Functional integrity on coral reefs is strongly dependent upon coral cover and coral carbonate production rate being sufficient to maintain three-dimensional reef structures. Increasing environmental and anthropogenic pressures in recent decades have reduced the cover of key reef-building species, producing a shift towards the relative dominance of more stress-tolerant taxa and leading to a reduction in the physical functional integrity. Understanding how changes in coral community composition influence the potential of reefs to maintain their physical reef functioning is a priority for their conservation and management. Here, we evaluate how coral communities have changed in the northern sector of the Mexican Caribbean between 1985 and 2016, and the implications for the maintenance of physical reef functions in the back- and fore-reef zones. We used the cover of coral species to explore changes in four morpho-functional groups, coral community composition, coral community calcification, the reef functional index and the reef carbonate budget. Over a period of 31 years, ecological homogenization occurred between the two reef zones mostly due to a reduction in the cover of framework-building branching (Acropora spp.) and foliose-digitiform (Porites porites and Agaricia tenuifolia) coral species in the back-reef, and a relative increase in non-framework species in the fore-reef (Agaricia agaricites and Porites astreoides). This resulted in a significant decrease in the physical functionality of the back-reef zone. At present, both reef zones have negative carbonate budgets, and thus limited capacity to sustain reef accretion, compromising the existing reef structure and its future capacity to provide habitat and environmental services.