A temporary crown is a molded, protective covering placed over a tooth prepared for a permanent crown. This provisional restoration shields the underlying, exposed tooth structure, primarily the sensitive dentin layer and the pulp, while the custom-made final crown is fabricated in a lab. Although designed for protection, the temporary crown process often results in some degree of thermal and pressure sensitivity. This temporary discomfort is a common side effect of the necessary dental work.
Why Temporary Crowns Cause Sensitivity
The most immediate cause of discomfort is irritation of the dental pulp, the tissue containing the tooth’s nerve and blood vessels. The high-speed drilling and friction required to reshape the tooth generate heat, which causes transient inflammation of the pulp, known as reversible pulpitis. This trauma makes the tooth temporarily hyper-responsive to stimuli like cold air or slight pressure.
The underlying dentin becomes exposed when the protective outer enamel is removed during preparation. Dentin is highly porous and contains millions of microscopic tubules that lead directly to the pulp chamber. Since the temporary crown material (often acrylic or resin) is less insulating than natural enamel, temperature changes easily travel through it and the tubules to the nerve, causing sharp sensitivity.
Micro-leakage is a frequent source of sensitivity unique to temporary crowns. The cement used to secure a provisional crown is intentionally weak for easy removal when the final crown is placed. This weak cement does not create a perfect seal, allowing microscopic gaps to form at the crown margin. Saliva, bacteria, and food debris can seep into this space, irritating the exposed dentin and pulp.
If the temporary crown is too tall, it causes bite discrepancies, leading to pressure sensitivity when biting down. This imbalance forces the crowned tooth to bear excessive force, stressing the periodontal ligament surrounding the tooth root. Additionally, the edge of the temporary crown resting near the gum line can cause localized inflammation and soreness in the gum tissue.
Immediate Steps for Managing Discomfort
Managing sensitivity begins with modifying your diet to protect the restoration. Avoid hard foods (like nuts or hard candies) and sticky foods (like caramels or taffy), as these can dislodge the temporary crown. Limit consumption of very hot or very cold items, opting instead for room or lukewarm temperatures to prevent shocking the already-irritated pulp.
For mild pain, non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or acetaminophen can be taken according to the recommended dosage. You may also apply a desensitizing toothpaste directly to the area using a clean finger or cotton swab, leaving it on for several minutes to help block the exposed dentin tubules. A warm salt water rinse can be used several times a day to reduce gum inflammation and keep the area clean.
Maintaining hygiene requires a gentle approach to prevent dislodging the crown. Use a soft-bristled toothbrush and brush gently in circular motions around the temporary crown. When flossing, avoid pulling the floss back up through the contact point. Instead, carefully slide the floss in and then pull it out from the side (cheek or tongue space).
Signs That Require Immediate Dental Attention
While mild, temporary discomfort is normal, certain symptoms indicate a more serious issue requiring immediate contact with your dental office. Severe, throbbing pain that persists after taking over-the-counter medication, or pain that wakes you up at night, is concerning. This unrelenting ache may signal irreversible pulpitis, meaning the nerve is not recovering and may require root canal therapy.
Other urgent signs include swelling in the face, jaw, or gums near the crown, which can signify an active infection or abscess. A persistent bad taste or foul odor, despite regular brushing, may also point to bacterial leakage and decay. If the temporary crown falls off completely, the exposed tooth becomes excruciatingly sensitive and vulnerable to fracture or shifting.
If the temporary crown comes off, retrieve it and call your dentist immediately for instructions. You can attempt temporary reattachment by cleaning the inside of the crown and the tooth, then using a small amount of temporary dental cement or plain toothpaste to gently hold the crown in place until your appointment. Never use household superglue, as it is toxic and interferes with professional re-cementation.
What Changes When the Permanent Crown is Placed
The transition to a permanent crown typically resolves most lingering sensitivity because the final restoration addresses the provisional crown’s shortcomings. Permanent crowns, made from materials like porcelain, zirconia, or metal alloys, are much stronger and more insulating against temperature changes than temporary resin. This superior insulation minimizes the transmission of hot and cold stimuli to the underlying dentin and nerve.
The final crown is secured with a permanent luting agent, a specialized dental cement that creates a durable bond and a near-perfect seal around the tooth margin. This seal prevents the micro-leakage of bacteria and fluids that irritated the pulp under the temporary restoration. Placement also includes meticulous adjustment of the bite, ensuring the crown is not “high” and eliminating pressure sensitivity caused by bite discrepancies.
Although the permanent crown provides better seal and insulation, patients may experience a brief return of mild sensitivity immediately after the final seating procedure. This is usually transient and related to the final cementation process. However, because the permanent crown offers an ideal fit and seal, this minor sensitivity typically disappears entirely within a few days or weeks as the tooth fully acclimates to its final protective covering.