Dental Crown Issues: When Your Prosthetics Feel Uncomfortable

Oral cavity, denture deformation?

Hello Doctor, I had a car accident that caused cracks in my front teeth.
Following the dentist's advice, I had two dental crowns placed.
Initially, everything seemed fine, but after almost a year, I started to feel that these two crowns were expanding or becoming swollen, almost like they were developing blisters.
However, the dentist examined them and said they looked fine.
Later, I bought a mirror to check my teeth whenever I felt something was off, and they appeared normal.
Yet, when my tongue touches the area, I still feel something unusual.

So far, I have been undergoing periodontal treatment for over a month, and I have more than just these two crowns, but only these two seem to have issues.
I'm unsure what to do or which specialist to see.
The dentist mentioned endocrinology and neurology, but I feel like those specialties might not be related.
Could you please give me some advice? I visited another dental clinic, and they said that even if I were to redo the crowns, it might not solve the problem since the fit of these crowns is fine in all aspects.
What should I do…?!

CHIA LIN, 50~59 year old female. Ask Date: 2021/09/10

Dr. Liu Hongxiang reply Family Medicine

Dear Miss Chia Lin,
Hello.
Your letter indicates that several dental examinations have shown no issues, yet you still experience discomfort.
Based on my personal experience, I recommend consulting the dental department at a medical center to explore potential methods to alleviate or improve your discomfort with the dentures.
Wishing you good health and well-being!
Sincerely,
Dr.
Liu Hongxiang

Reply Date: 2021/09/10

More Info

When dealing with dental crowns, especially after experiencing trauma such as a car accident, it is essential to understand the complexities involved in prosthetic dentistry. Your situation, where you feel discomfort or abnormal sensations with your crowns, can be frustrating and concerning. Let's break down the potential issues and solutions.

Firstly, it's important to recognize that dental crowns are designed to restore the function and aesthetics of damaged teeth. However, they can sometimes lead to complications or discomfort, even if they appear to be in good condition upon examination. The sensations you describe, such as the crowns feeling "inflated" or "like blisters," could be attributed to several factors.

1. Material Sensitivity: Some patients may develop sensitivities to the materials used in dental crowns, particularly if they are made from metals or certain ceramics. This can lead to discomfort or unusual sensations. If you suspect this might be the case, discussing alternative materials with your dentist could be beneficial.

2. Gingival Health: The health of the gums surrounding your crowns is crucial. If there is any inflammation or infection (gingivitis or periodontitis), it can lead to discomfort and abnormal sensations. Since you mentioned undergoing periodontal treatment, it’s vital to ensure that your gums are healing properly. If inflammation persists, further treatment may be necessary.

3. Occlusion Issues: Sometimes, crowns can interfere with your bite, leading to discomfort when chewing or even when at rest. If your crowns are too high or misaligned, they can cause undue pressure on the surrounding teeth and gums. A thorough occlusal adjustment may be needed to ensure that your bite is even and comfortable.

4. Nerve Sensitivity: If the underlying tooth structure is still sensitive or if there is nerve involvement, this can also lead to discomfort. In some cases, the nerves can become irritated after dental work, leading to sensations that feel unusual or painful. If this is suspected, a consultation with an endodontist (a specialist in root canal treatment) may be warranted.

5. Psychological Factors: Sometimes, the perception of discomfort can be influenced by anxiety or stress, especially after a traumatic event like a car accident. If you find that your discomfort is not consistent with clinical findings, it may be helpful to discuss this with a mental health professional who specializes in dental anxiety.

Given that you have already consulted multiple dental professionals and received varying opinions, it may be beneficial to seek a second opinion from a prosthodontist, a specialist in dental crowns and prosthetics. They can provide a comprehensive evaluation of your crowns and surrounding tissues, ensuring that all aspects of your dental health are considered.

In summary, while your crowns may appear to be in good condition, the sensations you are experiencing could stem from a variety of sources, including material sensitivity, gum health, occlusion issues, nerve sensitivity, or even psychological factors. It is crucial to communicate openly with your dental care providers about your symptoms and concerns. If necessary, don’t hesitate to seek a specialist’s opinion to ensure you receive the most appropriate care for your situation. Your comfort and health are paramount, and there are solutions available to address your concerns effectively.

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