A dental crown is a tooth-shaped cap placed over a damaged tooth to restore its original shape, size, strength, and appearance. These restorations completely encase the visible portion of a tooth, extending down to the gum line. While crowns are designed to be durable and comfortable, some sensitivity can occur after their placement.
Expected Sensitivity After Crown Placement
Mild, temporary sensitivity is a common experience immediately following a dental crown procedure. This sensitivity can manifest as discomfort when exposed to hot or cold temperatures, air, or pressure from biting. It often arises from irritation to the tooth’s nerve or pulp during the preparation process, which involves reshaping the tooth and removing a small amount of enamel.
The tooth’s dentin, the layer beneath the enamel containing microscopic tubules leading to the nerve, becomes more exposed during this procedure. This temporary sensitivity typically resolves within a few days to a few weeks, as the tooth adjusts to its new crown. It should gradually improve over time, not worsen.
Underlying Causes of Crown Sensitivity
Sensitivity that persists or intensifies after a crown placement can indicate a deeper issue. One common cause is a high bite, where the crown is slightly taller than the surrounding teeth, leading to excessive pressure on the crowned tooth during chewing. This uneven pressure can irritate the tooth’s nerve.
Pulp inflammation (pulpitis) can also cause ongoing sensitivity, often resulting from deep decay, repeated dental procedures, or trauma. Gum recession can expose the tooth root surface beneath the crown, leading to heightened sensitivity due to lack of enamel protection. New decay around the crown’s edge allows stimuli to reach inner tooth layers, causing discomfort.
A cracked or fractured tooth beneath the crown, or damage to the crown itself, can expose sensitive areas. Infection or an abscess beneath the crown is another cause of pain and sensitivity, often with swelling or pus. An ill-fitting crown that does not seal properly can create gaps, allowing bacteria and food debris to seep underneath and cause irritation or decay.
When to Consult Your Dentist
You should consult your dentist if the sensitivity worsens over time or persists beyond a few weeks, typically more than one month. Severe, sharp, or throbbing pain, particularly if it does not respond to over-the-counter pain relievers, warrants professional attention.
Pain when biting or chewing that does not subside, or pain that wakes you up at night, indicates an underlying issue. Sensitivity accompanied by swelling, redness, or pus around the crowned tooth also suggests a potential infection.
Relief and Treatment Options
Managing crown sensitivity involves both home care and professional interventions. For mild, temporary sensitivity, using desensitizing toothpaste can help block pain signals to the nerve. Avoiding extremely hot, cold, sugary, or acidic foods and drinks, and brushing gently with a soft-bristled toothbrush, can also provide relief. Over-the-counter pain relievers like ibuprofen or acetaminophen may help manage discomfort.
If a high bite is the cause, your dentist can perform a professional adjustment to reshape the crown slightly. For gum recession exposing the root, dental bonding or gum grafting procedures can cover the sensitive root surface. Addressing new decay or infection may involve removing the decay and re-sealing the crown, or for irreversible pulp damage or infection, root canal therapy may be necessary. Antibiotics may be prescribed for an abscess. If the crown is ill-fitting, fractured, or has significant unresolved issues, replacing the crown may be the best treatment.