Issues with All-Ceramic Crowns: Pain and Inflammation Solutions

Q: Issues with All-Ceramic Crowns: Pain and Inflammation Solutions

Hello： Based on your description, it has been two months since the dentures were placed, and the symptoms have not improved, even affecting your daily life. <br>It is recommended that you return to the original clinic, where the dentist can remove the all-ceramic dentures and the

All-ceramic crown

Hello Doctor: I had a full porcelain crown placed on my molar two months ago.
After one week of use, I have been experiencing persistent inflammation and pain at the contact point between the inner gum and the tooth surface, as well as in the posterior interproximal spaces.
The swollen gums make the entire tooth feel loose, resulting in severe occlusal pain.
Even light tapping on the tooth surface or brushing causes unbearable pain.
I have been undergoing continuous treatment with my dentist for the past two months, but I have only been told that the issue is due to poor oral hygiene.
Over these two months, my dentist has repeatedly instructed me on all methods of cleaning my teeth, but despite using every possible cleaning method daily (toothbrush, dental floss, interdental brushes, water flosser, mouthwash), my gums and teeth continue to be inflamed and the pain has worsened.
Could it be that there is a gap between the crown and the natural tooth, making it difficult to clean? Is it possible to have the original crown reinstalled?

Miss Ye, 30~39 year old female. Ask Date: 2021/07/14

Dr. Lin Jiayong reply Dentistry

Hello: Based on your description, it has been two months since the dentures were placed, and the symptoms have not improved, even affecting your daily life.
It is recommended that you return to the original clinic, where the dentist can remove the all-ceramic dentures and then determine if further treatment is necessary.
Sincerely, Lin Chia-Yung, Department of Dentistry, Taichung Hospital, Ministry of Health and Welfare.

Reply Date: 2021/07/14

More Info

The issues you are experiencing with your all-ceramic crown, particularly the persistent pain and inflammation in the gums, can be quite distressing. Based on your description, it seems that the pain is localized around the crown and the adjacent gum tissue, which may indicate several underlying problems.

Firstly, the inflammation and pain you are experiencing could be due to a few factors. One common issue is the presence of a gap or space between the crown and the natural tooth structure. This gap can trap food particles and bacteria, making it difficult to maintain proper oral hygiene, leading to gum inflammation (gingivitis) or even periodontal disease. This is particularly concerning if the crown does not fit snugly against the tooth, as it can create a microenvironment conducive to bacterial growth.

Another possibility is that the crown itself may be too high or improperly aligned, which can lead to excessive pressure on the underlying tooth and surrounding tissues during chewing. This misalignment can cause discomfort and pain, especially when biting down or when the tooth is tapped. If the crown is not seated properly, it can also lead to inflammation of the pulp (the innermost part of the tooth containing nerves and blood vessels), potentially resulting in pulpitis, which can be reversible or irreversible.

In your case, since you have been diligent with your oral hygiene practices and have not seen improvement, it may be worthwhile to consider a few options:
1. Re-evaluation of the Crown Fit: It would be prudent to have your dentist re-evaluate the fit of the crown. They can take X-rays to check for any gaps or issues beneath the crown and assess the health of the underlying tooth. If there is a significant gap, your dentist may need to adjust or remake the crown to ensure a better fit.

2. Consideration of Root Canal Treatment: If the pain persists and is indicative of pulpitis, your dentist may recommend a root canal treatment. This procedure involves removing the inflamed or infected pulp tissue, cleaning the root canals, and sealing them. Afterward, a new crown can be placed, which may alleviate the pain if the underlying issue is related to pulp inflammation.

3. Gum Health Assessment: Since you are experiencing gum swelling and pain, it may also be beneficial to assess your gum health. Your dentist may refer you to a periodontist, a specialist in gum diseases, who can provide targeted treatment to address any periodontal issues.

4. Communication with Your Dentist: It is essential to maintain open communication with your dentist regarding your symptoms. If you feel that your concerns are not being adequately addressed, seeking a second opinion from another dental professional may provide you with additional insights and treatment options.

In conclusion, the issues you are facing with your all-ceramic crown could stem from improper fit, alignment issues, or underlying pulp problems. A thorough examination by your dentist, possibly including X-rays, is crucial to determine the exact cause of your discomfort. Depending on the findings, adjustments to the crown, root canal treatment, or further periodontal care may be necessary to resolve your symptoms and restore your oral health.

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