Understanding Problems That Can Happen with Dental Crowns
Crowns are a great way to protect damaged teeth and bring back their shape, strength, and appearance. Whether you’ve had one for years or you’re getting one soon, it’s helpful to know what can go wrong and what to look out for. While crowns are made to last, they’re not completely free from problems. Like any dental work, they can sometimes chip, come loose, or feel uncomfortable. Let’s go over the most common dental crown complications, see why they happen, and what can be done to fix or avoid them.
What Is a Dental Crown and Why Might You Need One?
A dental crown is a tooth-shaped cover that fits over a damaged or weakened tooth. It works like a cap, sitting on top of the tooth to protect it and make it stronger. Crowns are designed to look and feel like a natural tooth, and they help with chewing, speaking, and smiling comfortably.
When Are Crowns Recommended?
Our professional Brisbane Dentists may suggest a crown if:
- Your tooth has a large filling and not much natural tooth left.
- Your tooth is cracked, worn down, or broken.
- You’ve had a root canal, and the tooth needs extra protection.
- You want to improve the shape or look of a tooth.
- You’re replacing a missing tooth with a dental implant—a crown sits on top of the implant.
Types of Crowns (Materials Used)
There are different types of crowns, and our dentists will choose the best one based on where the tooth is and how much pressure it needs to handle:
- Metal Crowns: Very strong and long-lasting. Usually used on back teeth where they’re less visible. Gold or other metal alloys are common.
- Porcelain Crowns: Look like natural teeth. Best for front teeth, where appearance matters most. Not as strong as metal.
- Porcelain-Fused-to-Metal (PFM): These have a metal base with a porcelain layer on top. They look natural and are stronger than full porcelain, but sometimes the metal edge can show if the gums recede.
- Zirconia Crowns: Very strong and tooth-coloured. Good for both front and back teeth. Becoming more popular due to their mix of strength and appearance.
Crowns on Natural Teeth vs Crowns on Implants
- Crowns on Natural Teeth: These are used to protect your own tooth that’s been damaged or weakened. The crown is glued (cemented) onto the tooth.
- Crowns on Implants: When a tooth is missing, a titanium screw (implant) is placed in the bone, and the crown is attached on top. It can be glued or screwed in.
How Long Do Crowns Usually Last?
Dental crowns usually last between 10 to 15 years, but with good care, they can last even longer. How long a crown lasts depends on a few key things—the type of material used (metal and zirconia crowns tend to last longer than porcelain), your oral hygiene habits (brushing, flossing, and regular check-ups matter), and how you use your teeth (biting fingernails, grinding your teeth, or chewing ice can wear a crown down faster). You might need to replace a crown if it becomes loose, cracked, worn out, or if the tooth underneath gets decay or infection. Other signs include pain when biting, a change in how your bite feels, or gums pulling away from the crown.
In short: A dental crown helps save a tooth that would otherwise need to be removed. It restores how the tooth looks and works, so you can eat and smile without worry. Choosing the right type of crown depends on the location of the tooth, your bite, and how you want it to look.
Common Problems with Crowns on Natural Teeth
While dental crowns are made to be strong and long-lasting, they can still run into problems. Below are some of the most common issues people experience with crowns and what can be done to manage or prevent them:
Chipping or Fracture of the Crown
Why it happens
A crown can chip or crack if you regularly chew hard foods (like nuts, ice, or popcorn kernels), use your teeth to open things, or grind or clench your teeth—especially while sleeping. Some crown materials, like porcelain, are more fragile than others and are more likely to break under pressure.
What to do immediately if it breaks:
If your crown chips or breaks, avoid chewing on that side, keep the area clean, and call your dentist promptly. If a sharp edge is cutting your tongue or cheek, you can cover it temporarily with orthodontic wax (available at pharmacies).
How to reduce your risk:
Avoid hard or sticky foods, don’t use your teeth as tools, and ask your dentist if you need a night guard—especially if you grind your teeth at night. Having your bite checked during regular dental visits also helps prevent uneven pressure on the crown.
What will your dentist do to fix it:
They’ll start by examining the crown to see how severe the damage is. If it’s just a small chip, it might be polished or repaired with a special filling material. For larger breaks or if the crown no longer protects the tooth properly, a replacement crown will likely be recommended.
Crown Feels Loose or Falls Off
Why it happens:
Crowns can come loose or fall out if the cement holding them weakens over time, if there’s tooth decay underneath, or if your bite puts too much pressure on them. Poor fitting or saliva contamination during the cementing process can also affect how well it stays in place.
What to do immediately:
Keep the crown safe—don’t throw it away. Rinse your mouth gently and avoid chewing on that side. Clean the crown and store it in a clean container. Don’t try to reattach it with glue. Call your dentist to have it checked and re-cemented or replaced.
How to reduce your risk:
Keep up with your oral hygiene and dental check-ups to catch early signs of decay or loosening. Avoid chewing on hard or sticky foods and make sure any bite issues are addressed early.
What will your dentist do to fix it:
The first step is to check whether the crown and the tooth underneath are still in good condition. If the fit is still sound, the crown can often be cleaned and re-cemented. But if there’s decay or the crown is damaged, a new one may need to be made.
For all those unexpected moments when your teeth need help, our Emergency Dentist Brisbane is just a call away.
Pain or Sensitivity Around the Crown
Why it happens:
It’s not unusual to feel some sensitivity after a crown is placed, especially to hot or cold drinks. Ongoing or sharp pain, though, may be caused by a high bite (when the crown is slightly too tall), exposed nerves, or an infection in the tooth underneath.
What to do immediately:
Try using toothpaste for sensitive teeth and avoid triggering foods or drinks. If the pain is sharp, throbbing, or doesn’t improve in a few days, make an appointment with your dentist.
How to reduce your risk:
Make sure your dentist checks the height and fit of the crown properly. If you know you have sensitive teeth, let them know in advance. Stay on top of regular check-ups to spot issues early.
What will your dentist do to fix it:
They’ll assess the bite and test the tooth to see if the crown is too high or if there’s nerve involvement. In some cases, simply adjusting the crown’s height is enough to relieve discomfort. If the nerve is inflamed or infected, further treatment such as a root canal may be necessary.
Crown Doesn’t Fit Right or Bites Feel Off
Why it happens:
Sometimes a crown may not fit perfectly due to an issue during its design or placement. The bite might feel off if the crown is too high, or the contacts with neighbouring teeth are too tight or too loose. Teeth can also shift slightly after a crown is made.
What to do immediately:
If your bite feels uncomfortable or if it causes pain when chewing, contact your dentist. Avoid grinding or clenching and try to avoid putting pressure on the crown until it’s adjusted.
How to reduce your risk:
Ensure you return for your bite check after the crown is placed. Regular dental visits will help spot issues early. If you have a history of bite problems, tell your dentist during the planning phase.
What will your dentist do to fix it:
The bite will be carefully checked, often using marking paper to spot any high points. Minor issues can usually be adjusted right away by reshaping the crown. If the fit is significantly off or causing ongoing discomfort, replacing the crown might be the better option.
Problems That Can Happen While the Crown Is Being Made or Placed
In some cases, problems can come up while the crown is being made or placed, before it’s even fully finished. These issues aren’t always obvious straight away, but they can affect how comfortable the crown feels or how well it functions in the long run. Here are some of the more common ones and what can be done to prevent or correct them:
Trouble with the Crown Sitting Properly
Why it happens:
Sometimes a crown doesn’t fit properly because it’s too tight against the neighbouring teeth, or there’s not enough space for it to fully sit due to insufficient room (often from over-grinding or a bulky crown). This can make it feel like the crown is jammed in, or it may not settle all the way down onto the tooth.
What should dentists do:
Dentists should check the contact points between the crown and nearby teeth and adjust them carefully—often by polishing the sides or using a thin dental strip. If there’s not enough space due to over-grinding, they may need to take a new impression and remake the crown to ensure it sits correctly. A proper fit is essential to avoid long-term problems like gum irritation or decay.
Too Much Tooth Removed During Preparation
Why it’s a problem:
If too much of the tooth is shaved away during preparation, it can irritate the nerve inside the tooth, increase the risk of future fractures, or weaken the crown’s hold. This is especially a concern in younger patients or teeth that already have large fillings.
What should dentists do:
To avoid this, dentists must carefully plan and measure how much needs to be removed based on the crown material. If the nerve becomes sensitive or exposed, a protective base or root canal might be needed before placing the crown. Preserving as much natural tooth structure as possible reduces long-term complications.
Cement Left Between Teeth After Fitting
Why it’s a problem:
If cement is left between the teeth after the crown is placed, it can irritate the gums, cause inflammation, or make flossing difficult. Over time, this can lead to bleeding gums or even gum disease.
What should dentists do:
Dentists must carefully clean off any excess cement, especially between the teeth. This usually involves using dental floss, explorer tools, and finishing strips. A final polish ensures the area is smooth and comfortable. Good clean-up is not just for comfort—it helps prevent future gum problems and keeps the area easy to clean at home.
Crowns on Implants: What Can Go Wrong?
Even though implant crowns don’t get cavities like natural teeth, they’re not completely problem-free. There are a few things that may go wrong with crowns on implants, especially if the bite isn’t quite right or if the crown wasn’t fitted carefully. Here’s what you should know:
Loose or Broken Implant Crowns or Screws
What causes it:
Implant crowns or the small screws holding them in place can come loose or even break over time. This often happens from too much biting force, especially if you grind your teeth, clench your jaw, or have an uneven bite. Poor implant placement or using too few implants to support a bridge can also increase stress on the components, making them more likely to fail.
Prevention and repair options:
To help prevent this, your dentist will carefully plan the placement and number of implants based on your bite and jaw structure. In some cases, a night guard may be recommended if you grind your teeth in your sleep. If something does loosen or break, the screw can often be tightened or replaced, and the crown may be repaired or refitted. Early signs, like a clicking sound or slight movement, should be checked before they turn into a bigger issue.
Bite Problems with Implants
Why it happens:
Unlike natural teeth, implants don’t have a ligament that lets them move slightly, which means they can’t absorb pressure in the same way. If your bite is off—even just a little—it can put too much force on one area of the implant crown, leading to loosening, screw damage, or bone loss over time.
How bite forces need to be carefully managed:
During and after treatment, your dentist will check how your teeth come together and adjust the crown’s shape to make sure the pressure is spread out evenly. Implant crowns often have a slightly flatter shape to reduce stress during chewing. Ongoing check-ups are important because natural teeth can shift slightly, which may throw off the balance if not monitored.
Cement Complications Around Implants
Why it’s a concern:
When implant crowns are glued in (cement-retained), leftover cement can sometimes stay trapped under the gums. This can lead to inflammation, soreness, or even an infection known as peri-implantitis, which can damage the bone around the implant if not caught early.
Why screw-retained crowns are sometimes preferred:
To avoid this issue, many dentists prefer screw-retained crowns, which don’t require cement and can be easily removed if maintenance is needed. They also make it simpler to clean around the implant and fix any problems down the track. If a cement-retained crown is used, your dentist must take extra care to remove all excess cement during the fitting process.
Crowns on Root Canal-Treated Teeth
When a tooth has had a root canal, it’s already been through a fair bit — and while placing a crown can help protect it, there are still some risks to be aware of. In some cases, issues can develop after the crown is placed, especially if the tooth structure is weak or if the crown isn’t sealed properly. Here’s what can go wrong and why timing and technique really matter:
Tooth Fracture After Crown Placement
Why root canal-treated teeth may be more fragile:
Once a tooth has had a root canal, it loses its blood supply and becomes more brittle over time. Without that internal moisture and strength, the tooth is more prone to cracking or breaking—especially if there’s not much natural structure left to support it.
Why full crowns may not always be ideal for front teeth:
For front teeth, a full crown often requires removing extra tooth structure, which can actually weaken the tooth even more. In many cases, a composite filling or a partial crown (onlay) is a better option, as it protects the tooth while preserving more of what’s already there. The goal is to keep the tooth strong without overdoing the cutting.
Bacteria Getting Back In (Coronal Microleakage)
How gaps or delays in crown placement can lead to reinfection:
If there’s a gap between the crown and the tooth, or if the crown isn’t placed soon after the root canal, bacteria can sneak back in. Even a small leak can allow germs to reach the sealed canal, which risks reinfection—and that often means needing another root canal or losing the tooth altogether.
Importance of permanent restoration soon after root canal treatment:
To avoid this, it’s important to have a well-sealed, permanent crown or onlay placed not long after the root canal—ideally within a few weeks. Temporary fillings don’t last and can break down quickly, so the sooner the final crown is fitted, the better the long-term outcome for the tooth.
How to Prevent Crown Problems
Good oral hygiene habits: Brush your teeth twice a day and floss once a day to keep the area around your crown clean. This helps prevent gum problems and tooth decay under the crown. Using a fluoride toothpaste also gives extra protection to the tooth holding the crown.
Nightguards for grinding: If you grind or clench your teeth at night, a custom nightguard can protect your crown from cracking or coming loose. It acts like a cushion between your teeth while you sleep. Wearing one regularly can save you from costly repairs down the track.
Regular dental check-ups: Seeing your dentist every 6 to 12 months helps catch problems early—before they turn into bigger issues. They’ll check the crown’s fit, your bite, and look for signs of wear or decay. Early treatment is always easier and more affordable than fixing something that’s been left too long.
Proper bite checks during placement: When your crown is first fitted, your dentist will ask how it feels and check how your teeth come together. If the bite is even slightly off, it can cause pressure that may lead to pain or damage. A small adjustment at this stage can make a big difference later.
Avoiding sticky or hard foods if advised: Chewing on things like hard lollies, ice, or sticky toffees can damage or loosen your crown. If your dentist tells you to avoid certain foods, it’s for a good reason. Being mindful of your eating habits can help your crown last much longer.
Make Sure You Call Us If:
- Crown feels loose: If your crown moves slightly or doesn’t feel as secure as it used to, it could mean the cement underneath has weakened. A loose crown can let bacteria in, which may lead to decay. It’s best to have it checked before it comes off completely.
- Pain when biting: If you feel sharp or lingering pain when you bite down, the crown might be too high, or the tooth underneath could be irritated. This kind of pain isn’t normal and should be looked at. A quick adjustment or treatment can usually fix it.
- Bad taste or smell near the crown: A bad taste or smell coming from around the crown could be a sign of trapped food, decay, or infection. Even if you don’t see anything wrong, it’s worth getting it checked. Ignoring it could lead to gum problems or damage to the tooth underneath.
- Gum irritation or swelling: Red, puffy, or bleeding gums around a crown may point to an issue like leftover cement, poor fit, or infection. Healthy gums shouldn’t feel sore or look inflamed. Your dentist can clean the area and check the crown’s fit to prevent it from getting worse.
- Crown cracks or falls off: If your crown cracks or comes off, don’t try to glue it back yourself. Keep it clean and bring it to your dentist, as it might be reusable if it’s still in good shape. Leaving the tooth exposed can lead to pain, sensitivity, or further damage.
Final Thoughts: Crowns Are Great, But They Need Care
You’ve invested time and money in your smile — so it’s completely normal to feel concerned if your crown doesn’t feel quite right. The good news is, most crown-related problems are straightforward to fix, especially if they’re picked up early. Staying on top of your oral care and checking in with your dentist when something feels off is the best way to keep your crown — and the tooth underneath — in great shape for years to come.
Frequently Asked Questions
Can a dental crown stain or change colour over time?
Dental crowns made from porcelain or ceramic are quite resistant to staining, but over time they can pick up surface discolouration from coffee, tea, red wine or tobacco. If the protective glaze on a porcelain crown wears off or gums recede to expose darker margins, the crown may appear darker even though the material itself hasn’t changed. Crowns don’t whiten with bleach like natural teeth, so if they discolour, they usually need to be replaced rather than whitened.
Is it possible to whiten a dental crown if it becomes discoloured?
It’s not possible to whiten a dental crown using bleach or whitening gels because crowns are made from non‑porous materials like porcelain or ceramic, so the chemicals simply can’t penetrate them. If your natural teeth become lighter through whitening, the crown stays the same shade, which can make it stand out or look mismatched. The only way to match a discoloured crown to your brighter natural teeth is to replace it with a new one in the correct shade.
Do dental crowns interfere with airport metal detectors or MRIs?
Most dental crowns won’t set off airport metal detectors because they’re made from non-magnetic materials like ceramic or resin. Even crowns with a metal base—like porcelain-fused-to-metal—contain metals that don’t trigger detectors or interfere with scans. Dental crowns are also safe in MRI machines, as the metals used are generally non-ferromagnetic and won’t heat up or move.
Can a crowned tooth still get decay?
Yes — a tooth with a crown can still get decay, especially around the edges where the crown meets the natural tooth. If plaque builds up at the gumline, bacteria can sneak under the crown and cause rot in the tooth underneath. Brushing well and flossing daily is key, because the crown only protects the top part — the tooth roots and margins are still at risk.
Are there allergy concerns with certain crown materials?
Some people can have allergic reactions to certain metals used in crowns, like nickel or palladium. If you’ve had skin allergies to jewellery or metal before, let your dentist know so they can choose a metal-free material like ceramic or zirconia. Fully ceramic and zirconia crowns are biocompatible, meaning they’re safe for nearly everyone and rarely cause irritation or allergic responses.
Can you get a crown if you have gum disease?
You can’t get a crown straight away if you have active gum disease, because the gums need to be healthy for the crown to fit properly. If there’s swelling, bleeding, or bone loss, your dentist will treat the gum issues first — otherwise, the crown may not last or could trap bacteria. Once the gums are stable and clean, a crown can be safely placed to protect the tooth and help keep everything sealed.
Can dental crowns be used on baby teeth?
Yes — dental crowns can be used on baby teeth, especially when a tooth is badly decayed or damaged and can’t hold a regular filling. Our Brisbane Paediatric Dentists might use a stainless steel crowns or zirconia crowns to protect the tooth and keep it in place until it naturally falls out. This helps maintain proper spacing for adult teeth and prevents biting or speech issues down the track.
How many times can a dental crown be replaced?
A dental crown can be replaced more than once, but each time it depends on how healthy the tooth underneath still is. If the tooth remains strong and there’s no major decay or damage, a new crown can be fitted when the old one wears out or breaks. However, if the tooth gets weaker over time, there may come a point where another replacement isn’t possible, and other options like dental implants might be needed.
Disclaimer: This article is for general informational purposes only and does not constitute professional dental advice, diagnosis, or treatment. Always consult a qualified dental practitioner regarding any concerns or questions about your oral health or specific dental conditions.
Don’t Ignore Dental Crown Warning Signs
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