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Badly fitting crown or gum infection?

User Level:
Patient
Posted by: judeswifey  (10 years ago)
Dear Doctor!

About six months ago, I got a large filling on my lower left first molar. Following the dentist's suggestion, I agreed to have this tooth crowned. (There is no root canal treatment performed on this tooth prior to the filling). During the crown prep, no matter how many injections the dentist tried, he could not get the tooth numb. It was a bit painful for me but we proceeded.

The temporary crown did not fit right. From the day he put the temporary crown on, the tooth was very sensitive to cold and would not stop hurting. Even after he placed the permanent crown, the pain and sensitivity to cold continued. It also seemed to move up and down when I chew. The dentist adjusted it, filed it, and did some more tweaks but nothing worked. It hurt so bad that the pain would shoot to my jaw and ear. The gums around the tooth were very much inflamed. The dentist took X-ray and said there is no problem on the nerve. He thinks that a gum infection is causing the pain. He prescribed antibiotics and pain killers and advised me to go back after 7 days.

Is the dentist correct about thinking that a gum infection is the culprit of my unending pain or do you think the crown did not properly fit and is causing the pain? I would love to hear your inputs! Thanks a lot.
User Level:
Student
Posted by: ghnane  (10 years ago)
Hello,

The sensitivity is due to the preparation of the tooth for crown. Once enamel gets stripped off our teeth we become very sensitive because under enamel we have dentin which has tubules with nerve endings that conduct all the sensory stimuli to the pulp.

Gingival inflammation which may lead to recession can be caused by badly contoured crown that irritates your gum if it goes too deep.
I know a number of dentist who avoid crowning teeth unless they perform RCT on the tooth se it does not give problems down the road.

I advice you to seek a second opinion and re-evaluate the quality of the crown.
User Level:
Dentist
Dear Doctor!

About six months ago, I got a large filling on my lower left first molar. Following the dentist's suggestion, I agreed to have this tooth crowned. (There is no root canal treatment performed on this tooth prior to the filling). During the crown prep, no matter how many injections the dentist tried, he could not get the tooth numb. It was a bit painful for me but we proceeded.

The temporary crown did not fit right. From the day he put the temporary crown on, the tooth was very sensitive to cold and would not stop hurting. Even after he placed the permanent crown, the pain and sensitivity to cold continued. It also seemed to move up and down when I chew. The dentist adjusted it, filed it, and did some more tweaks but nothing worked. It hurt so bad that the pain would shoot to my jaw and ear. The gums around the tooth were very much inflamed. The dentist took X-ray and said there is no problem on the nerve. He thinks that a gum infection is causing the pain. He prescribed antibiotics and pain killers and advised me to go back after 7 days.

Is the dentist correct about thinking that a gum infection is the culprit of my unending pain or do you think the crown did not properly fit and is causing the pain? I would love to hear your inputs! Thanks a lot.


Probably the pulp is inflamed. Nothing shows up on x-ray. Gum inflammation is seldom as severe as you describe.

Grinding a tooth down for a porcelain crown is pretty radical. Better are partial gold crowns, where the tooth is not cut down nearly so much.
Posted 10 years ago
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