Painful new crown/cap

Q:
Via email Wed. Feb. 24, 2010 from Cheryl

I had a crown placed on the rear bottom tooth on the left side a couple of months ago, and when the freezing wore off after placement of the permanent crown, I was up every few hours taking painkillers - it was the worst pain I've ever had. This tooth had never bothered me in the past, but a small piece had broken off, and my dentist recommended getting a crown.

I went back several times, and he gave me prescriptions for antibiotics, painkillers, ground the tooth down, and eventually, after about 3-4 weeks, the pain subsided.

A week ago, it has started up with a vengeance. It is excruciatingly painful, will wake me up out of a sound sleep.

He never did give me a reason as to why it happened in the first place, why placing the permanent crown would cause such awful pain.

Any help you can give would be appreciated.


A:
Thank you for your question. I am sorry to hear you are in pain from your newly placed crown. A permanent crown can give discomfort for a few reasons.

Sometimes after initial preparation and placement of a new crown the nerve can flare up and cause discomfort in the tooth. This will typically settle down with time. If it doesn't then the new crown may be 'high' and need adjustment (ie. grinding the crown down a little) so it doesn't meet with the opposing teeth in an irregular manner. When a tooth is high it can aggravate the nerve and cause discomfort, almost how a bad bruise gives you discomfort, so can a irritated nerve of a tooth. This should be alleviated after adjustment (grinding of the tooth), typically it would go away within a few days.

The last reason may be that the nerve is irritated irreversibly (due to bacteria, trauma or otherwise) and thus may need a root canal (simply put the removal of the pulp) so you will not have the pain any longer.

You will need to see your dentist to assess the situation of the tooth so a solution can be found.

Nathan