Pressure in the tooth after crown prep/sensitivity

[raspberry]

Doctor has prepared my tooth (molar, #30) for a crown, however while waiting for a crown for a about a week I've experienced pain in my down and even upper jaw from the right side. Took ibuprofen, so I could function during the day and sleep during night.  No pain directly in the tooth, but dull pain around it in the jaw.
Went back to the doctor, he took my temporary crown off, to relief, as he said the pressure inside the tooth; looked at x-rays, said that he doesn't see/think that it is infaction. Assistant put some dental material on the top of the tooth (used for fillings?) and put temporary crown that I can actually take off easily myself.  
The same day in the evening I started having pain again and could sleep, so I took the temp crown off, pain dissapeared and I slep very well. In the morning didn't have much pain, put temp. crown back so I could eat. Doctor told me that next week they'll get crown from the lab and he'll put it on temp cement for several months.
I was wondering if you could please explain what is happening with my tooth and if I'll end up having a RC whether I could save my tooth? I am young female and it upsets me alot. Thank you very much in advance.

[Jerome Bogin, D.D.S.]

Something doesn't sound right. I have been a dentist for over thirty eight years and I have never had one of my patients remove a temporary so they could sleep and replace it the next day.I don't understand what you meant by the pressure in the tooth.Maybe the temp is not fitting well and that is what may be the cause of the discomfort.I would not be happy with placing a crown on this tooth with the symtoms as they are. I don't know if you will need RCT but I  don't think you are going to keep removing and replacing the finished crown.

[mike1105]

sounds like one of two things--- either a pulpitis (inflamed nerve) which in your case should be reversible--- i'm assuming the tooth is sensitive from the work that was done on it and not decay or a fracture (which is not always visible on films believe it or not)..... you should realize that teeth are alive, and even though you are numb there is alot of trauma to the tooth when it is prepared (drilled down) for a crown. it usually heals but not always--- sometimes root canal treratment is needed.  i always explain this possibility to my patients before i do any drilling at all on any tooth but especially for crowns since so much tooth structure is removed. the other thing it coulod be is a poorly fitting temporary that irritates the tissues around the tooth or perhaps even the tooth itself. If the temporary is too high you can get sensitivity easily since the bite is off and all your biting pressure is on one tooth. I like the idea of cementing the crown with a medicated cement. If you are comfortable and the crown has extremely well adapted margins, I would consider leaving it like that indefinitely and checking it for looseness or cement washout at your recall visits. I have 2 crowns in my mouth with temporary medicated cement for 13 years.  one other thing it may be is trauma from the injection but this would not feel better by simply removing the temporary.

[raspberry]

thank you for your comment.
after doctor took the temp crown off and made a new one that I can take off myself (without cement) I had less pain and could sleep at night, most of the time I don't have pain at all.  He'll get a new crown from the lab soon and hopefully will place it on the medicated/temp cement. But there is a possibility that I might need a RC, and I don't know whether I should just get it without waiting?
As I am afraid that if I'll leave it like that there might be some kind of inflammation later when the crown we'll be placed on the tooth.

[raspberry]

I do have one more question--about temp crown that was placed with no cement.
Since it's only for 3-4 days (my perm. crown should be back soon) and since my gums were irritated/had a lot of pain, my doctor put it without cement, which decreased my pain.
I am worried about my tooth being exposed to bacteria and saliva that enters from the inside of the temp. crown all day long. Will that cause a problem? The inflammation of my gums around the tooth has decreased, but what about the potential infection that I could get? Thank you.

[mike1105]

a few days or even a couple of weeks is not enough time for bacteria to set in and do damage. i would not worry about an infection as long as the pulp (nerve) is not exposed.... which i would doubt because it's be pretty obvious  and the dentist would have told you that a root canal treatment is needed in that case. do not have the root canal done unless your dentist tells you one is needed----- they do not always work, they are expensive, and more tooth structure will need to be removed which further weakens the tooth. i would have the permanent crown cemented with medicated cement and see how you do. If all is well, leave it for a while and have periodic films/clinical exams to check it's integrity. If it comes off, I'd cement it with permananet cement at that time. If root canal is needed, a good endodontist can make a small access hole through the top of the crown and many times the crown willl not have to be remade..... i just wonder why your dentist has not explained all these scenarios to you... something is not right there, unless you did not ask----- and even then I would wonder why you did not ask......??

[raspberry]

Thank you.
I didn't ask because I wasn't able to see him over the weekend and on Friday I didn't think about asking...(too much pain).  My tooth is doing much better since my initial question, inflammation has decreased, most of the time I don't have pain,or only pain around the tooth (not in my jaw) so hopefully I will not need a RC.
I saw my dentist yesterday, he also pointed out that I shouldn't worry about bacteria at this point, when my tooth is without a temp crowm, he thinks that my gums look much better, so on TH I'll go back to his office to get a perm crown (I think he wants to put it on the medicated cement as you suggested in your previous message).  
Thank you once again for your answers!

[G'Na]

I am experiencing the same thing.  Supposed to get the actual crown put on this Thrs. but after seeing this site, am going to ask dentist if he will put a temporary "medicated" crown on, I guess?  It was a large filling on tooth #3 that had broken last month.  It wasn't bothering me at all.  He put temp. crown on and it's been "sensitive" for 10 days.  It doesn't hurt with hot or cold or when I eat on it.  But it's sensitive afterward.  I went back last Friday and he x-rayed it again, and removed a little of leftover cement - I felt immediate relief, but now it's still a little sensitive.  He said possibly a root canal is next - your opinion or comments, please?

[essbeep]

Hi all. I had a tooth prepared for a crown on Tues. March 7. After the carbocaine wore off, i decided to have lunch and when i bit down on that side, a SHOCK of pain went through my mough..like i "hit a nerve." I called the dentist and they said it was most likely cuz the  truth had been traumatized. It's now Thursday evening and it STILL  hurts to bite down... i did not have a root canal, and i did go to the dentist this afternoon to have  him look at it. He said the gum and crown look good and he did file it down a bit, but it also  hurts when i press from the side or even just wiggle my mouth...it's not an ache, it feels like nerve/root pain. Long ago i had a freak extra root and had a root canal with NO novacaine and boy do i know what root/nerve pain feels like. This is similar but the dentist said i should take a NSAID and let it heal for a few more days. Does this sound right? thanks, Sue

[Begee]

A related discussion, Large Anterior Crowns was started.