A dental crown is a tooth-shaped cap placed over a damaged tooth to restore its shape, size, strength, and appearance. When throbbing pain develops beneath this restoration, it signals underlying irritation or inflammation within the tooth structure or surrounding tissues. This rhythmic sensation is often caused by pressure against the sensitive nerve within the tooth’s core. Understanding the potential causes of this symptom is the first step toward seeking appropriate care.
Primary Causes Under the Crown
The most frequent biological source of throbbing pain is inflammation of the dental pulp, a condition known as pulpitis. The pulp contains the tooth’s nerves and blood vessels, and irritation causes swelling that presses against the rigid interior walls of the tooth. This pressure manifests as a pulsating discomfort, especially in response to temperature changes or pressure. Pulpitis often arises from recurrent decay, which is the formation of a new cavity beneath the crown margin. If the seal between the crown and the tooth breaks down, bacteria can invade through a tiny gap, known as micro-leakage, irritating the underlying nerve and leading to chronic inflammation.
Structural and Alignment Issues
Throbbing pain may also originate from mechanical problems, such as a crown that does not align correctly with the opposing teeth. If the crown is slightly “high,” it receives excessive force when biting or chewing, creating trauma to the tooth and its supporting structures. This abnormal pressure inflames the periodontal ligament, the tissue that anchors the tooth to the jawbone, resulting in a throbbing ache. Physical damage, such as a crack or fracture in the crown material, also compromises its protective function. A compromised crown allows bacteria and temperature stimuli to reach the underlying dentin, which can progress into a steady throbbing as the nerve becomes agitated.
When Throbbing Signals Infection
A persistent, intense throbbing pain often indicates that pulpitis has progressed to a full-blown infection and the formation of a dental abscess. An abscess is a pocket of pus that develops at the root tip due to the death of the tooth’s nerve tissue. The pressure buildup from this pus accumulation within the jawbone causes the unrelenting, severe throbbing sensation. Specific symptoms accompany this serious progression, requiring immediate professional assessment to prevent the spread of bacteria. Signs like noticeable swelling in the gums or face, a foul taste from pus discharge, or a fever are strong indicators that the infection is active and needs urgent intervention.
Immediate Pain Management
While waiting for a dental appointment, temporary steps can be taken to alleviate the throbbing discomfort. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen are effective because they reduce both pain and inflammation at the source. Applying a cold compress to the outside of the cheek near the affected area can help minimize external swelling and temporarily numb the throbbing sensation. A simple rinse using a mixture of warm water and half a teaspoon of salt can also soothe irritated gum tissue. Until the cause of the pain is diagnosed, avoid chewing on the affected side and stick to soft foods.