Is throbbing pain and sensitivity to cold normal with a temporary crown?!


Question:

Is throbbing pain and sensitivity to cold normal with a temporary crown?

I had a temporary crown placed on my rear bottom molar 12 days ago. No root canal was done. At first, only the gums were irritated, but now I am waking up in the morning with a throbbing toothache. Advil completely clears this up, but I have to take it regularly to prevent it from coming back. The crowned tooth is sensitive to cold, but not to anything hot. I have gone back once to have the bite adjusted. It is still not perfect, but it is much better than it was. Two aggravating factors could be because I clench my teeth during the night and also I have noticed that since the gums have gone down, the very back of the crown seems to be possibly exposing the tooth underneath. The tooth did not bother me before this work was done, but it had a large filling and part of the tooth had broken off. I'm really starting to regret my decision to have this done. How does a dentist determine if you need a root canal? Is this something that can be seen through X-Ray?


Answers:

Throbbing pain and sensitivity to cold is NOT normal following crown preparation. However, it is NOT unusual either. You say you had your bite adjusted but it is still "not perfect." You need to have it adjusted until it is perfect. A temporary crown that hits too hard when you bite will cause irritation to the tooth. If you combine that irritation with the trauma to the tooth following a fracture and tooth preparation you've got a tooth that's been severely traumatized and therefore will hurt. Your dentist will most likely cement your permanent crown with temporary cement so the crown can be removed if a root canal has to be done.

An x-ray at this stage of the game will probably indicate nothing because the need for a root canal is not always seen on a root canal and your dentist should have taken an x-ray before he/she prepared the tooth for a crown anyway. Nothing on the x-ray would have changed in such a short period of time.

Recommendation: have your dentist adjust the temporary crown until it feels just right. Suggest that the permanent crown be placed with temporary cement. Continue to take NSAID's (non-steroidal anti-inflammatory drugs, like Advil) for the pain and to eliminate the inflammation to the pulp of the tooth--that's what is causing your pain.

Hope this helps, good luck.




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