How to Tell a Crown Isn’t Fitting Right

Dental crowns are among the most powerful restorative dentistry procedures. They can take a severely damaged tooth and restore it into a brand-new tooth. The tooth can look more beautiful and functional than the original. They are done when no other option exists, and it is the only way to restore the tooth back to its original function and appearance. If it is not done right, a dental crown can also cause problems. So how do you know if a crown fits right? 

The Process of Creating and Fitting Dental Crowns

Dental crowns are meticulously crafted to restore damaged teeth. The process begins with the dentist numbing the area and reshaping the tooth to fit the crown. Next, an impression of the tooth is taken to create a custom crown, ensuring a perfect fit. A temporary crown is placed while the permanent one is made. Once the permanent crown is ready, it is bonded to the tooth with dental cement, restoring the tooth’s function and appearance. 

This precise process ensures that the crown feels natural and integrates seamlessly with the patient’s bite. However, even with the most careful crafting and fitting, issues can still arise. Below are some signs that a crown is not properly fitted.

Note: be aware that the best-fitting crown may still develop symptoms, which you should discuss with your dentist. Below are some indications, but not certainties, that a crown was done properly.

Bite Does Not Feel Right

Your dental crown should feel comfortable, just like any of your other teeth. If your bite feels off after getting a dental crown, it might be because the crown isn’t fitting right. You might feel the bite problem right on the dental crown, but you might also feel it on the opposing side of your mouth.

Do not worry about this right away. If the tooth is not hitting first, it may take time to settle in, especially if you were numbed when the crown was placed. Also, if you are focused on the bite, you might be unconsciously doing something different. Give yourself time to settle into a routine with a new crown, but if it still does not feel right, then it may be time to get it fixed.

If the crown tooth is hitting first when chewing or simply closing your mouth, it can lead to pain when the tooth hits or cold sensitivity. Do not wait. Call your office right away, and it will take seconds to adjust the crown. Leaving it high long-term could permanently damage the nerve.

Related Topic: Understanding Dental Crowns And If You Might Need One

Pressure on Neighboring Teeth

You might also feel pressure from a dental crown on the teeth adjacent to it. A crown should be in touch with its adjacent teeth but not enough to cause them to shift. I personally like to place crowns slightly tight because, as we get older, the contacts lighten up. Also, it takes a few minutes for the mouth to adjust to a new crown. Give it a few days, and it should feel better. If you cannot fit floss between two teeth, then the contacts are tight. When you floss, make sure to use a sawing motion to break through the contact and not just force it down.

Food Getting Stuck Around Crown

A crown might have too much space around it, which leads to food getting stuck there. Food can feed oral bacteria, which can lead to cavities on neighboring teeth and increase the risk of gum disease around the crown. When flossing around the crown, you should feel a tightness similar to that between natural teeth. If you do not feel that tightness with floss, the crown is not fitting properly. If you had a crown done and the contacts were present initially and are no longer present, it indicates your teeth are shifting. This most often occurs on a tooth that is missing an adjacent tooth, such as the most posterior tooth. Also, it is more likely to happen to an individual who has much wear on the teeth’s top surfaces because of grinding. Flat teeth have nothing to lock onto, and once the lock is gone, they are free to shift. A crown can shift within days of the crown being placed. Redoing the crown will fix the situation for a week or so until it shifts again.

It is also important to mention that even with tight contacts, food can get jammed into the gums through the sides of the tooth. That results because of gum recession. Even with the best fitting crown, this may not be resolved. As we get older and our gums recede, this will be a common problem. Redoing a crown will not solve this issue. Discuss this issue with your dentist to see if the crown can be redesigned. Making a bulky crown can make the area less cleanable and not ideal.

A poor-fitting crown can also have ledges where food and bacteria can hide, leading to unhealthy gums. This usually results in puffy and bleeding gums.

Crown Is Loose

The dental crown should be bonded firmly to your tooth. It should not move except as part of the tooth. If the crown is moving independently, then it is not properly fit or bonded. Even if the crown does not come off, it can have spaces underneath it that can allow bacteria and food to slip between the tooth and crown, which can lead to decay and destruction of the tooth.

Related Topic: The Benefits of Porcelain Crowns

Painful or Inefficient Chewing

Once your bite settles in, you should be able to chew naturally and normally. But if the crown is not fitted right, you might notice that your teeth are contacting the opposing harder or more frequently than in the past. If it hits first during closing or if it hits during chewing, contact your dentist because grinding the high spot resolves the problem.

On the other hand, you might also notice that you are not able to effectively chew your food with the new crown because it is not even with the other teeth, creating a space where food can collect and not be chewed properly. Crowns are designed to match the opposing. If the opposing teeth are flat, then the new crown will be made flat. As a rule, you cannot improve function and can only go back to function right before the crown is done. However, if the crown is under occluded (does not touch the opposing), it can lead to improper chewing, or food getting jammed on the top surface of your crown.

Red, Inflamed Gums

Sometimes, you cannot tell that a crown does not fit properly, except by the signs that something has changed with your oral health, especially your gum health. If you have noticed that the gums around a tooth crown are turning redder, bleeding, or potentially receding, then you know that you have got a problem that needs to be fixed. If decay is deep and the crown was designed more than a couple of millimeters below the gums, even the best fitting crowns will have redness, inflammation, and even pus present. These teeth will need gum surgery to alleviate the issue. In other instances, such as a bulky crown, overhang, open contact, or an open margin can have red and inflamed gums. These crowns should be replaced.

No Symptoms

Even the worst fitting crown may not have any symptoms. I have seen crowns that looked like they were designed for another person, and the patient is unaware of any problems or symptoms, especially root canal teeth.

Related Topic: Same Day Crowns vs. Traditional Crowns: Which is Right for You?

What to Do if You Have a Poor Fitting Crown

Throughout my career, I have done many thousands of crowns. To say that every crown is perfect would be a lie. I can tell you that every time I place a crown, I believe it to be the best-fitting crown possible. Sometimes the patient does not bite properly, causing a shift in the crown, or sometimes the x-ray does not capture the defect. Often, a mistake or misangled x-ray shows the defect. Also, do not assume a crown with new developing symptoms is a poor-fitting crown. Underlying factors such as invisible fractures or other underlying undetectable factors may surface, leading to symptoms indicating the tooth needs a root canal.

My policy in my office is that if I can determine via an x-ray or an exam that a crown was done poorly, I will remake it at no charge if the patient did not go missing for many years. Most defects are caught by the patient’s next exam. It is crucial to keep your appointments because not only are dentists checking for decay, but we are also checking our own work. I can tell you statistically I redo one or two crowns a year that do not meet my expectations. Most often, the patient is unaware of any issues.

If you know you think you have a poor-fitting crown, go back to your original dentist who placed it and have a discussion with them. I am sure that if the crown was not done right, they would be willing to replace it.

Find a Better Fit

If you notice any of these problems with a provisional crown, then you should mention them to make sure that your final crown fits properly. If your final crown has these problems, you also need to report them so that the crown can be fitted better. Sometimes this might mean that you need to get a new crown, but other times the current crown can be made to fit properly.

If you are looking for a great fitting crown in the Scripps Ranch area of San Diego, please call (858) 271-1010 today for an appointment with cosmetic dentist Dr. Ramin Goshtasbi at Oasis Dental Arts.