Monday, November 16, 2009

How long after getting a dental crown should the tooth ache? (it's constant now)?

The tooth has a large filling, and after two months it started being sensitive to cold and aching when pressure was applied to it. My dentist recommended a crown. This was done last week, and now the pain is constant. Will this get better when they mount the permanent crown, and what are my chances of needing a root canal?

How long after getting a dental crown should the tooth ache? (it's constant now)?
This is a question that arises frequently and there is no cut and dried answer.





Sometimes the trauma to the tooth from preparing the tooth for a crown can cause the pulp to become inflammed a bit. Other times the need for the restoration or crown in the first place is the reason the pulp is irritated. The tooth becomes sensitive and can hurt a bit when you tap it or bite on it. If this goes away, then tooth is recovering. If it does not, then you will need a root canal (the pulp got pushed over the edge!)





The transition from cold sensitivity to constant pain is a bad sign. Chances are you are going to need a root canal.





You can visit your dentist - maybe he can work on the temporary crown so you don't bite on it when you close your teeth together (if he/she hasn't already) - this can help the pulp heal.





If your tooth doesn't start feeling better you should not get the final crown just yet (because if the tooth acts up more after you cement the final crown they have to either cut the crown off or cut a hole in it to do the root canal (which ruins the crown). So ... you want this problem resolved before you get the final crown.





Also, if the pain goes away the dentist should do a cold test on the tooth (with cold water or a cold piece of cotton) before cementing the crown. If there is no response to cold at this point it means the nerve is dead and should be removed (as it is necrotic tissue that is a source of infection). If there is a brief amount of sensitivity to cold but it goes away, then this is a sign the pulp recovered and the final crown could be cemented.





Hopefully you don't need the root canal. If you do, though, get it done before the final crown is cemented. Hope this helps.
Reply:it sounds like you need a root canal,,, while mild discomfit is normal when a temporary crown is placed, it shouldnt hurt that bad! it sounds like you have an infection in the root
Reply:If you have a throbbing pain, or swelling it has moved to the nerve and you will need a root canal. Check your bite too. If your new crown is high ( you are hitting it first) It will continue to aggravate the tooth. Also if you still have your temporary crown on, the margins may not be perfect and you may have some root exposer. Temporary crowns are made chair side and tend to have this problem. once you have your real crown on this problem should go away. brush you teeth with warm water and try a tooth paste for sensitive teeth.
Reply:maybe there's something wrong wth the way your dentist did with the procedure. try the permanent first. if it still hurts after a couple of days, visit your dentist again.maybe you need a root canal.
Reply:The Dentist should have checked the vitality of the tooth. The tooth is probably sensitive because of the amount of filling material in it. If the tooth needs a root canal it would be best to do it prior to having the crown placed. They can do a root canal through the crown but then you will have a small hole in the crown. The Dentist will tell you that it will be filled but no matter what you have now broken the seal and bacteria can get in. The pain should be better once they place the crown. If not then you may need a root canal. I think that the Dentist should have first looked into doing the root canal, then placing a crown over that. You should ask him why they are choosing not to do root canal first.
Reply:The symptoms you described are classic of a tooth that is on the verge of abscessing. It very well may be doing just that. Your dentist may have suspected a weak cusp, crack or fracture, or sensitivity due to the large filling, and that was the reason for the crown. It's really hard to say with out an exam. It could be that the temp isn't fitting correctly at the margins, allowing leaking that is causing sensitivity. Or your bite is off on the temp and you've been hitting it so long the tooth has become hypersensitive. Since you are in pain constantly, I would call the doctor. He will probably phone in an antibiotic and pain med for you to get started on tonight. If it's an abscess, it will take a couple of days for the antibiotic to start working giving you some relief. I am sure the doctor won't seat the crown until the tooth is sound. He doesn't want to drill a hole into a perfectly good crown to do a root canal unless he has too. Also it's easier to get to the canals without the crown covering it. At any rate the doctor will be the one to diagnosis the problem with a simple x ray and an exam. For now you can start taking Advil or Motrin at 600mg to help ease the pain and inflamation. But call tonight and leave a message, the doctor is always available to take care of his patients in an emergency. I hope I've been of some help to you in this situation. Good luck.


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