A dental crown is a tooth-shaped cap placed over a damaged tooth to restore its shape, size, strength, and appearance. While crowns protect teeth and improve their function, they do not make the underlying tooth immune to problems or pain. Experiencing discomfort in a crowned tooth can be concerning, but understanding the potential causes and appropriate actions can help address the issue effectively.
Common Reasons for Pain
Pain in a crowned tooth can stem from various underlying issues. Tooth decay can form at the margin of the crown or even beneath it if the seal is compromised, leading to sensitivity or persistent pain.
Gum disease, such as gingivitis or periodontitis, can also cause pain around a crowned tooth. Inflammation or infection of the gums surrounding the tooth can result in tenderness, swelling, or bleeding. When gums recede, they expose the tooth’s root, making it more vulnerable to plaque and disease, which can cause sensitivity.
The underlying tooth structure can still crack or fracture despite being crowned. This can lead to sharp pain, especially when biting down or chewing, and sensitivity to temperature changes. A cracked tooth under a crown is considered a dental emergency and requires prompt attention.
Damage to the crown itself, such as it becoming loose, chipped, or broken, can expose the sensitive tooth underneath or cause irritation. A crown that does not fit properly, perhaps being too high, can also lead to pain due to uneven pressure on the tooth or an altered bite.
If the tooth did not have a root canal before the crown was placed, the nerve within the tooth remains. This nerve can become inflamed or infected, a condition known as pulpitis, leading to significant pain and sometimes requiring a root canal. Additionally, teeth grinding or clenching (bruxism) can exert excessive force on the crowned tooth and surrounding structures, causing discomfort and potentially damaging the crown or underlying tooth.
Immediate Steps and When to Seek Professional Help
When experiencing pain in a crowned tooth, several immediate steps can provide temporary relief. Over-the-counter pain relievers like ibuprofen or acetaminophen can help manage discomfort. Rinsing the mouth with warm salt water can also reduce inflammation and pain.
Avoiding chewing on the affected side and steering clear of hot, cold, or sugary foods and drinks can prevent exacerbating sensitivity. Using desensitizing toothpaste might also offer some relief for general sensitivity.
It is important to seek professional dental help promptly if the pain is severe, persistent, or accompanied by other concerning symptoms. Swelling in the gums or face, fever, or a crown that feels loose or broken warrant an immediate visit to the dentist.
A dental emergency, such as severe, unrelenting pain, swelling that spreads, or a badly cracked tooth, requires immediate attention. If you experience difficulty swallowing or breathing, this could indicate a severe infection and necessitates emergency medical and dental assistance.
Dental Diagnosis and Treatment
When you visit the dentist for crowned tooth pain, a thorough diagnostic process will be performed to identify the cause. This typically includes a visual examination of the crown and surrounding gum tissue, dental X-rays to check for decay beneath the crown or issues with the tooth’s root, and vitality tests to assess the health of the tooth’s nerve. The dentist may also check your bite and tap on the tooth (percussion test) to pinpoint the source of pain.
Treatment options vary depending on the diagnosis. If decay is found under the crown, it may be removed, the decay cleaned out, and a new filling placed, sometimes requiring a new crown if the decay is extensive. For gum issues, treatment may involve professional cleaning (scaling and root planing) to remove plaque and tartar, and possibly antibiotics to control infection. In more severe cases of gum disease, gum surgery might be necessary.
If a cracked tooth or nerve issues are identified, root canal therapy is often recommended to remove infected tissue and save the tooth. In situations where the tooth is severely damaged or the crack extends too far, extraction may be the only option, followed by discussions about tooth replacement. If the crown is loose, it can often be re-cemented, but a damaged crown may need to be repaired or replaced entirely. For bite alignment problems, the dentist can adjust the crown’s height to ensure proper occlusion. If bruxism is a contributing factor, a custom nightguard may be recommended to protect the teeth from grinding forces.
Preventing Crowned Tooth Pain
Maintaining good oral hygiene is fundamental to preventing pain in crowned teeth. Regular brushing at least twice a day with fluoride toothpaste and daily flossing, paying close attention to the margins where the crown meets the tooth, helps prevent plaque buildup and decay.
Regular dental check-ups and professional cleanings are important for early detection of any problems. Dentists can identify issues like subtle decay or gum inflammation before they become painful. These routine visits allow for monitoring the crown’s integrity and the health of the underlying tooth.
Avoiding certain foods can also help protect crowned teeth. It is advisable to limit hard, crunchy, or sticky foods that could potentially chip, crack, or dislodge the crown.
If teeth grinding or clenching (bruxism) is suspected, discussing it with a dentist is beneficial, as they might recommend a nightguard to protect the teeth and crowns from excessive force. For individuals participating in sports, wearing a protective mouthguard can prevent trauma to the teeth, including crowned ones.