Why are teeth sensitive after a crown?
To make room for a crown, tooth structure is removed, and this can expose the more sensitive dentine beneath the enamel. Some sensitivity after fitting is therefore to be expected. According to Cleveland Clinic, sensitivity to heat and cold for a couple of weeks is normal, and the gums around the tooth can be sore or tender for a few days. The preparation usually reaches close to the gum line, which explains the initial soreness.
Sensitivity is also possible during the temporary phase. According to the consent form of Süleyman Demirel University, it usually ends once the final crown is cemented. How much tooth is removed is explained in our guide how much tooth is removed for zirconia crowns; what counts as ordinary wear and tear, in how long do zirconia crowns last.
The table gives a rough orientation; the cause is established at an examination.
| Symptom | Possible cause | What usually happens |
|---|---|---|
| Brief twinge with cold or heat in the first weeks | temporary sensitivity after preparation | settles in most people; observe |
| Pain on biting, also in the opposing tooth | crown meets the opposing tooth too early | bite is checked and adjusted |
| Sharp pain on chewing that comes and goes | crack in the tooth | examination, X-ray if needed |
| Throbbing pain without a trigger | inflammation of the tooth nerve | root canal treatment may be needed |
| Sensitivity after months or years | decay at the margin, gum recession or a nerve problem | examination and X-ray |
Why does it hurt when you bite?
A common cause is that the crown touches the opposing tooth before the other teeth do. The Süleyman Demirel University consent form describes how a temporary that is too high meets the opposing tooth too early and can cause pain in both the treated and the opposing tooth. If you feel a premature contact with the final crown as well, do not wait to get used to it: adjusting the bite is a short step and should, where possible, be done during your stay. That is why a buffer day before your flight home for a check is worthwhile; more on our zirconia crowns page.
Another possibility is a crack in the tooth. According to the American Association of Endodontists (AAE), cracked teeth cause erratic pain on chewing, often when biting pressure is released, and react to cold or heat. A crown offers a cracked tooth the most protection, according to the AAE, but does not guarantee success. Grinding can also make a crowned tooth ache; Cleveland Clinic recommends asking about a mouth guard if you grind your teeth.
What lies behind sensitivity that starts only after months?
If symptoms appear after the crown has been trouble-free for a long time, several causes come into question:
- Tooth nerve: according to the University Dental Hospital of Manchester, a small percentage of crowned teeth need root canal treatment; this is usually identified before cementing, but symptoms can appear months or years later. Bristol Dental School puts the chance that a living nerve under a crown becomes inflamed and dies at roughly 20 percent, and Cork University Dental School gives 10 to 20 percent. Treatment can be carried out through a small opening in the crown or after the crown is removed.
- Decay at the margin: according to Cleveland Clinic, poorly fitting crowns can trap bacteria and lead to decay. Cork University Dental School warns that unnoticed decay at the crown margin can make root canal treatment and a new crown necessary, and in some cases extraction.
- Gum recession: according to Cleveland Clinic, the exposed root surface becomes sensitive when the gum pulls back; hard brushes and too much pressure contribute.
Late symptoms should not be dismissed as “normal with crowns” without being checked: have the tooth examined by a dentist near you and inform us on WhatsApp at the same time.
Why does the gum at the crown bleed or swell?
The University Dental Hospital of Manchester describes the gums around crowns as highly sensitive to plaque; bleeding is usually a sign of plaque. The junction between crown and gum is one of the places where plaque collects most easily.
The position of the crown margin plays a part too. According to the review by Ercoli and Caton (Journal of Clinical Periodontology, 2018):
- margins within the gum sulcus do not cause gum inflammation as long as plaque is removed regularly and check-ups take place
- margins that reach into the tissue that attaches the tooth to bone and gum are associated with inflammation and possibly recession
- the design, fabrication and material of the crown influence how much plaque is retained
The 26-year study by Schätzle and colleagues confirms that margins below the gum line are harmful to the supporting tissues.
Why does the gum recede after a crown?
Bristol Dental School points out that gums can recede over time and the crown margin can become visible. According to the University Dental Hospital of Manchester, slight recession occurs mainly in people with thin gums; the darker root surface or the edge of the crown then becomes visible, but this is uncommon.
Factors that can contribute to recession:
- plaque at the crown margin and the inflammation it triggers
- a crown margin that reaches too far into the gum tissue
- hard toothbrushes or too much pressure when brushing
- a thin gum type
With metal-ceramic crowns, a dark metal edge can show when the gum recedes; zirconia contains no metal and does not show this effect. The comparison is in our guide zirconia or porcelain crowns. The cause and course of recession are assessed at an examination.
Can the crown material cause an allergy?
Possible, but rare. Cleveland Clinic describes allergic reactions to crowns as rare and names metal-free all-ceramic crowns as an option for people with metal allergies. Ercoli and Caton report that hypersensitivity reactions to dental materials do occur. Mention known allergies at the preliminary assessment; persistent redness, itching or burning around a crown should be examined.
What can you do at home, and when should you get in touch?
Following the sources above:
- Brush twice a day with a soft brush and fluoride toothpaste.
- Clean the crown margins daily with floss or an interdental brush; details in our guide caring for zirconia crowns.
- For sensitivity, try a desensitising toothpaste, as Cleveland Clinic suggests.
- Avoid ice cubes, hard nuts and very sticky sweets.
- Attend the review appointment: Bristol Dental School checks bite, fit and whether you can clean around the crown at the review after fitting. After your return, this check can take place with your dentist at home.
According to Cleveland Clinic, a crown should not cause pain that keeps you awake at night. If the pain increases over weeks rather than easing, the crown loosens, you notice a bad taste or smell, or an edge rubs against your tongue or gum, do not wait. For painkillers, ask your dentist or pharmacist which product is suitable for you.
How do we handle problems after crowns at Rönesans?
During your stay, the fit of the crown margin, the bite, the gums and the tooth nerve are checked; plan a buffer day before your flight home so that a premature contact can still be adjusted on site (see how many visits do zirconia crowns take). If a crack, a root fracture or inflammation at the root tip needs to be clarified, a cone-beam CT (CBCT) scanner is available at the clinic; endodontics (root canal treatment) and prosthodontics are among our fields.
If symptoms appear after you are back home, write to us on WhatsApp at +90 532 363 49 54, ideally with a photo; during opening hours we reply in English and German within 15 minutes. With increasing pain or a loose crown, also have the tooth examined by a dentist near you; the copies of your X-rays and the treatment summary you receive when you leave help with this. Our treatments carry a guarantee under set conditions for problems not caused by the patient; we explain its scope before treatment starts. More on aftercare and follow-up.