A temporary crown is a protective cap placed over a prepared tooth while the permanent crown is being fabricated. This temporary restoration safeguards the underlying tooth structure and prevents adjacent teeth from shifting into the open space. Experiencing pain when biting down on this temporary covering is common, ranging from mild inconvenience to a sharp sensation. This pressure-induced discomfort usually signals that the protective device or the underlying tooth requires attention.
Mechanical Reasons for Pain During Chewing
The most frequent cause of pain when a temporary crown is placed is an issue with how the upper and lower teeth meet, known as occlusion. If the temporary crown is even slightly too tall, it will strike the opposing tooth first and with excessive force whenever the jaw closes. This premature contact is often called a “high spot” or occlusal interference, and it transmits concentrated pressure directly to the tooth and its supporting periodontal ligament. This constant, heavy force can “bruise” the fibers that hold the tooth in the jawbone, setting up inflammation that registers as pain when chewing.
Temporary crowns are made from softer materials, such as acrylic or resin, making them less durable than permanent restorations. These materials may wear down or chip unevenly, altering the bite pattern or fracturing under the strain of chewing. Additionally, temporary crowns are secured with a weaker cement designed for easy removal. If this cement seal fails, the crown can shift or rock slightly under biting pressure, irritating the sensitive prepared tooth underneath.
Underlying Tooth Sensitivity and Inflammation
Beneath the temporary crown, the tooth structure has been significantly modified, which often leads to a biological response from the living tissue inside the tooth. The process of preparing the tooth for a crown involves drilling, which generates heat and can irritate the dental pulp, the soft tissue containing the nerves and blood vessels. This irritation can lead to inflammation, known as reversible pulpitis, which manifests as increased sensitivity to external stimuli.
A common symptom is sensitivity to temperature, particularly cold, which occurs if the underlying dentin is exposed or the temporary crown does not seal perfectly. Although the crown protects the prepared surface, inflammation within the pulp can cause a throbbing ache exacerbated by biting pressure. Chewing pressure can push fluid toward the inflamed nerve, intensifying the pain sensation.
Another source of discomfort relates to the temporary seal around the crown margins. If the temporary crown does not fit precisely, microleakage can occur, allowing saliva, bacteria, and their byproducts to seep underneath the restoration. The presence of bacteria beneath the crown can worsen pulp inflammation, leading to persistent, sharp pain that feels worse when force is applied to the tooth.
Immediate Steps for Comfort and Relief
Patients experiencing discomfort can take immediate steps to manage the pain while awaiting a dental appointment. It is advisable to modify the diet by avoiding hard, crunchy, or sticky foods that could dislodge the temporary crown or strain the sensitive tooth. Chewing should be shifted entirely to the opposite side of the mouth to minimize mechanical forces on the affected area.
Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can be helpful as they work to reduce swelling and inflammation around the tooth nerve and supporting ligaments. However, these medications should only be used as directed and if medically appropriate for the individual. Maintaining gentle oral hygiene is also beneficial, which includes carefully brushing around the temporary crown and rinsing the mouth with warm salt water. A salt water rinse helps to soothe irritated gum tissue surrounding the crown margin and reduce localized inflammation.
Knowing When to Call Your Dentist
While some mild, temporary sensitivity is expected after crown preparation, certain symptoms require professional intervention. If the pain is sharp, persistent, and cannot be managed with over-the-counter relievers, it signals a deeper issue needing clinical evaluation. Pain lasting longer than a week or pain that wakes an individual from sleep should be reported to the dental office.
Any instance where the temporary crown falls off, becomes loose, or fractures warrants immediate contact with the dentist. Without the temporary crown, the prepared tooth is exposed to bacteria and temperature changes, which can lead to rapid sensitivity or infection. Persistent biting pain suggests a mechanical “high spot,” which the dentist can often resolve quickly by filing down the excess material to adjust the bite. Signs of infection, such as fever, facial swelling, or pus or a foul odor around the crown, necessitate an emergency dental visit.