Sensitivity in Dental Crowns: Causes and Solutions

Q: Sensitivity in Dental Crowns: Causes and Solutions

Hello： 1. <br>It is recommended to observe for about six months to determine if the root canal treatment has failed. <br>2. <br>It is advisable to proceed with the extraction of the remaining root as soon as possible.

The dental crown feels sharp when tapped?

The lower third molar had a cavity, and after the root canal treatment, a prosthetic tooth was placed (without a dental post).
However, when tapping the prosthetic tooth with the upper teeth, there is a tingling sensation (difficult to describe), and gently tapping it with a spoon also causes the same feeling.
Could this indicate that the prosthetic tooth was not properly fitted, or is there a possibility that the nerve was not completely treated? Additionally, the lower second molar was not completely extracted initially, and recently the tooth root has become exposed.
Should it be extracted again? Is there a possibility that leaving it in place could lead to inflammation and pain?

Chloe, 20~29 year old female. Ask Date: 2022/09/09

Dr. Lin Jiayong reply Dentistry

Hello: 1.
It is recommended to observe for about six months to determine if the root canal treatment has failed.
2.
It is advisable to proceed with the extraction of the remaining root as soon as possible.

Reply Date: 2022/09/09

More Info

Understanding sensitivity in dental crowns can be quite complex, as it involves various factors related to the dental procedure, the condition of the tooth, and the surrounding tissues. In your case, it seems you are experiencing sensitivity in your lower third molar (wisdom tooth) that has undergone root canal treatment and has been fitted with a crown. Additionally, you mentioned issues with your lower second molar, which may require further extraction.

Causes of Sensitivity in Dental Crowns
1. Incomplete Root Canal Treatment: If the nerve was not completely removed or if there are remaining infected tissues, it can lead to persistent sensitivity. This is often characterized by a sharp or throbbing pain when pressure is applied to the tooth, such as when biting or tapping it with a utensil.

2. Crown Fit and Material: If the crown is not properly fitted, it may not align correctly with the opposing teeth, leading to discomfort when biting. Additionally, the material used for the crown can also play a role in sensitivity. Some materials may conduct temperature changes more than others, causing discomfort when exposed to hot or cold substances.

3. Gum Recession or Inflammation: If the gums around the crown are inflamed or receding, this can expose the underlying tooth structure, leading to sensitivity. Gum health is crucial for the longevity of dental restorations.

4. Underlying Tooth Structure: If the tooth structure beneath the crown is compromised, such as having cracks or decay, this can also lead to sensitivity.
5. Occlusal Issues: If the bite is not properly adjusted after the crown placement, it can lead to excessive pressure on the crown, causing discomfort when biting or tapping.

Solutions to Address Sensitivity
1. Consult Your Dentist: The first step is to return to your dentist for a thorough examination. They may take X-rays to check for any remaining infection or issues with the root canal treatment. If the crown is not fitting properly, adjustments can be made.

2. Consider a Different Crown Material: If the sensitivity is due to the material of the crown, your dentist may suggest switching to a different type that may be less sensitive to temperature changes.

3. Gum Health: Maintaining good oral hygiene is essential. If gum inflammation is present, your dentist may recommend treatments such as scaling and root planing to improve gum health.

4. Sensitivity Treatments: There are desensitizing agents that can be applied to the tooth surface to help alleviate sensitivity. Your dentist can provide these treatments during your visit.

5. Occlusal Adjustment: If your bite is off, your dentist can perform an occlusal adjustment to ensure that the crown aligns properly with your other teeth, reducing pressure and sensitivity.

Regarding the Lower Second Molar
If you have a lower second molar with a root that has not been completely extracted, it is essential to address this issue promptly. Retained root fragments can lead to:
- Infection: Remaining root pieces can become a source of infection, leading to pain, swelling, and potential abscess formation.

- Pain: As the root fragment moves or becomes irritated, it can cause significant discomfort.

- Impact on Adjacent Teeth: The presence of a retained root can affect the health of nearby teeth and gums.

If you are experiencing pain or discomfort in that area, it is advisable to consult your dentist as soon as possible. They may recommend imaging studies to assess the situation and determine if extraction is necessary.

Conclusion
Sensitivity in dental crowns can arise from various factors, including issues with the root canal treatment, crown fit, and gum health. It is crucial to communicate any discomfort to your dentist, who can provide tailored solutions to alleviate your symptoms. Additionally, addressing any retained roots promptly is vital to prevent further complications. Regular dental check-ups and maintaining good oral hygiene will help ensure the longevity of your dental restorations and overall oral health.

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