Permanent and temporary dental crowns - Common Problems.
Sensitivity, pain and other complications.

This page discusses and explains some of the different types of problems that tend to occur with teeth that have dental crowns, both permanent and temporary.

Common problems associated with Permanent Crowns:

1) Tooth pain    2) Thermal (hot/cold) sensitivity    3) Irregular bite / Tenderness when biting   
4) What to do if you have a permanent crown come off.

Common problems associated with Temporary Crowns:

1) Tooth pain    2) Hot / cold sensitivity    3) Abnormal bite    4) Gum tissue pain   
5) What to do if your temporary crown comes off.    6) Temporary crown precautions.

I) Permanent dental crowns: Common problems, pains, sensitivities.

Listed below are some of the types of complications that a person might experience with a tooth that has had a permanent crown placed. If you do notice any of these or any other symptoms, you should let your dentist know sooner rather than later, so they can evaluate them and make a treatment recommendation in a timely fashion.

A) Problems that cause tooth pain.

The same events and circumstances that can lead to the need for a dental crown (such as tooth fracture, tooth decay or a lost filling) can also have a detrimental effect on a tooth in other ways. And for this reason, even a tooth that previously seemed just fine, either before the crowning process was begun or even many years after, may begin to display some type of symptoms.

While the timing of the symptoms may seem suspicious, they're most likely an indication that all was not well with the tooth before the crowning process was begun, and, unfortunately, the full extent of these problems could not be definitively identified beforehand.

Common problems.

For example, sometimes after the crowning process has been begun, or even long after it's been completed, a problem with a tooth's nerve becomes apparent, thus creating the need for root canal therapy. (We describe the relationship between dental crowns and the need for root canal treatment in greater detail here.)

These teeth may just be a little tender to biting pressure or, at the other extreme, involve severe pain that lasts for hours. The discomfort may be triggered by a stimulus (hot things tend to set these teeth off, and the pain typically lingers), or else it occurs spontaneously. Often it has a throbbing, sometimes a radiating, nature.

With other cases, it's possible that a fractured tooth has cracked seriously enough that even a crown cannot securely splint its broken parts together. Teeth having this complication will continue to be painful in response to biting pressure, even after having a crown placed.

Neither of these situations are ones that your dentist can diagnose or anticipate with certainty. If you have symptoms develop or persist, all you can do is report them to your dentist so they can evaluate your status and make a treatment recommendation.

B) Crowned teeth whose bite doesn't seem right.

Your dentist will evaluate the way your new crown comes together with its opposing teeth before they cement it in place. Even so, you may find (especially after your numbness has worn off) that your crown's shape is still not quite right.

You may find that your crowned tooth touches first when you bring your teeth together. Or maybe as you slide your teeth from side to side, you can feel some aspect of the crown seems too prominent (is too "high").

This type of problem is usually an easy fix for your dentist. They simply need to buff your crown down, so its shape is more in harmony with your bite. Don't expect this type of problem to take care of itself, however, because it won't. In fact, if this condition is not remedied in a timely fashion, it can lead to serious consequences, such as a need for root canal treatment.

C) Crowned teeth that are sensitive to hot and cold.

After a dental crown has been cemented into place, a person may notice that their tooth is sensitive to hot and cold foods and beverages. The location of this sensitivity is usually right at the edge of the crown, down by the gum line.

As an explanation, it might be that the crown doesn't cover over the tooth quite as far as it ideally should (possibly on a scale so small you can't even visualize it). It's this "exposed" surface that responds vigorously to hot and cold stimuli.

This type of problem may have an easy fix. The cure might be as simple as using toothpaste that's marketed as a treatment for "sensitive teeth" (the active ingredient in these products is usually potassium nitrate). Or, the dentist may apply a solution to the tooth that helps to protect (and therefore desensitize) the exposed surface.

II) Temporary crowns: Common problems, pains, sensitivities.

Teeth with temporary crowns can experience all of the same type of problems as those fitted with a permanent one, and due to the disposable, temporary nature of these restorations, a few other types of complications too. Just like with permanent crowns, if you experience any type of problem, you should feel free to report it to your dentist so they can make an evaluation and treatment recommendation.

A) Teeth that have increased thermal sensitivity.

It's common that a person may notice some increased sensitivity to hot and cold foods and beverages with their tooth that's been fitted with a temporary crown. It may be related to the fact that the edges of a temporary typically fit over a tooth less precisely and fully than a permanent crown, thus creating a space at the gum line where thermal irritants can get at the tooth.

B) Gum tissue irritation.

A temporary crown is placed during that same appointment when a tooth is initially shaped for its new crown. And since the edge of most crowns end at or below the gum line, it's easy for a person's gum tissue to get roughed up during the crown-making process.

The irritated tissue might feel a little tender for a day or so. As a remedy, rinsing with warm salt water, up to three times a day, can help to speed up healing.

C) Problems with the temporary crown's bite.

After your numbness wears off, you may find that when you bite down your temporary crown seems to be too "high" (it contacts opposing teeth before any neighboring teeth do). Your dentist will be eager to adjust your crown's bite so to remedy the problem. Don't expect this situation to take care of itself or improve with time. It may not and allowing this condition to persist can seriously aggravate or even compromise a tooth's nerve, even to the point of needing root canal treatment.

D) Tooth pain.

After having been shaped for a dental crown (drilled upon), it's possible that your tooth may feel a little tender. If you do notice some discomfort, go ahead and let your dentist know so they can evaluate your symptoms.

As a solution for minor, reversible conditions, a dentist will often recommend taking an anti-inflammatory pain reliever such as ibuprofen or aspirin. (A tooth's discomfort is often caused by an inflammation reaction, this type of analgesic can provide both pain relief and help the tooth to settle down faster.) [You will need to read and evaluate the directions and precautions that accompany these products so that you know that their usage is appropriate for you.]

In some instances, the pain or discomfort you notice can be a sign of more serious tooth complications. If so, it is likely that you'll require the attention of your dentist to resolve them. Don't be hesitant to ask. Dentists know that complications can and do occur.