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Sensitivity to heat/cold in tooth with crown
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Sensitivity to heat/cold in tooth with crown

In November 2006 I received a permanent crown on an upper molar.  At that time, there was slight sensitivity to heat and cold, but I was not concerned. Then in January 2007, I underwent a free gingival graft procedure where tissue was harvested from my palate - the site was directly adjacent to the tooth with the new crown.  Since graft procedure, the crowned tooth has become extremely sensitive to heat and cold and is also uncomfortable with chewing pressure.  The tissue graft and harvest site have healed perfectly and both look "excellent" according to the periodontist that performed the procedure. The periodontist claims that the tissue graft procedure could not have had any impact whatsoever on the sensitivity I now feel in the crowned tooth (and hew was, in fact, rather defensive when I asked about the possibility).  He speculates that it is pulpitis. I have not yet returned to my dentist who did the crown for a diagnosis.  Is it possible that the graft procedure is related to the discomfort I now feel in the crowned tooth?  If not, is it common for symptoms of pulpitis to appear several months after the crown procedure?  How is it determined that pulpitis is reversible and will heal on its own versus irreversible and require a root canal?  
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Avatar_dr_m_tn
These are all good questions. If the graft(and I do not know this) has exposed any root structure around the crowned tooth that could explain the sensitivity. A pulpitis can improve but considering how long you have had the crown if it is a pulpitis it is more likely to need a root canal. See your gp and have him take an x-ray and examine the area.
4 Comments
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Avatar_m_tn
could be the tooth that had the graft. could be a coincidental occurrence of pulpitis in the crowned tooth. could be that the graft procedure resultd in exposed tooth structure of the crowned tooth, making it sensitive. if you are not happy with the opinions you are getting from the possibly prejudiced (they did the work) dentists who treated you, i'd advise an idependant second and maybe third opinion, perhaps from a well referred periodontist or endodntist.
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Avatar_n_tn
I recently sold a parcel of land to a cosmetic implant specialist. During the course of our meetings he said that the best thing that ever happened to his business was putting crowns on live teeth. He said he would reccomend that old fillings be replace unless absolutely necessary to put a crown on. My dentist has been pushing me very hard to put crowns on my teeth with large fillings. I went to another dentist for an exam and his consult on the condition of my teeth and no mention was made of the necessity of having crowns. My dentist, when I reported  the implant specialist opinion, responded vehemently that it was bull. The response from my dentist was so strong that it concerned me that he wasn't telling me everything. My question is whether there is any truth to the implant specialists comment. To date I have had three crowns and two have given me problems with sensitivity for several years. I am suspicious that I made a mistake having crowns on these teeth simply because they had large fillings since I had do problems with them before the crown work. Is this issue being currrently debated in the dental community?
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Avatar_n_tn
I have gone to the dentist every 6 months for all of my adult life (35 years).  I had the same dentist all of this time.  I recently moved out of state and had to find a new dentist.  My old dentist was believed that if it isn't broke, don't fix it.  I had several teeth with large fillings.  The new dentist immediately told me I needed to have caps put on as a proactive measure.  I listened to him and have had the worse 4 weeks of my life.  One problem after another with two upper molars that I prior to this had absolutely no problem with.  My gums have been red and swollen and I have been in constant pain and taking constant over the counter pain killers while having the temporary cap.  At one point I went back to the dentist and he removed the cap (that his assistant had cemented) and cleaned out chunks of cement.  Even though I switched off on the pain killers, I ended up in the ER one night doubled over in pain, with dizziness, cold sweats, chills, etc.  My dentist said I might need a root canal, so I went to an Endodontist.  He advised I had an infection and put me on antibiotics.  I just started them, one full month after the start of cap prep.  And I likely will need root canal.  So, I will NEVER, EVER listen to a dentist who tells me to fix something that isn't broken.  This has been a very painful and expensive lesson to learn.  To add insult to injury, I had to pay a high co-pay for all of this work and pain and I've now exhausted my annual insurance limit and will have to pay for the RCT on my own.
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Jerome Tsang, DDSBlank
Irvine Modern Dentistry
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