Pain After Dental Crown: Causes and Solutions

Pain after getting a crown on a molar?

Hello Doctor: My upper left last molar had a root canal treatment and was fitted with a crown.
At that time, my upper left wisdom tooth had already erupted, but it was not extracted, and I had no issues afterward.
However, last year, my upper left wisdom tooth decayed, so I had it extracted.
After a while, I noticed that the gap between the crowned molar and the adjacent teeth had widened, often trapping food.
Although I have improved my oral hygiene, in June of this year, the gum area around the crowned molar suddenly experienced severe pain.
The tooth itself might not have felt anything due to the root canal treatment.
I immediately visited a dentist, but after the examination, the dentist said there was no issue.
They mentioned that since the crown was secured with a post, it could not be removed for inspection or replacement, and they prescribed anti-inflammatory and pain relief medication for me to take home.
After following the doctor's advice and taking the medication, the pain persisted for another two to three days before subsiding.
Since then, I have experienced a dull ache in that area just before my menstrual period, and generally, there are no major issues.
However, biting down on hard food with my left side can cause discomfort.
I would like to ask the doctor: 1.
Does this situation indicate that there may be an infection, decay, or other issues within the crown of my upper left last molar? If so, how can I address this problem? 2.
Given that the gap between the crowned molar and the adjacent teeth is quite large, making eating inconvenient and uncomfortable, is there a way to reduce the space between the crowned molar and the teeth in front? Thank you, Doctor.

ginger, 20~29 year old female. Ask Date: 2018/08/28

Dr. Zhu Guanyu reply Dentistry

Hi Ginger,
Hello, the feeling of enlarged gaps between teeth is often the result of loss of gingival papillae, which can be attributed to gingivitis.
It is well known that staying up late (leading to decreased immunity), poor oral hygiene (not using dental floss), and excessive stomach heat (consuming too many heat-inducing foods) can often cause gum inflammation.
However, the regeneration of gingival papillae is difficult, so avoiding the aforementioned three factors can prevent further deterioration.

Thank you for your message! Wishing you peace and health.
Sincerely,
Dr.
Kuan-Yu Chu
Director of Dentistry, Taoyuan Hospital, Ministry of Health and Welfare

Reply Date: 2018/08/28

More Info

Understanding pain after receiving a dental crown can be complex, as it may stem from various underlying issues. Based on your description, it seems that you are experiencing discomfort in your crowned tooth, particularly after the extraction of an adjacent wisdom tooth. Here’s a comprehensive look at potential causes and solutions for your situation.

Potential Causes of Pain After Dental Crown Placement
1. Infection or Inflammation: Even though you had a root canal treatment prior to the crown placement, there is still a possibility of infection developing in the surrounding tissues or within the tooth itself. This can happen if bacteria enter through microleakage at the crown margins or if there are remnants of infected tissue that were not adequately treated during the root canal procedure.

2. Gum Issues: The sudden onset of severe pain in the gum area around the crowned tooth could indicate gingivitis or periodontitis, especially if there is inflammation or infection in the gum tissue. This could be exacerbated by the extraction of the wisdom tooth, which may have altered the dynamics of your bite or the health of the surrounding gums.

3. Crown Fit and Marginal Integrity: If the crown does not fit properly or if there is a significant gap between the crown and the adjacent teeth, food particles can become trapped, leading to discomfort and potential decay. The increased space you mentioned could be a sign of crown displacement or wear over time.

4. Underlying Tooth Issues: Although the nerve was removed, other issues such as a fracture in the tooth structure or issues with the supporting bone can cause pain. Sometimes, even after a root canal, the tooth can develop a condition known as "apical periodontitis," which is inflammation at the root tip.

Solutions and Recommendations
1. Consultation with a Dentist: It is crucial to return to your dentist for a thorough examination. They may recommend X-rays to check for any signs of infection, bone loss, or other issues that may not be visible during a standard examination. If there is an infection, they may need to perform additional treatments, such as a retreatment of the root canal or even extraction if the tooth is beyond saving.

2. Crown Adjustment or Replacement: If the crown is found to be improperly fitted, your dentist may be able to adjust it. In some cases, if the crown is significantly compromised, it may need to be replaced. This would involve removing the existing crown and fabricating a new one that fits better and seals properly against the tooth and gums.

3. Managing Pain and Discomfort: In the interim, over-the-counter pain relievers can help manage discomfort. However, it is essential to follow up with your dentist to address the root cause of the pain.

4. Improving Oral Hygiene: Since you mentioned that food gets trapped between your crowned tooth and the adjacent teeth, it’s vital to maintain excellent oral hygiene. Consider using interdental brushes or floss to clean between the teeth effectively. Your dentist may also recommend a specific cleaning regimen to help manage any gum inflammation.

5. Orthodontic Consultation: If the gap between your crowned tooth and the adjacent teeth is significant, you might want to consult with an orthodontist. They can evaluate whether any orthodontic treatment is necessary to close the gap or improve your bite.

Conclusion
In summary, the pain you are experiencing after receiving a dental crown could be due to several factors, including infection, gum issues, or crown fit. It is essential to consult with your dentist for a comprehensive evaluation and appropriate treatment. Addressing these issues promptly can help alleviate your discomfort and prevent further complications. Remember, maintaining good oral hygiene and regular dental check-ups are key to ensuring the longevity of your dental work and overall oral health.

Similar Q&A

How to Manage Sudden Tooth Pain After Getting a Dental Crown

If you have just had a dental crown placed and are experiencing sudden pain in the middle of the night after a week, here are some steps you can take to manage the situation: 1. Pain Relief: Take over-the-counter pain relievers such as ibuprofen or acetaminophen to help alle...

Dr. Zeng Guanghui reply Dentistry
If the pain persists and does not improve, it is recommended to return to the dentist who provided the dental crown for an examination. Dr. Tseng Guang-Hui, Department of Dentistry, Nantou Hospital.

Understanding Tooth Pain After Dental Work: Causes and Solutions

In June, I went for a routine dental check-up. I was concerned about a large cavity on the lower left second molar, fearing it might crack, and I occasionally experienced mild pain. I asked the dentist if I could get a crown for that tooth, and the dentist agreed. Therefore, I ha...

Dr. Huang Tingfang reply Dentistry
Hello Sally: There are many reasons for occlusal pain. As you mentioned, deep cavities causing pulpitis or cracked teeth are among the causes of occlusal pain. Root canal treatment followed by the placement of a crown is one option for treating this type of pain. However, the exa...

Understanding Dental Issues: Pain and Concerns with Dentures

Hello Dr. Chang, I would like to ask you a few questions: I have a connected dental crown on my upper left teeth #5 and #6 (meaning there are no individual crowns). The dental pulp has been bonded, but the crown has not been permanently cemented yet; it is only temporarily atta...

Dr. Zhang Xiangyuan reply Dentistry
Dear online user, Based on your description, here are the responses: 1. It is possible to experience pain after completing root canal treatment. However, you should consult your dentist for an X-ray and further examination to determine the potential source of the pain. 2. T...

Understanding Pain in Root Canal Treated Teeth with Crowns

The molar that has undergone root canal treatment and has a post and crown is experiencing soreness, tenderness, and swelling when biting down while eating, which lasts for a while. There is no bleeding when using dental floss, and X-rays taken during the dental visit show no oth...

Dr. Zhang Xiangyuan reply Dentistry
Dear online user, based on your description, it seems that you have undergone root canal treatment and received a crown on your molar, but you are experiencing sensitivity and pain when biting down. It is advisable to avoid excessively hard foods while eating and to maintain good...