How to Manage Dental Crown Pain
Once you've gone to the trouble and expense of having a crown placed on a tooth, it can be frustrating to experience dental crown pain. The cause may not be serious, but it is a red flag that you need to call your dentist.
Identifying the Source of Pain
There are a number of reasons why patients sometimes experience dental crown pain and some clues that may be helpful in pinpointing the source of pain.
"It's important to consider why the crown was done," says Sharon Siegel, MS, DDS, Chair and Professor at Nova Southeastern University-College of Dental Medicine in Fort Lauderdale, Florida. "Usually, it's been placed on a tooth that has already been stressed."
Often, she explains, when decay forms around an old filling in a tooth, removing the restoration and cleaning out the decay leaves very little remaining tooth structure. After a new restoration is done, a crown is needed to protect and support the portion of the tooth that's left.
"Since the new restoration is closer to the pulp, the nerve may have some inflammation. It could also be that just removing the old restoration and working on the tooth has affected it," Dr. Siegel says. Many times the tooth is able to recover, but when it can't, a root canal is needed to relieve the pain.
Often, the nerve may have already had a problem that was unrelated to the crown that just hadn’t surfaced yet. It's likely that the tooth would have required a root canal even if the crown had not been placed.
Dental Crown Pain vs. Sensitivity
A tooth may become sensitive to temperature following the placement of a crown if the nerve inside the tooth is still alive. Both hot and cold foods and drinks can trigger a painful response when they come into contact with the crowned tooth.
If the new crown contains metal, that could be the cause of the sensitivity. Crowns are made from variety of materials including all metal, porcelain covered metal, resin and ceramic. According to Siegel, metal restoratives are more likely to result in sensitivity to cold than those made of other materials.
"Sometimes the discomfort is because the substructure of metal is sensitive to temperature," says Siegel. In these cases, the sensitivity is usually temporary and disappears in two to four weeks once more tooth structure is produced. This new growth is known as secondary dentin.
Dentin is the hard connective tissue found throughout the tooth that protects the roots of the tooth. Unlike enamel, which cannot be replenished, dentin forms continuously throughout the life of a tooth and grows at a faster rate in response to dental decay, irritants or excessive wear. Dental crown pain should subside as the secondary dentin forms.
Discomfort when biting could indicate a problem with the position of a crown. "If the crown was left a little high, your dentist may need to adjust the height," Siegel says. It's important to correct the problem right away since any delay can lead to further complications including jaw pain and issues with the bite.
What to Do About Dental Crown Pain
Dental crown pain that is due to problems with a tooth's nerve may require a root canal. It’s possible for your dentist to perform a root canal on a crowned tooth without removing the crown. "If the nerve dies, you can go through the crown to do a root canal and still preserve it as long as you have a good seal," says Siegel.
Following the root canal, a restorative material is used to seal the crown. This procedure can save patients both the time and expense of replacing the crown.
When a crown is too high, the teeth don't come together in the same way they used to. The bite can quickly be evaluated to determine which portion of the crown is causing the problem. "Your dentist will mark the area that's too high and adjust it with a rotary instrument. Afterwards, the area is smoothed and polished. It's very simple," explains Siegel.
It's not unusual for a newly crowned tooth to be sensitive to cold for a few days. If that is your only symptom, it's probably okay to wait a week to see if the issue resolves on its own. But if you experience spontaneous pain, a bad taste in the mouth or swelling, it's a good idea to call the dentist right away.
"I would prefer patients call me rather than waiting until they get to the point where the problem is hard to reverse," Siegel says.