A dental crown is a cap placed over a damaged tooth, restoring its shape, size, strength, and appearance. While crowns protect compromised teeth, sensitivity after placement can cause concern. This article explores common reasons behind crown sensitivity.
Common Reasons for Crown Sensitivity
Sensitivity immediately following a crown procedure is common as the tooth and surrounding tissues adjust to the new restoration. The preparation process removes a portion of the tooth’s enamel, which can temporarily expose dentin, leading to increased sensitivity to temperature changes. This initial sensitivity typically subsides within a few days to a couple of weeks.
New or recurrent tooth decay beneath a crown is a frequent cause of sensitivity. Bacteria can accumulate at the crown’s margins, especially if oral hygiene is not meticulously maintained. This can lead to cavities, which erode tooth structure and reach sensitive inner layers like dentin or pulp. Decay in these areas can cause persistent sensitivity or pain, especially when exposed to hot, cold, or sweet stimuli.
Gum recession can expose the root surface of a crowned tooth, leading to heightened sensitivity. The root surface lacks enamel and is covered by softer, more porous cementum. As gums recede, often due to aggressive brushing, gum disease, or aging, these sensitive root surfaces become exposed. This exposure can result in sensitivity when cold air, cold liquids, or even light touch stimulate the exposed dentinal tubules.
An improper bite, where the upper and lower teeth do not meet correctly, can place undue pressure on a crowned tooth, resulting in sensitivity or discomfort. If a crown is too high, it can lead to excessive stress on the tooth’s supporting structures. This pressure can inflame the ligament surrounding the tooth root or irritate the tooth’s nerve, causing pain upon biting or general soreness.
A cracked or damaged crown, or a fracture in the underlying tooth structure, can contribute to sensitivity. Crowns can chip or crack from biting on hard foods or from trauma, compromising their protective seal. If the underlying tooth develops a crack, it can create a pathway for bacteria and temperature changes to reach the sensitive pulp. Both scenarios can lead to pain, particularly when chewing or exposed to temperature extremes.
Inflammation or infection of the tooth’s nerve (pulp) can cause significant sensitivity or pain. Deep decay, repeated dental procedures, or injury can damage the pulp. If the pulp becomes inflamed or infected, the tooth may become highly sensitive to hot and cold, and the pain can linger for extended periods. This sensitivity often signals a serious issue requiring dental intervention.
When to Seek Professional Help
Persistent sensitivity lasting more than a few days or weeks after a crown placement warrants professional evaluation. While some initial discomfort is normal, prolonged sensitivity suggests an underlying issue. Seek dental attention if you experience sharp pain, especially when triggered by hot, cold, or sweet foods.
Pain upon biting or chewing, particularly if it feels like pressure or a sharp jab, indicates a potential problem with the crown’s fit or the underlying tooth. Swelling or redness around the crowned tooth or gum line can signal an infection or inflammation. Any visible damage to the crown, such as chips, cracks, or if it feels loose, necessitates a dental visit. If sensitivity is accompanied by a fever or general malaise, it could indicate a widespread infection.
What to Expect at the Dentist
Your dentist will begin with a thorough examination of the crown and surrounding gum tissue, checking for signs of inflammation, decay, or damage. They will likely take dental X-rays, which can reveal issues not visible during a visual inspection, such as decay beneath the crown or problems with the tooth’s root. The dentist may also use a bite paper to assess how your teeth meet, identifying any high spots on the crown causing discomfort.
If the bite is determined to be the cause of sensitivity, the dentist can often resolve the issue with a simple bite adjustment. This involves adjusting the crown to ensure it no longer contacts the opposing tooth excessively. If decay is discovered beneath the crown, the dentist will need to remove the existing crown to treat the decayed tooth structure. A new crown will then be placed.
For gum issues, such as inflammation or recession, the dentist might recommend oral hygiene instructions, professional cleaning, or referral to a periodontist. If the tooth’s nerve is inflamed or infected, a root canal treatment may be necessary to remove the damaged pulp and save the tooth. If the crown is significantly damaged, or the underlying tooth structure is compromised, replacing the crown might be the solution.
Long-Term Crown Care
Maintaining excellent oral hygiene is paramount for the long-term health of your crowned tooth and to prevent future sensitivity. Brush your teeth twice daily with fluoride toothpaste, cleaning thoroughly around the crown and at the gum line. Daily flossing is important to remove plaque and food particles from between teeth and around the crown’s margins.
Regular dental check-ups and professional cleanings are important for monitoring your crown’s condition and detecting problems early. Avoiding hard or sticky foods protects your crown from chipping, cracking, or dislodging, preserving its integrity and fit. If you clench or grind your teeth, discuss this with your dentist. They may recommend a nightguard to protect your crown and natural teeth.