Patient question
Why does my crowned tooth still hurt?
Quick answer
A crown covers the outside of a tooth, but the living pulp inside the root remains, so the tooth can still hurt. Common causes include a high crown, a crack, decay under the crown, or pulp inflammation that needs a root canal. Brief sensitivity after a new crown can be normal; pain that worsens, lingers after cold, or wakes you at night should be examined by a dentist or endodontist.
Medically reviewed by Dr. Jason Kung, DDS, MS · Specialist Endodontist · UCLA DDS · OHSU MS ·
A crown doesn't remove the nerve
It's a common surprise: you got a crown to fix a tooth, so why does it still hurt? A crown is a protective cap over the visible part of the tooth — it doesn't touch the pulp, the nerve and blood vessels living inside the root beneath it. That pulp can still become inflamed or infected, and when it does, the tooth hurts right through the crown. The crown itself is rarely the problem; it's usually what's happening underneath.
The common causes
Pain in a crowned tooth almost always traces back to one of a handful of causes:
- A crown that's slightly too high — even a fraction of a millimeter overloads the ligament around the root, causing soreness when you bite. This is a quick adjustment.
- A cracked tooth — sharp pain when you bite down or release is the classic sign; tiny movements of the crack irritate the pulp.
- Decay under the crown margin — bacteria slipping beneath the edge of the crown can reach fresh tooth structure and, eventually, the nerve.
- An inflamed or dying pulp — sometimes the tooth was already stressed when the crown went on, and the nerve declines afterward, needing a root canal.
Why bite pain deserves attention
Pain specifically when biting or when you release the pressure is the hallmark of a cracked tooth. Because a crack lets the two halves of the tooth flex against each other, it inflames the pulp and can progress. Diagnosing this early matters: caught in time, the tooth can often be saved with a root canal; if the crack runs down into the root, the tooth may not be restorable. A specialist uses magnification and testing to locate the crack.
Is some sensitivity after a new crown normal?
Yes. Mild sensitivity to cold or pressure for a few days to a couple of weeks after a new crown is expected as the tooth settles. What is not normal is sensitivity that keeps getting worse, lingers well after the cold is gone, or wakes you at night — those point to an inflamed pulp rather than routine settling, and they're worth having checked.
Can the crown be saved if I need a root canal?
Usually, yes. In most cases the endodontist makes a small access opening through the top of the existing crown, completes the root canal, and seals the opening — your crown stays in place. Only if the crown is loose, leaking, or poorly fitting does it need to be replaced afterward. So needing a root canal rarely means losing the crown you already paid for.
When it's an emergency
Steady, worsening pain is the tooth telling you the nerve is dying — it should be seen soon, though it isn't usually an emergency. Throbbing pain with swelling of the gum or face, a bad taste, or fever is a sign of active infection and warrants a same-day call. If that's you, call (669) 234-2354 and we'll get you seen.
Related questions
Can a tooth with a crown still need a root canal?
Yes. A crown protects the outside of the tooth, but the living pulp still sits inside the root underneath it. If decay slips under the crown margin, or the tooth was already inflamed when the crown went on, the nerve can become infected and need a root canal — right through the existing crown.
Why does my crowned tooth hurt when I bite down?
Sharp pain on biting or release is the classic sign of a cracked tooth or a crown that sits a hair too high. A high crown overloads the ligament around the root and is a quick adjustment. A crack lets tiny movements irritate the pulp and often needs a root canal or, if it runs into the root, extraction.
Can my crown be saved if I need a root canal?
Usually yes. In most cases the endodontist makes a small access opening through the top of the crown, completes the root canal, and seals the opening with a filling — your crown stays in place. Only if the crown is loose, leaking, or poorly fitting does it need to be replaced afterward.
How long should a new crown stay sensitive?
Mild sensitivity to cold or pressure for a few days to a couple of weeks after a new crown is normal as the tooth settles. Sensitivity that is getting worse, lingers after cold is removed, or wakes you at night is not normal and suggests the pulp is inflamed — have it checked.
Is pain under a crown a dental emergency?
Not usually, but it shouldn't wait long. Throbbing pain, swelling of the gum or face, a bad taste, or fever point to an active infection under the crown and warrant a same-day call. Steady worsening pain is the tooth telling you the nerve is dying and needs attention.
Still have questions? Talk to a specialist.
Dr. Kung is happy to answer your question by phone before you book — no pressure, no charge for the conversation.