March 22, 2023


I’m rick buck and i’ve been a dentist for 15 years in this video we will go over most of the possibilities as to why teeth becomes sensitive or painful after a crown or temporary crown is done when talking about any pain we talk about the different possible mechanisms or pathways of the pain and in this case how having a crown done may have triggered one of those

Pathways then we can understand the different remedies or treatments needed so like and subscribe if you have teeth here is what you need to know about tooth pain after a crown to help find out what is going on first is the tooth sensitive to cold and if so how long does that cold pain last and how severely and sensitive is it to the cold second do you have pain

To biting as well third does the tooth throb on its own fourth is the crown or tooth catching food in between the teeth fifth does your bite feel uneven or off since the crown was done with those in mind let’s talk about the different mechanisms of pain that may have been triggered by doing a crown or a temporary crown let’s begin by talking about the tooth pain

Mechanism referred to as papayas pulpitis is the inflammation of the pulp chamber in the center of your tooth where its main nerve system lies so with your tooth this increased inflammation in the center of the tooth changes how the nerves there react and it makes them more excitable or easily triggered and will cause pain especially when cold touches the tooth

If this cold sensitivity is a short duration normally less than 10 seconds then pulbitis is said to be possibly reversible meaning the tooth may possibly heal on its own and the pulpitis will eventually go away and back to being normal in the future and so will the pain however teeth are not as good as other parts of your body and healing themselves so sometimes

Pulpitis won’t heal at all and will get worse and worse until the tooth dies which then turns that tooth and that central canal where all of those nerves are into a breeding ground for bacteria and infection because now it has no blood supply apply to get in there to fight the infection now if the inflammation is on this path to dying and becoming a breeding ground

For bacteria this is what is called irreversible pulpitis we determine if a tooth has irreversible pulpitis if when testing the cold sensitivity it lasts longer than 10 seconds you don’t need cult to determine this dentists can also determine this with what they call a pulp vitality tester but most of us just do it anyways with the cold because it tells us so much

About the pain if you have irreversible pulpitis the tooth will need a root canal eventually to save the tooth and prevent further infection here’s the thing though even if you have reversible pulpitis which i explained anytime you get reversible pulpitis it can turn into irreversible pulpitis if it lasts long enough and just doesn’t heal on its own in a second i’ll

Tell you what i have my patients to do to hopefully prevent the progression of reversible pulpitis to irreversible by this which once again would eventually be the root name but first let’s go over how did your tooth get a form of pulpitis at all from having a crown a couple possibilities actually first you may have noticed that as your dentist was drilling on your

Tooth for the crown he was using a drill with tons of water shooting out of it this water spray is for many reasons but the main reason is to keep the tooth cool so it doesn’t heat up while working on the tooth why because if the tooth heats up too much as the dentist is drilling this will elicit inflammation or pulbitis in your tooth if your dentist wasn’t using

Water or enough water then it would likely cause pulpitis but even if they did use sufficient water sometimes the tooth can still heat up enough to cause pulpitis and pulpitis isn’t only caused by heat your teeth can also sense trauma so drilling in general can possibly cause pulpitis the deeper the cavity or drilling the more likely your tooth will sense trauma

Causing one of the forms of pulpitis i have a trick that i use with my patients to hopefully prevent pulpitis from progressing into irreversible pulpitis anytime a patient has pain or cold sensitivity after a cramp which to my credit is sell them with my patients because i use a lot of water and i use a lot of other techniques that prevent sensitivity what i do

Is i have my patients take over-the-counter ibuprofen three times a day for three days with the recommended dose on the bottle which is usually around 400 milligrams i use this not for pain but for ibuprofen’s anti-inflammatory properties and the sooner you do this to when you start filling the inflammation pain the better and mostly because of this my patients

Rarely ever have pulpitis advanced to irreversible pulpitis because of this trick alone and then a few other things that i do for patients that can’t tolerate ibuprofen i have them take omeprazole or prilosec otc to adequately calm the stomach first and then they take the ibuprofen and hopefully it won’t bother the stomach as much that way or i will prescribe an

Anti-inflammatory normally one called medrol that can also reduce inflammation speaking of crowns and cavities and before i go on to other causes you need to watch my daily brushing and flossing routine video it will show you how to optimally take care of your teeth each day with all the best products that i have tested out and other videos that i’ve made these

Products include my favorite floss toothbrush and toothpaste by far in fact all of those are linked to below this youtube video as well but you can see why are they my favorite with the stunning results that they provide in a video that will pop up at the end of this video and you can see why that is the best technique for taking care of your teeth now let’s move

On to another pathway that is like pulpitis that a crown may have caused you to have this is called dentin hypersensitivity the mechanism of dentin hypersensitivity will help you understand how doing a crown can cause it you see if you remove the enamel layer of your teeth and looked at the underlying surface of your tooth under a microscope you would see all these

Small tubu tools this layer under your enamel is called your dentin under a microscope it almost looks like pvc pipes that have been placed into a wall and they’re all lined up kind of near each other these tubules are filled with a fluid and the tubules are also connected to nerve endings toward the center of your tooth when the dynamic of the fluid in those tubules

Changes it sends a sensitivity or pain signal to your brain the more of those tubules your teeth have and the wider their diameter is the more your teeth will become sensitive if those tubules are exposed and or stimulated so what changes the fluid dynamic in those tubules so that it sends sensitivity signals well cold can cause dentin hypersensitivity also simply

Touching the exposed dentin can cause it or sugars can change the fluid dynamic you see if you have a crown normally the dentist drilled down past the enamel layer to this dentin layer so it is possible for anyone to develop dentin hypersensitivity applying cold to the tooth is is how dentists test for dentin hypersensitivity now as opposed to pulpitis if the tooth

Is sensitive to cold and it lasts less than three seconds it is likely dent in hypersensitivity and not papayas two things can affect the possibility of hypersensitivity at the time dentists work on the tooth first the deeper the drilling is the more likely it causes hypersensitivity second dentists have desensitizers they can use after drilling on a tooth to help

Reduce the chances of hypersensitivity however it should be noted that a dentist can do everything correctly and you still develop hypersensitivity personally i try to make sure to keep the drilling depth of crowns as small as possible if a patient develops hypersensitivity while in the temporary crown i will apply a good amount of desensitizer before placing the

Permanent crown temporary crowns because they aren’t made to be precise will at times get leakage of let’s say cold water under the crown that will set off hypersensitivity and thus that’s why you can get some cold sensitivity while in a temporary crown the permanent crown is likely to fix this issue as they seal off and prevent leakage much better than temporary

Crowns but it still can happen with a permanent crown as well the point is if you have dentin hypersensitivity in a temporary crown and don’t have the permanent crown yet the permanent crown is likely to help resolve the hypersensitivity moving on to another cause of dentin hypersensitivity due to a crown is if a crown has an internal high spot this can set off a

Zing or sensitivity every time or sometimes when you bite down luckily patients will often notice this high spot at the appointment where i’m trying on the permanent crown and adjusting it so that it fits perfectly if it happens that they do start getting this little zing i just filed down that spot internally on the crown until they don’t feel it anymore anyway

Hopefully your dentist is doing that and that would take care of that but even if the dentist doesn’t adjust that spot most of the time when putting on the permanent cement for the permanent crown it will just resolve this by itself but because it is possible that they still feel it after the cementation i like to just adjust the high spots that are touching the

Tooth and causing sensitivity before i permanently cement it if for some reason none of this does reduce the sensitivity it does require redoing the crown in the future to get another crown on there that hopefully doesn’t put as much sensitivity when biting but luckily that seldomly happens i’ve been to dentist 15 years and probably count on my hand the amount of

Times that may have happened the next possibility of tooth pain after a crown is inflamed tooth ligaments you see you have little ligaments that anchor your teeth into your jawbone if too much pressure goes on those tooth ligaments the tooth can become sensitive and very painful when biting you may have noticed that the dentist or assistance had you bite on a piece

Of paper like carbon paper at the end of your appointment and asking you if the temporary or permanent crown feels high or if it feels normal when you’re biting down we know it’s hard to tell when you’re numb but we’re doing our best to make sure the crown isn’t too high if it is too high every time you’re biting on the tooth ligaments of that tooth can take the

Brunt of the pressure of each bite instead of evenly distributing the pressure of your bite on all your teeth and that will in turn cause the ligaments to become inflamed and sore and stretched and even may be bruised over time if you don’t adjust a high crown the ligaments of that tooth will become painful luckily the solution is as simple as just having the

Dentist file down the high spot of the crown just a little bit i’m surprised how often this happens with people with them not realizing the tooth feels uneven at all but still causes them pain then what happens is you just adjust those spots where they’re biting high and then the patient will notice that they feel hey that does feel better or more even and that is

The solution but they didn’t even realize it felt uneven until you adjusted it all they had felt beforehand was the pain and if you’re worried about having your crown adjusted you shouldn’t really worry about that i mean the crown is adjusted at the lab before it’s made it’s adjusted at the dentist office the only difference this time is it’s just adjusted while the

Crown is on your tooth let’s move on to the mechanism of gum irritation when dentists work on teeth especially for a crown sometimes the surrounding gums take a beating to help us accomplish the crown and it’s just an unfortunate truth this gum irritation normally manifests as a general soreness without a cold pain there can be some biting pain too but normally not

Cold pain for gum irritation now the good thing about gum irritation is normally this will heal up on its own in a few days and in the meantime clove oil or something like orajel will help with this pain but there is another specific type of gum irritation with crowns and especially temporary crowns that is really painful sometimes a hidden jagged edge or piece of

Temporary crown or hardened temporary crown cement pokes out into the gums or how tiny this sharp edge can be it can also be very painful actually normally this manifests as a biting pain that increases in time without much cold pain once again a lot of people will notice that the tooth just becomes really sensitive to even to a slight touch or even just flossing the

Gums normally the dentist or the assistant can just smooth out the temporary crown or they can numb the gums and then smooth off the excess bonding whichever is causing the irritation of the gum another gum irritant can come if the new crown is trapping a lot of food when you eat this happens if the crown doesn’t butt up tight against the tooth next to it normally

In this case you will notice a lot of debris coming out when you floss your teeth right next to or around the crown a way you can tell if the crown is adequately contacting the adjacent tooth is if the floss snaps when you floss as opposed to just gliding through without any resistance or snapping through when you’re flossing however even a tight crown contact can

Still catch food if this happens on your permanent crown you will likely need to redo the crown to make it even tighter but hopefully the dentist catches this before cementing it into place and sends the crown back to the lab so they can just add some contact to the crown to make it tighter if it is a temporary crown catching the food this will likely be fixed with

The permanent crown so you don’t need to worry much about that in the meantime remove as much debris as possible by tying knots in the floss and then threading it back and forth to remove as much of the debris as possible but be very careful not to snap the floss back out of the temporary crown because you don’t want to pop off the temporary crown just thread it

All the way through and out moving on sometimes the crown was done to fix a fracture or sensitivity to a cracked tooth 99 of the time if diagnosed and treated correctly the crown fixes the pain due to the crack in the two you see when you bite just right on a cracked tooth it will make the tooth flex and the tooth flexing will set off a sharp pain or zing down

The tube a crown will normally stop the flexing of the cracked tooth and hold it together so it doesn’t flex and set off that zing but every once in a while a crack will still be sensitive even after the crown is done if the dentist catches this before he permanently attaches the final crown he can often adjust the internal of the crown to remove pressure on the

Spot causing the crack to flex if the fracture paint still remains after the tooth has been finely cemented into place it will likely take assessing the pain to see if you want to perform a root canal redo the crown or extract the tooth or leave the tooth as is if the pain is not that intense but this is a decision between you and the dentist and it takes a lot

Of back and forth in deciding what you want to do it can be a confusing situation but most of the time this does not happen remember my favorite toothbrush floss toothpaste and other dental products are linked to below this video everyone should watch my daily tooth care routine video i have posted now and i will show you why in that video it is the best technique

To brush floss and more this video is part of a larger series of oral pain i’m doing so you can match up the symptoms we talked about here and watch more videos on a possible diagnosis and treatments that way you can further narrow down the cause of your pain and hopefully find a remedy or see a dentist that can provide you an official diagnosis and treatment if

In southern california my dental office is linked to below like and subscribe if you have teeth

Transcribed from video
Every Cause of TOOTH PAIN AFTER CROWNS & TEMPORARY CROWNS! Why It Hurts Years Later or Comes & Goes By Baseline Dental