Tooth Pain Under the Crown

If your tooth hurts under the crown, do not panic – discomfort may occur immediately after the visit to the doctor and the installation of the crown. Most likely, the pain will subside within 2-3 days. However, if the tooth under the crown, which has been in place for a long time, starts to hurt – this is the reason to go and see the doctor again. The possibilities of modern dentistry in most cases allow you to save a tooth and its crown – mainly the prognosis depends on whether the tooth hurts “alive” or it has already been pulped earlier.

There are several common reasons for a toothache under a crown.

Causes of Pain Under Tooth Crown

Usually, before a crown is placed, the tooth is depulled-that is, the neurovascular bundle in the root and crown is removed, and then the canals are filled. Pain can be caused by some peculiarities of these manipulations:

Tooth Pain Under the Crown

  • incomplete canal filling – as a result of the formation of voids in the root canals, an infectious process may begin to develop; pus accumulates near the apex of the root, this becomes a cause of pain. This is a common complication of endodontic treatment, especially in cases where the root canals are too narrow or curved;
  • Sagging of the filling materials over time – even if the root canals are fully filled, changes in the physical properties of the materials can also lead to cavities – infection develops in them, the inflammation spreads to the tissues near the apex of the tooth root;
  • Removal of the filling material beyond the apex of the root – “extra” material in the periodontal tissues can provoke irritation and inflammation.
  • Pulpitis. Inflammation of the pulp may occur in cases where it has been decided to preserve it – treatment of the tooth can lead to burns, the infectious process may already begin in the pulp and be asymptomatic, which causes inflammation.
  • Keeping the pulp alive before placing a crown on the tooth is a rare occurrence, usually the “nerve” must be removed.

Perforation of the root canal walls. Perforation is the creation of a hole in the root canal, a phenomenon that occurs for several reasons:

  • Perforation can be a consequence of mechanical treatment of the canal with a thin instrument – it must enter the entire length of the canal. If the canal is curved, even a slight pressure can cause the instrument to pass through the tooth tissue;
  • installation of a post can lead to perforation – it is installed in the root canal, which in the corresponding anatomical features of the structure of the root system can also lead to the formation of a hole.

The hole is a “gateway” for infection – tissues become inflamed some time after the placement of a post or endodontic treatment, which causes pain.

It can also be caused by the presence of a foreign body in the root canal. During endodontic treatment, the tip of the instrument may break off, and the subsequent filling of the root canal with the foreign body leads to pain. There can be several reasons for the breakage – the most common is canal curvature. If they are difficult to pass, the instrument can break due to high stress.

Other Causes of Tooth Pain Under the Crown

As a rule, in this case, the patient feels pain when exposed to temperatures, and the tooth under the crown hurts when pressed. The throbbing can appear when you load, chewing on the side with the crown in place. Tapping on the tooth also causes discomfort.

In order to avoid this complication, the dentist always performs an X-ray before placing a crown or any other dental prosthesis.

If the treatment and preparation of the tooth for dentures is followed, the crown can also cause pain – if the restoration is overbite, the patient feels discomfort while clamping the jaw. That is why it is important to “try on” the crown before the final placement – a good orthopedist will assess the degree of comfort for the patient beforehand.

What to Do?

Many people ask themselves the question – if a tooth hurts under the crown, how can you relieve the pain? First of all, it is important to consult a doctor – do not make independent attempts to eliminate unpleasant feelings. Today there are several ways of treatment that do not involve the removal of the crown – the doctor will offer one of them if indicated.

What will doctors do if you have pain under the crown

First, diagnosis
X-rays solve many questions. If necessary, prescribe a more detailed examination – a CT scan, consultations with related specialists, such as an oral surgeon. It all depends on the situation.

Then – anesthesia
All procedures are performed under anesthesia. This simplifies the work of a doctor, ensures good accessibility and quality of work.

Next, the treatment
It can be a nerve extraction, filling or re-treatment of the root canal. Or surgery, such as an apical root resection if the process has progressed to periodontitis and a root cyst. Or extraction, if there is no chance to save the tooth.

At the end – restoration of dental tissue integrity and function
The choice of method depends on the stage of inflammation and the amount of “loss”. It can be simply a filling made of special material, or a new crown or implant. Prices vary by orders of magnitude. Therefore it is better even in terms of money to apply immediately if it hurts under the crown.

What You Shouldn’t Do if Your Tooth Hurts Under the Crown

  • Treatment over the Internet – look for folk remedies, gargle, self-prescribe medicine and take it. Now it is not a problem to buy or order any medication. But the consequences of improper treatment can be more expensive than a visit to the doctor.
  • “Muffle” the pain – painkillers simply “mask” the symptoms, and meanwhile the inflammatory process continues and spreads to other tissues. The result can be sepsis, a severe and often fatal complication.
  • Ignore the symptoms – so it happens that the tooth hurts only when pressing or biting, and does not bother at other times. There are no other signs of obvious inflammation, such as swelling of the jaw or fever. Nevertheless, even a sluggish process requires treatment.
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Dr. R.Mammadli (Dental Expert Team)

Bachelor in biotechnical medicine. Author of several medical blogs, author of articles on dentistry and oral health.