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Pain w/ heat sensitive crown.
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Questions in the Dental Health forum are answered by Dr. Jerome Tsang. Topics covered include bridges, cavities, crowns, and x-rays.

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Pain w/ heat sensitive crown.

I had a root canal and crown put on at least 3 years ago. Everything was fine except biting down which was only pressure. Over time the pressure went away.  About a year ago I felt something funny in there ( a sweet pain type feeling, like a tiny cavity) and the dentist had a crappy attitude and offered to take the $850 crown off and put a new one on at my expense.  She ultimately wanted to wait cause she didn't find anything with an x-ray.  Now, about another year later.  I am having pain when the tooth is exposed to heat...any heat, even warm.Nothing seems to happen when there is cold,but I haven't really tried direct contact with cold.  I can put my tongue over the tooth after I have eaten something warm and get intense pain.  I have not gone to the dentist yet.  I have had this pain for several months now and am wondering if it is serious enough for the crown to be replaced.  I'm looking for what the right procedure for this will be.  Please list all options that I should be looking at.
Thank you for all your help.
Related Discussions
Avatar_dr_m_tn
I think you have to look into the root canal being the problem. Usually pain to heat is indicative of gases in the canal which expand causing the discomfort. I do not think the crown should be redone without addressing the rct issue.
19 Comments
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Avatar_m_tn
teeth that had root canal treatment had the nerve removed. these teeth should not be sensitive to heat. changing the crown is like repainting a car hoping to make it run better. something is going on possibly related to a fracture, a periodontal problem, or a different tooth, or maybe something else altogether. I'd have a root canal specialist evaluate it.
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Avatar_n_tn
there is always the possiblity (if this is in fact the root canal tooth) that they didnt remove all of the nerve. id follow the advise having the tooth and surrounding teeth examined
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Avatar_n_tn
Don't get the crown replaced until you have the internal structure of the tooth examined, it will be a waste of your money if you need another root canal.  It could be several things:

1. A cracked root.  It doesn't matter if the nerve IN the tooth is gone; a cracked root will inflame the nerves all around it.
2. A different tooth.  It can be very difficult to distinguish pain from one tooth to another especially if it's BETWEEN the teeth but on the "different" tooth than the one you had the work done on.
3. An incomplete or failed root canal.  This happened to me on TWO teeth.  Both root canals failed and within a few years I started getting odd sensations in the teeth, and the x-rays showed the slow growth of cysts on the end of the roots as a result.  I ended up needing apicoectomies on them (surgical root canals performed from the tip end of the root).  I could have had regular root canals again, but once infection spreads outward from the tip of the root, the prognosis for a regular root canal is NOT good (two oral surgeons and my dentist all conformed that.)  Don't let that panic you.  It's not as bad as it sounds.  They were about the same price as a regular root canals, and mine were done with just regular novocaine.  It was annoying having stitches in my gums for a few days though.

Hope that helps.  Good luck.
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Avatar_n_tn
Thankyou so much for your help and especially the doctors who take the time to answer all our questions.
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Avatar_f_tn
novacaine hasnt been used in years just to let you know. im sure you meant lidocaine.
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Avatar_n_tn
Well, I don't know, they've always called it novocaine in front of me.  In fact, I've had discussions with them about the "novocaine" and the effects of the epinephrine in it.  I looked it up and according to google results "novocaine" is still regularly used.  That included my "surgeries" in which I was fully awake, and just numbed.
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Avatar_f_tn
i used to do the ordering at a dental office. there wasnt "novocaine" anywhere in the supply books. people refer to it as that, when in fact it is now a different make up.
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Avatar_f_tn
Novacaine was a brand name of a dental local anesthetic that was discontinued years ago. People use the term Novacaine like a generic term for local anesthetic similar to how we call all brands of facial tissue "kleenex."

i hope this helps jordy. now i read about another type of anesthetic with the spelling of novocain, it was referred to as procaine. im not sure if that is what you meant. i took the above clipping from a site i googled
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Avatar_n_tn
It doesn't help me because it doesn't matter to me.  Comb through this site and count how many times someone uses the word "novocaine."  (I knew it was used as a generic term as well, by the way.)  Perhaps you can start a thread on that to correct everyone going forward.
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Avatar_f_tn
i was trying to help, if you dont like it, then i suppose you are embaressed. you in no way said it was generic, you just are the type that doesnt like to be proven wrong. have a GREAT day!!
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Avatar_n_tn
I'm not embarrassed.  I told you I don't care.  How does "just novocaine used" say I WASN'T using it as a generic term?  Your first post got me wondering, so I looked it up.

I'm just more interested in why you picked MY post, when this board is littered with novocaine references.  Who really cares?  Your tone and phrase was "I'm sure that's what you meant" which I have to wonder...who cared?  EVERYONE knows what "novocaine" means, but for some reason you took issue with that.

You have no clue what "type" I am. Wow, one or two brief exchanges with a stranger on the internet about ONE topic (about ONE WORD, in fact) and you have that person completely analyzed--that's very impressive on your part!  Here's what I'm not--I'm no dental professional (like most on this board aren't.)  I really don't care if you feel the need to correct someone using "novocaine" instead of "lidocaine."  What would you expect when all around me (and likely most non-dental professionals on this board) all that was said by several oral surgeons and dentists that they were using "novocaine?"

Fine, you're a dental expert.  That's great.  I'm going to recommend again that you start a post informing everyone going forward the proper usage of the word "novocaine" (and I'm still puzzled as to why you picked out MINE to comment on.)

I did have a great day, thanks!
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Avatar_f_tn
to everyone that had to read this nonsense, i simply stated what i have heard from many people. they really dont know what is used and what isnt. my intentions were not to cause the uproar and lashings that were given. i dont come here often and this is one of the few posts i have read. Dr.'s, im sorry your posts were used in a nonprofessional and rude manner. i will stay away from that poster since he cannot discuss or take a simply correction. thanks!
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Avatar_n_tn
I'm with Kitty on this one.
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Avatar_n_tn
Well, I thought this was a site that had informative people on it, but wow!  I had no idea what level some people will go to to correct someone on a very minor term. And BTW, I have always heard the dentist even call it "Novacaine".  Sorry, I just had to add my 2 pennies. Whether it's important or not

I have been to a dentist and he couldn't find anything (again) in the x-ray. The dentist that looked at me said that I should have a deep cleaning and antibiotics put in the deep crevice that is between the area of the tooth that hurts so much.  I think it will be okay if I took antibiotic pills to clear it up. I have Cipro 500mgs. Does anyone have any thoughts on that,without the drama?  lol....10 fold!

The endodontist quit that morning of my appointment,so I didn't get to see him. Seems like Gentle Dental has a high turn over.  Almost every time I go to them there is a new dentist to see me.
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Avatar_f_tn
oh my god! people are crazy! ive never heard a dr call it novocaine, nor do i feel it has been a big deal to correct someone. some people need to GET A LIFE!!! so i corrected someone. and if your dr calls it novocaine, maybe you should switch drs. lord people, i didnt say anything that big of a deal. get over it!! if your skin is that sensitive then maybe you should stay in your house the rest of your life, hide from the world, and pretend it doesnt exist, god i cant imagine being that sensitive to the world!!
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Avatar_f_tn
get over it! so i corrected someone i cant believe you have nothing else to do but say im wrong!!!!! you may need to get a life
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Avatar_n_tn
BTW,  I use a waterpik almost everyday and a sonic care toothbrush.  That cleans between the teeth very well and hardly leaves any debri .  I thought I might get some other comments on what the dentist said and my thoughts about the antibiotic, not my attempt to clean up the extra debri that is floating around.
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Avatar_n_tn
Just so you know, I found this website and thread of discussion by searching the Web under    
'NOVACAINE/injection/pain/tooth'   .......
  There, does that fan the flame back up  ?!?!   :)
  I'm glad I initially used the incorrect term of 'Novacaine' in my search, because after reading all of this and going back out of curiosity and searching again, substituting the word 'Lidocaine' for 'Novacaine', this page didn't come up!
(The links I did get with 'Lidocaine' were much more technical  and generally did not include web discussions.)
So thanks for the correction of terminology; it's good to know  two anesthesia words for related searches.  Keep in mind they  will probably bring different results!  
  I hope your pain issues are resolved.  h.i.s.
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