Can a Tooth Crack Under a Crown?
Dental crowns are designed to protect and restore damaged teeth, but even with this strong coverage, the tooth underneath isn’t completely immune to damage. One common concern patients have is whether a tooth can crack under a crown, and the answer is yes. In this blog, we will explain why this happens, what symptoms to look for, and treatment options for a cracked tooth under a crown.
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What Causes a Tooth to Crack Under a Crown?
While crowns are durable, several factors can cause the natural tooth underneath to crack, including:
- Biting hard foods: Chewing ice, nuts, or hard candy can put excess pressure on the tooth.
- Teeth grinding or clenching (bruxism): Chronic stress on teeth can weaken the structure over time.
- Trauma or injury: A fall or direct blow to the mouth can crack even a crowned tooth.
- Tooth decay: Undetected decay under the crown weakens the tooth and increases fracture risk.
- Wear and tear: Over time, repeated chewing and clenching can gradually weaken the tooth’s integrity.
Apart from the above, high bite on a crown, very thin remaining tooth structure, or very rigid materials (e.g., some zirconia designs) can concentrate stress.
Visible vs. Invisible Cracks
Cracks under a crown can be visible or hidden.
- Visible cracks often extend below the gum line and usually mean the tooth cannot be saved, requiring extraction. Cracks under a crown are usually not visible until the crown is removed. Dentists use bite tests, transillumination, periodontal probing, and imaging to help locate them.
- Cracks often don’t appear on X-rays. We rely on symptoms (sharp pain on bite/release), selective bite tests (Tooth Slooth), transillumination, and probing; imaging helps rule out other issues or show bone changes. These can sometimes be treated by removing the crown, repairing the tooth, and placing a new crown. 3-D scans (CBCT) don’t show the crack line itself, but can show bone loss patterns that suggest a vertical root fracture.
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Common Symptoms of a Cracked Tooth Under a Crown
You may not always see a crack, but you can often feel the warning signs, such as:
- Sharp pain when biting or chewing
- Sensitivity to hot, cold, or sweet foods
- Localized tenderness
- New isolated deep gum pocket next to the tooth
- Redness or swelling around the crown
- Tooth discoloration or darkening
- Gaps between the crown and gum line
- Loosened or shifting crown
- Visible chip or fracture on the crown
If you notice any of these symptoms, it’s important to schedule a dental visit as soon as possible.
Treatment Options for a Cracked Tooth Under a Crown
The best treatment depends on the severity and location of the crack. Your dentist will typically perform a detailed exam and digital imaging to determine the right approach.
Possible treatments include:
- Crown removal and root canal therapy: If the nerve is inflamed or infected, a root canal may be needed before rebuilding the tooth and placing a new crown. Not every cracked tooth needs a root canal.
- Dental bonding: For minor cracks or fractured cusps, bonding or a build-up can strengthen the tooth before making a new crown. Cracks into the root cannot be predictably repaired.
- Tooth splinting: Splinting is rare for cracks under crowns and is mainly used for trauma-related mobility. It does not “heal” a crack.
- Extraction and replacement: If the crack extends below the gum line, extraction may be necessary, followed by a dental implant or bridge for restoration.
Overall Insight
Yes, a tooth can crack under a crown due to reasons like biting hard foods, teeth grinding, decay, or injury. Sometimes the crack is visible, but other times only a dentist can find it through X-rays. You might feel pain when chewing, sensitivity, or notice swelling or changes around the crown. The good news is that treatment options like bonding, a new crown, root canal therapy, or even replacement with an implant can fix the issue.
If you suspect any of the following signs, book a consultation with Dr. Yoni Mizrahi at Cloud 9 Dental of Encino. Call us at (818) 986-7411 for more inquiries.