Dentistry - Pressure sensitve after crown

Author

Pressure sensitve after crown

Dale R

2007-01-27, 10:08 pm

I just had a permanent crown put on my very back bottom tooth.
The toothdidn't ache, but rather a large filling became detatched to
necessitate the crown.
The dentist never could get it all the way numb to grind it down for
the crown, but we managed to get the tooth ground down to fit it for a
crown.
We removed the temporary crown several days ago and installed the new
one. The tooth seems to be very sensitive to pressure now.
Is this normal?
Does this sensation typically go away?
If so, how long before it subsides?
TIA

Steven Bornfeld

2007-01-27, 10:08 pm

Dale R wrote:
> I just had a permanent crown put on my very back bottom tooth.
> The toothdidn't ache, but rather a large filling became detatched to
> necessitate the crown.
> The dentist never could get it all the way numb to grind it down for
> the crown, but we managed to get the tooth ground down to fit it for a
> crown.
> We removed the temporary crown several days ago and installed the new
> one. The tooth seems to be very sensitive to pressure now.
> Is this normal?
> Does this sensation typically go away?
> If so, how long before it subsides?
> TIA
>

Have the dentist check the bite again. It shouldn't be pressure
sensitive. There's either a problem with the bite, or the pulp is in
trouble.

Steve

JimSocal

2007-01-27, 10:08 pm

On Fri, 19 Jan 2007 04:23:14 GMT, Steven Bornfeld
<dentaltwinmung@earthlink.net> wrote:

>Dale R wrote:
>
> Have the dentist check the bite again. It shouldn't be pressure
>sensitive. There's either a problem with the bite, or the pulp is in
>trouble.
>
I have a tooth that is still sensitive a year later, after a root
canal. Did you have a root canal in the tooth?

Sometimes teeth can be sensitive for a LONG time after a root canal.

Dale R

2007-01-27, 10:09 pm

I just had a permanent crown put on my very back bottom tooth. =A0 The
toothdidn't ache, but rather a large filling became detatched to
necessitate the crown.
=A0=A0=A0=A0The dentist never could get it all the way numb to grind it
down for the crown, but we managed to get the tooth ground down to fit
it for a crown.
=A0=A0=A0=A0We removed the temporary crown several days ago and
installed the new one. The tooth seems to be very sensitive to pressure
now.
=A0=A0=A0=A0=A0=A0Is this normal?
=A0=A0=A0Does this sensation typically go away?
=A0=A0=A0If so, how long before it subsides?
=A0=A0=A0TIA
************************************
Dr. Steve wrote:=A0=A0"Have the dentist check the bite again. It
shouldn't be pressure sensitive. =A0 There's either a problem with the
bite, or the pulp is in trouble."
*******************************************
JimSocal wrote: "I have a tooth that is still sensitive a year later,
after a root canal. Did you have a root canal in the tooth?
Sometimes teeth can be sensitive for a LONG time after a root canal."
**************************************
The tooth didn't have a root canal; it just had a large filling which
came loose. It had no pain nor sensitivity to anything prior to that
incident.
It did, however, become very sensitive to hot and cold upon
installation of the temporary crown. I attributed this to the temporary
one not fitting perfectly and not covering 100% of the
freshly-ground-down tooth, and hence a small area was exposed.
Indeed, with the permanent crown, it isn't temperature sensitive at
all, which seems to confirm my thoughts on that.
The permanent crown seemed to fit remarkably well in terms of bite;
only a small amount of grinding was necessary to make it 'mesh' squarely
with the opposing (top) tooth, which is a crown also.
Since the new crown was only put on a matter of a few days ago,
perhaps it's to be expected that the tooth would take a little while to
'settle down' and feel normal.
Also I was wondering, what could cause the pulp to be "in trouble" --
in an otherwise painless tooth after having had this procedure done to
it.
Thanks for your replies thus far.

Steven Bornfeld

2007-01-27, 10:09 pm

Dale R wrote:
> I just had a permanent crown put on my very back bottom tooth. The
> toothdidn't ache, but rather a large filling became detatched to
> necessitate the crown.
> The dentist never could get it all the way numb to grind it
> down for the crown, but we managed to get the tooth ground down to fit
> it for a crown.
> We removed the temporary crown several days ago and
> installed the new one. The tooth seems to be very sensitive to pressure
> now.
> Is this normal?
> Does this sensation typically go away?
> If so, how long before it subsides?
> TIA
> ************************************
> Dr. Steve wrote: "Have the dentist check the bite again. It
> shouldn't be pressure sensitive. There's either a problem with the
> bite, or the pulp is in trouble."
> *******************************************
> JimSocal wrote: "I have a tooth that is still sensitive a year later,
> after a root canal. Did you have a root canal in the tooth?
> Sometimes teeth can be sensitive for a LONG time after a root canal."
> **************************************
> The tooth didn't have a root canal; it just had a large filling which
> came loose. It had no pain nor sensitivity to anything prior to that
> incident.
> It did, however, become very sensitive to hot and cold upon
> installation of the temporary crown. I attributed this to the temporary
> one not fitting perfectly and not covering 100% of the
> freshly-ground-down tooth, and hence a small area was exposed.
> Indeed, with the permanent crown, it isn't temperature sensitive at
> all, which seems to confirm my thoughts on that.
> The permanent crown seemed to fit remarkably well in terms of bite;
> only a small amount of grinding was necessary to make it 'mesh' squarely
> with the opposing (top) tooth, which is a crown also.
> Since the new crown was only put on a matter of a few days ago,
> perhaps it's to be expected that the tooth would take a little while to
> 'settle down' and feel normal.
> Also I was wondering, what could cause the pulp to be "in trouble" --
> in an otherwise painless tooth after having had this procedure done to
> it.
> Thanks for your replies thus far.
>
>

To have required a crown, the tooth was likely pretty broken down
beforehand. Preparing the tooth is another stress to the pulp, and the
pulp has limited ability to heal. Pain to biting pressure is one
symptom of abscess, though it can also be caused by even a slight
discrepency in the bite.
Yes, it is not unusual for a tooth to need a bit of time to settle down
after inserting a crown. Usually however sensitivity after insertion is
momentary cold and occasionally hot sensitivity.
Not saying that there's anything wrong at all, but the tooth should be
followed. Also keep in mind that the nerve can die, settle down and be
assymptomatic for a long time (sometimes forever) and yet this does not
necessarily mean no damage has been done to the pulp.

Steve

Newbie

2007-01-27, 10:09 pm

On Fri, 19 Jan 2007 19:49:46 GMT, Steven Bornfeld <dentaltwinmung@earthlink.net> wrote:

>
>
> To have required a crown, the tooth was likely pretty broken down
>beforehand. Preparing the tooth is another stress to the pulp, and the
>pulp has limited ability to heal. Pain to biting pressure is one
>symptom of abscess, though it can also be caused by even a slight
>discrepency in the bite.
> Yes, it is not unusual for a tooth to need a bit of time to settle down
>after inserting a crown. Usually however sensitivity after insertion is
>momentary cold and occasionally hot sensitivity.
> Not saying that there's anything wrong at all, but the tooth should be
>followed. Also keep in mind that the nerve can die, settle down and be
>assymptomatic for a long time (sometimes forever) and yet this does not
>necessarily mean no damage has been done to the pulp.
>
>Steve

A good rule of thumb is that a pulp may sustain ~2 - 3 traumas before
irreversible pulpitis occurs.

A little sensitivity after crown placement is common IMO.
If it gets worse, get it checked.

As usual, Dr. Bornfeld is spot on.

vibharathi@gmail.com

2007-01-27, 10:09 pm

Question for NewBie...
I ahev a tooth which had a big filling that necessitated a
crown...Though it was not hurting at the time...the dentist said to get
the root canal done anyway since it would require one before putting
the crown on...now the problem is that the root canal never really
worked...it is still sensitive a year later...and I am afriad of having
it redone lest it may cause more damage...there is nothing on the x-ray
yet..but the sensitivity has increased over the year...should I let the
dentist touch it again...will the trauma cause the tooth to give up
entirely and be extracted?
Thanks!!
Newbie wrote:
> On Fri, 19 Jan 2007 19:49:46 GMT, Steven Bornfeld <dentaltwinmung@earthlink.net> wrote:
>
>
>
> A good rule of thumb is that a pulp may sustain ~2 - 3 traumas before
> irreversible pulpitis occurs.
>
> A little sensitivity after crown placement is common IMO.
> If it gets worse, get it checked.
>
> As usual, Dr. Bornfeld is spot on.

Steven Bornfeld

2007-01-27, 10:09 pm

vibharathi@gmail.com wrote:
> Question for NewBie...
> I ahev a tooth which had a big filling that necessitated a
> crown...Though it was not hurting at the time...the dentist said to get
> the root canal done anyway since it would require one before putting
> the crown on...now the problem is that the root canal never really
> worked...it is still sensitive a year later...and I am afriad of having
> it redone lest it may cause more damage...there is nothing on the x-ray
> yet..but the sensitivity has increased over the year...should I let the
> dentist touch it again...will the trauma cause the tooth to give up
> entirely and be extracted?
> Thanks!!

I'm sure Newbie will answer, but since I stopped by ;-):

There is no way to give a definitive answer. It is possible for a root
canal to fail--sometimes even one that appears to have been done well.
Problems will not always show up on x-ray.
There are other possible problems as well, most seriously a root
fracture. In this case redoing the root canal will likely do no good,
and the tooth likely will need to be extracted.
Retreatment may be an option, esp. if there is some sense that
something may need to be done differently. For example, most
endodontists now use operating microscopes--this is becoming the
standard of care. Often it is found with high magnification that a
canal may have been missed. If this is the case then retreatment may
well be fruitful. But if at all possible, the presence of root fracture
should be ruled out before this is done.
BTW, do you happen to recall why the dentist said a root canal would be
necessary prior to having a crown placed?

Steve

> Newbie wrote:
>

vibharathi@gmail.com

2007-01-27, 10:09 pm

How can we find out if there is a fracture? The dentist recommended a
rot canal since the decay was too deep and said that I would need a
root canal very soon anyway..
Steven Bornfeld wrote:[vbcol=seagreen]
> vibharathi@gmail.com wrote:
>
> I'm sure Newbie will answer, but since I stopped by ;-):
>
> There is no way to give a definitive answer. It is possible for a root
> canal to fail--sometimes even one that appears to have been done well.
> Problems will not always show up on x-ray.
> There are other possible problems as well, most seriously a root
> fracture. In this case redoing the root canal will likely do no good,
> and the tooth likely will need to be extracted.
> Retreatment may be an option, esp. if there is some sense that
> something may need to be done differently. For example, most
> endodontists now use operating microscopes--this is becoming the
> standard of care. Often it is found with high magnification that a
> canal may have been missed. If this is the case then retreatment may
> well be fruitful. But if at all possible, the presence of root fracture
> should be ruled out before this is done.
> BTW, do you happen to recall why the dentist said a root canal would be
> necessary prior to having a crown placed?
>
> Steve
>
>

Steven Bornfeld

2007-01-27, 10:09 pm

vibharathi@gmail.com wrote:
> How can we find out if there is a fracture? The dentist recommended a
> rot canal since the decay was too deep and said that I would need a
> root canal very soon anyway..

It's not always easy to tell. Eventually there is usually evidence on
x-ray, but this can take a while--and you're in pain. If it's not
severe you can wait it out and usually things become more apparent with
time. If not, I'd remove the seal and all restorative material and look
at the tooth with high magnification. If there is no sign of a
fracture, then a retreat of the root canal would be in order.
Personally, if I do a root canal that fails(or a patient comes to me
with a failing root canal that was done by another dentist), I almost
always refer to an endodontist who is generally more well equipped to
deal with problem situations.

Steve

> Steven Bornfeld wrote:
>

Newbie

2007-01-27, 10:09 pm

On 19 Jan 2007 13:32:48 -0800, vibharathi@gmail.com wrote:

>Question for NewBie...
>I ahev a tooth which had a big filling that necessitated a
>crown...Though it was not hurting at the time...the dentist said to get
>the root canal done anyway since it would require one before putting
>the crown on...now the problem is that the root canal never really
>worked...it is still sensitive a year later...and I am afriad of having
>it redone lest it may cause more damage...there is nothing on the x-ray
>yet..but the sensitivity has increased over the year...should I let the
>dentist touch it again...will the trauma cause the tooth to give up
>entirely and be extracted?
>Thanks!!
>Newbie wrote:

My recommendation is to have the RCT evaluated by an endodontist,
a root canal specialist.
You can learn more here: www.aae.org

If your tooth was severly broken down it is possible that you have
a root fracture. Can't tell from here.

My statement about 2 - 3 traumas only applies to 'live' teeth,
so, no, another procedure is unlikely to doom your tooth.
With that said, sometimes you reach the point of diminishing
returns.

Your best bet is to get evaluated by an endodontist, and see
what s/he says.

Best wishes,+

vibharathi@gmail.com

2007-01-27, 10:09 pm

Thanks for the replies. I actually had it redone a few days ago and
that along with antibiotics seems to have taken care of the
problem...hope it stays this way post the antibiotics...can you advice
on what I cna do from my side to make this work this time? The
endodontist who did the retreat mentioned something about a canal
ahving a hook shaped side canal - he used a microsocope and all - but
did'nt say anythign about a crack etc..
Thanks
Newbie wrote:
> On 19 Jan 2007 13:32:48 -0800, vibharathi@gmail.com wrote:
>
>
>
> My recommendation is to have the RCT evaluated by an endodontist,
> a root canal specialist.
> You can learn more here: www.aae.org
>
> If your tooth was severly broken down it is possible that you have
> a root fracture. Can't tell from here.
>
> My statement about 2 - 3 traumas only applies to 'live' teeth,
> so, no, another procedure is unlikely to doom your tooth.
> With that said, sometimes you reach the point of diminishing
> returns.
>
> Your best bet is to get evaluated by an endodontist, and see
> what s/he says.
>
> Best wishes,+

Mark & Steven Bornfeld

2007-01-27, 10:09 pm

vibharathi@gmail.com wrote:

> Thanks for the replies. I actually had it redone a few days ago and
> that along with antibiotics seems to have taken care of the
> problem...hope it stays this way post the antibiotics...can you advice
> on what I cna do from my side to make this work this time? The
> endodontist who did the retreat mentioned something about a canal
> ahving a hook shaped side canal - he used a microsocope and all - but
> did'nt say anythign about a crack etc..
> Thanks

On your side? Just make sure the tooth is properly restored.

Steve

> Newbie wrote:
>
>
>

--
Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001