I've just had a temporary crown fitted yesterday over a cracked tooth and I'm still experiencing pain when biting or chewing on it, and I'm wondering if this is something that will stop when a permanent crown is fitted, or will it need root canal treatment?
Here's a bit of a background on it:
The tooth in question is a lower left molar, tooth #5 I think. It had a filling on top (middle) done years ago, and some 5 weeks ago I had the misfortune of biting on to a popcorn kern which seems to have landed straight in the middle of the filling, and immediately I was hit by sharp pain. I went to the dentist straight away and he said the amalgam filling was fine, but the tooth has cracked in two places, and he spotted an older crack that might have been there a while.
He attempted to fix it by replacing the old amalgam filling and sealing over the cracks with a new epoxy resin filling, which left me with a tooth that was painful when chewing/biting. My dentist checked the bite on the tooth and found out that it was painful only on one corner of the molar. He filed it down a bit, and I spend 4 weeks waiting to see if it would settle down, which it hasn't. So my dentist suggested crowning the tooth as the next step. It would appear that the nerve is still fine, it's not too sensitive to hot/cold (not more than other teeth), it's just biting down that causes pain. He doesn't seem to think that root canal treatment was neccessary, but now that the tooth is prepped and a temp crown is on it, it's still painful when biting and I don't want to end up with a permanent crown that will need to be taken off for a root canal treatment. Not to mention still having the pain.
I am going to ring my dentist on monday to let him know of the problems, but I'd like to be well informed and aware of any possible solutions or complications when I do.
It appears that there is occlusal interference introduced by new temporary restoration. If the temporary can not achieve 100% comfort of bite, success of final restoration is questionable. Going back to your restorative dentist to have more occlusal adjustment is advised.If your dentist can not deliver a restoration with comfortable bite, you amy need to see an occlusionist or prosthodontist.
I went to see my dentist today, and he suggested to go ahead with the proper crown (metal bonded porcelain), but once it's ready to use temporary cement to see how I get on with it. If the pain goes away he will then cement it permanently, otherwise it still leaves an option to take the crown off and refer me to an endodontist for root canal treatment, and not destroying the newly built crown.
Sounds good to me, leaving all the options open. I'm still not sure that the permanent crown will fix the cracked tooth, but at least he has a way of checking that before setting it permanent.
even if you end up needing a root canal with a crown they drill and fill a small hole in the middle. it isnt as pretty but fully functional and not destroyed. since its a molar you might want to consider a gold crown. they are much more durable.
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