Sensitivity Issues with Porcelain Crowns: What to Do? - Dentistry

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Understanding sensitivity issues with porcelain crowns can be a source of concern for many patients. It’s important to first recognize that sensitivity after the placement of dental crowns, particularly porcelain crowns, can occur for a variety of reasons. In your case, it seems that you initially had no issues after the crowns were temporarily placed, but now you are experiencing sensitivity when consuming cold beverages.
Sensitivity in teeth can arise from several factors:
1. Pulpal Sensitivity: If the tooth's pulp (the innermost part of the tooth containing nerves and blood vessels) is irritated or inflamed, it can lead to sensitivity. This could be due to the preparation of the tooth for the crown, which may have exposed the dentin or caused some trauma to the pulp.

2. Cementation Issues: If the crown was not properly sealed or if the cement used to bond the crown is not adequately protecting the tooth, it can lead to sensitivity. This is especially true if there are gaps between the crown and the tooth that allow temperature changes to affect the tooth.

3. Underlying Dental Issues: If there was pre-existing decay or damage to the tooth that was not addressed prior to placing the crown, this could also lead to sensitivity.
4. Material Reaction: Some patients may have a reaction to the materials used in the crown or the cement, which can lead to sensitivity.

5. Gum Recession: If there is any gum recession around the crown, it can expose the root surface, which is more sensitive than the enamel-covered part of the tooth.

Given that you have experienced a sudden onset of sensitivity after a period of none, it is advisable to consult your dentist as soon as possible. Here are some steps you can take:
- Dental Evaluation: Schedule an appointment with your dentist to evaluate the crown and the underlying tooth. They may take X-rays to check for any issues with the tooth's pulp or surrounding structures.

- Sensitivity Management: In the meantime, you can use desensitizing toothpaste, which can help reduce sensitivity over time. These toothpastes contain compounds that block transmission of pain signals from the tooth surface to the nerve.

- Avoid Triggers: Try to avoid very hot or cold foods and drinks until you have seen your dentist. This can help prevent further discomfort.

- Consider Temporary Solutions: If the sensitivity persists, your dentist may suggest a temporary filling or a different type of crown material that may be less sensitive.

Regarding the concern about needing a root canal, it is not uncommon for sensitivity to arise after crown placement, but it does not always mean that a root canal is necessary. Your dentist will be able to assess whether the pulp is healthy or if there is an infection that requires treatment.
In summary, while sensitivity can be concerning, it does not automatically indicate that the crown needs to be removed or that a root canal is necessary. A thorough evaluation by your dentist will provide clarity and help determine the best course of action. Remember, timely communication with your dental care provider is key to addressing any issues that arise after dental procedures.