits too close to the gum, it may cause irritation that leads to recession and contributes to dental crown failure.
When gum recession occurs, it can lead to both cosmetic changes and functional concerns that may affect comfort and dental health.
Aesthetic Concerns Linked to Gum Recession:
- Visible Crown Margins:
The base of the crown may become exposed, creating a dark or uneven line near the gum line. - Longer-Looking Teeth:
Receding gums can make the crowned tooth appear longer than the surrounding teeth, affecting the overall appearance of the smile.
Functional Issues Linked to Gum Recession:
- Increased Sensitivity:
Exposure of the tooth or crown margin may lead to sensitivity to temperature or pressure. - Greater Risk of Decay:
Recession can expose areas of the tooth that are more vulnerable to decay if not cleaned thoroughly.
While gum recession can’t always be prevented, there are ways to reduce its risk.
Preventive Tips to Reduce the Risk of Gum Recession:
- Use a Soft-Bristled Toothbrush:
Brushing with softer bristles helps prevent damage to the gum line over time. - Brush Gently in Circular Motions:
Avoid aggressive scrubbing; gentle, circular brushing is more effective and less likely to cause gum irritation. - Floss Daily:
Cleaning between teeth helps remove plaque that can lead to inflammation and gum recession. - Schedule Regular Dental Check-Ups:
Professional monitoring allows early detection of gum changes and crown-related concerns. - Have Regular Professional Cleanings:
Routine dental cleanings help manage plaque buildup and reduce gum inflammation that can contribute to recession.
Crown Wear and Deterioration
Dental crowns are built to withstand everyday use, but like natural teeth, they can wear down over time. A review found that while around 95% of crowns last at least five years, survival at 15–20 years ranges between 50% and 80%. This variation depends on the material used and how well the crown is maintained.
Factors That Can Affect Crown Longevity:
- Oral Habits:
Grinding, clenching, or using teeth as tools can place stress on crowns and increase the rate of wear. - Diet:
Frequent consumption of hard, sticky, or highly acidic foods may weaken the crown or its bond to the tooth. - Oral Hygiene Routine:
Poor dental hygiene habits can lead to plaque buildup near the crown, affecting both the restoration and the underlying tooth. - Material Type:
Crowns made from zirconia or metal alloys tend to be more wear-resistant than porcelain or resin-based materials. - Regular Dental Care:
Routine check-ups allow for early detection of wear or deterioration, often before more noticeable problems develop.
Over time, wear may become visible or affect how the crown functions. Being familiar with early signs can help guide timely follow-up with your dentist.
Signs That a Crown May Be Wearing Down:
- Visible Thinning:
The crown’s surface may appear flatter or more translucent in areas of frequent contact. - Changes in Texture or Shape:
You may notice rough patches, uneven edges, or a change in how your bite feels. - Discolouration or Dull Appearance:
A worn crown may lose its original shine or appear darker along the margins. - Small Chips or Loosening:
Chipped crowns, fractured crowns, or slightly dislodged crowns can indicate that the restoration is no longer functioning properly and should be checked.
Preventing Dental Crown Complications
Long-term success with dental crowns depends not only on the materials used but also on how well they are cared for over time. A consistent daily routine helps maintain the health of both the crown and the surrounding teeth and gums.
Proper Oral Hygiene Practices
Maintaining clean and healthy teeth and gums is essential for supporting the longevity of dental crowns. Paying attention to how you clean around the crown can make a significant difference in preventing complications, such as dental decay or gum inflammation.
Techniques for Cleaning Around Crowned Teeth:
- Use a Soft-Bristled Toothbrush:
Gently clean around the crown to avoid damaging the gums and exposing the crown margins. - Brush in Small Circular Motions:
Use small, gentle circles when brushing around your crown. This helps lift away plaque without irritating your gums. - Floss Carefully Around the Crown:
Guide the floss down the side of the tooth and gently clean beneath the crown margin in an up-and-down motion. - Try Interdental Brushes or Water Flossers:
These tools can be helpful for cleaning between teeth and around areas where dental floss may not reach easily. - Rinse Daily with a Non-Alcoholic Mouthwash:
This is a good oral hygiene practice that helps reduce bacteria and support gum health without drying out the mouth.
Diligent dental crown care at home plays a key role in preventing common crown-related issues and supporting long-term oral health.
Regular Dental Check-ups
Routine dental visits are essential for monitoring the condition of dental crowns over time. These appointments give your dentist the opportunity to identify early changes that may not yet be noticeable to you. Catching these issues early allows them to be managed before they develop into more complex concerns.
What Dentists Look for During a Crown Evaluation:
- Margin Integrity:
Your dentist will assess how well the crown fits at the edges, checking for any gaps that could allow bacteria to enter. - Signs of Wear or Surface Changes:
The crown is examined for visible damage, thinning, or rough spots that may affect how it functions or feels. - Movement or Loosening:
Any slight movement in the crown could indicate cement breakdown or changes in the tooth underneath. - Gum Health Around the Crown:
The surrounding gum tissue is checked for signs of inflammation, recession, or plaque buildup that may eventually affect the crown’s stability. - Decay Under the Crown:
The opacity of dental crowns can hinder the detection of decay on an X-ray while the crown remains cemented on the tooth. However, X-rays are still useful for identifying damage in the tooth’s root or detecting lesions in the surrounding bone.
By checking for these early warning signs, your dentist can help prevent more serious issues down the line. Check-ups every six months are usually recommended, though more frequent visits might be advised depending on your oral health needs.
Lifestyle Adjustments
Everyday habits and choices can have a significant impact on the longevity of a dental crown. Making small adjustments can help reduce unnecessary stress on it and protect it from avoidable damage.
Practical Tips for Protecting Dental Crowns:
- Avoid Chewing on Hard Items:
Refrain from biting into hard foods like nuts, popcorn kernels, or ice, as these may lead to chips or cracks. - Limit Sticky or Chewy Foods:
Items like toffees or chewy lollies can loosen a crown or pull at the edges if the cement has weakened. - Address Grinding or Clenching:
If you tend to grind your teeth, particularly at night, speak to your dentist about treatment options to reduce pressure on the crown. - Don’t Use Teeth as Tools:
Avoid using your teeth to open packaging or hold items, which can place unnecessary strain on restorations. - Wear a Mouthguard for Contact Sports:
Using a custom-fit mouthguard during physical activity helps protect both natural teeth and crowns from dental trauma or impact.
Following these simple lifestyle tips can make a big difference in preserving your dental crown for years to come. These are not strict rules, but they offer helpful ways to support the long-term function and condition of your dental crown.
When to Seek Professional Help
While many crown-related issues are minor and manageable, signs should not be ignored. Prompt attention can help prevent further complications and protect the tooth underneath the crown.
Symptoms That Warrant Prompt Dental Attention:
- Severe or Persistent Dental Crown Pain:
Intense discomfort that doesn’t improve may indicate a problem involving the tooth’s nerve or improper crown placement. - Crown Mobility:
If the crown feels loose or shifts when chewing, it should be assessed as soon as possible. - Crown Detachment:
A crown that has completely come off needs to be stored safely and brought to your dentist for assessment. - Signs of Infection:
Swelling, persistent bad taste, or pus near the crown could point to an underlying infection requiring immediate care. - Unusual Sensitivity:
Sudden or prolonged hot or cold sensitivity or pressure may suggest a problem underneath the crown or along the gum line.
During an emergency visit, your dentist will examine the area, assess the crown’s condition, and determine the appropriate next steps. This may involve taking X-rays, recementing the crown, or recommending further treatment based on the underlying cause.
Modern Crown Technologies and Reduced Complications Associated with Dental Crowns
Advancements in dental materials and technology have significantly improved the quality, precision, and longevity of dental crowns. Modern treatment methods not only enhance comfort and appearance but also contribute to reducing the risk of complications over time.
How Digital Dentistry Helps Improve Crown Fit and Reduce Complications:
- Accurate Digital Impressions:
Intraoral scanners create precise 3D images of the mouth, which helps in improving fit and minimising errors compared to traditional moulds. - Customised Design with CAD/CAM Technology:
Computer-Aided Design and Computer-Aided Manufacturing (CAD/CAM) systems let your dentist design and fabricate a crown right in the clinic, using precise digital scans. It also helps create a crown that fits more naturally with your bite, reducing the likelihood of discomfort or the need for future adjustments. - Same-Day Crowns in Some Cases:
CAD/CAM systems allow some crowns to be made and placed in one visit, streamlining the dental crown procedure. This can eliminate the need for a temporary crown, which is usually used while waiting for a lab-fabricated crown in traditional methods. - Improved Material Quality:
Recent studies have shown that zirconia and hybrid ceramics demonstrate improved durability and wear resistance compared to earlier crown materials. These advancements contribute to fewer crown-related issues over time. - Consistent Fit Across Multiple Stages:
Digital records can be reused for future treatments, supporting long-term tracking and reducing the risk of fit-related issues.
These innovations contribute to more predictable outcomes and help minimise the chances of developing complications of a crown over time.
Final Thoughts
Dental crowns are a widely used treatment for restoring damaged teeth, and many patients continue to function effectively for extended periods with good-quality crowns. Common dental crown problems, such as sensitive teeth, wear, or loosening, can occur, but they are often manageable when identified early. Consistent oral hygiene and regular follow-up appointments can support long-term crown performance.
Crowns tend to last longer when oral care habits are consistent and professional check-ups and cleanings are scheduled at recommended intervals. Working with a dentist who focuses on precision and continuous care can help reduce the likelihood of issues over time. Clear communication and regular monitoring are key parts of maintaining good oral health after crown placement.
If you have questions about your dental crown or are planning to get one, book an appointment at Timberlands Dental Clinic in Wanneroo. Our team is here to provide professional guidance tailored to your situation and oral health goals. While this blog offers general information, personalised advice should always come from a qualified dental professional.
