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Pain won’t go away after porcelain crown.

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Last month I had a porcelain crown placed on a back molar. From that point on, I have had a lot of sensitivity on the tooth. It doesn’t really hurt or bother me all the time. However, I think about it often and feel like the tooth is aggravated. Also, it seems to be bothered by temperature changes too, which I never had an issue with before the crown.

I went back in to have it checked out and the dentist said there was probably something wrong with the crown and said I will now require a root canal. This is concerning to me since I never had any issues with the tooth before. How did the tooth go from fine, to now requiring a root canal? I thought the crown was supposed to solve future issues for that tooth. Will the tooth calm down or do I really need to get a root canal done?

-John in California

John,

Every patient is different and it is difficult to predict how your teeth will respond to a porcelain crown. Even if the dentist is an expert cosmetic dentist and experienced in crowns, the patient still may end up with issues after the procedure. With the placement of a porcelain crown, a large portion of the tooth is removed during the preparation. Therefore, all the insulating enamel is gone and the root is more vulnerable. Also, the tooth may be stressed. So, the sensitivity isn’t uncommon. However, it usually will settle down after a couple weeks without requiring intervention.

diagram of a porcelain crown fitting over a toothAlso, it is possible that the dentist didn’t get your bite just right. If your tooth isn’t hurting all the time, it may be a contact issue. For example, the crown may be hitting first when you are chewing. Think of it like a bruise that keeps getting bumped over and over again. It will become quite sore if it isn’t adjusted. Ask the dentist to check your bite, which should have already been done. Sometimes, it takes several adjustments to get it right. If this cannot be corrected, then the fit of the crown where it is seated to the tooth may not be perfect. Most reputable dentists will go ahead and redo the crown if this is the case, with the hope of avoiding a root canal.

Then, if the discomfort doesn’t subside, you may actually need a root canal. If your dentist doesn’t seem to be getting it right, you may consider seeing another dentist to take a look. But, you will likely have to pay out-of-pocket for a new dentist.

In the meantime, anti-inflammatory medication will be beneficial. But, if the pain worsens, throbs or keeps you up at night, you need to be seen right away. Unfortunately, that situation may require a root canal because the tooth was so inflamed it may be infected. Hopefully, it doesn’t come to that.

Good luck!

This post is sponsored by Lexington cosmetic dentist Hamburg Expressions.