Tooth hurts after crown?

Tooth hurts after crown? Why does a tooth hurt after a dental crown?

Tooth hurts after crown is a common search term for someone that is in pain AFTER a dental crown. There can be several reasons for this and there can also be several solutions as well. Typically people have a concern because the tooth did not hurt before the crown.

Why does a tooth hurt after crown? It didn’t hurt before the crown!

The very short version is whatever the cause of you needing a crown, a crack, decay, or break, causes some trauma to the nerve and the dentist fixing the problem causes more. The combination of the two things cause inflammation in the nerve which you experience as pain.

The pain comes from the nerve in the center of the tooth and/or the tissue around the roots of the tooth. The crown procedure is traumatic and will cause some pulpal inflammation, the pulp is the tissue in the center of the tooth that contains the nerve for the tooth.

The preparation of a tooth for a dental crown is traumatic to the nerve of the tooth. The reason you are getting a crown causes trauma as well. For example, a crack in a tooth will cause some low grade inflammation in the nerve of the tooth. Breaking a tooth will do the same. Decay typically grows pretty slowly so if you have decay the nerve can adapt to some extent to that but it will also cause inflammation. Removing decay, old filling material, cracks and just preparing the tooth for a crown happens all at once and is traumatic. This in addition to whatever was the cause for you to need a crown can push a tooth that felt fine over the edge and cause the tooth to hurt after the dental crown.

You can see how much of a tooth we remove for a crown.

There are several reasons a tooth hurts after crown.

1. The tooth needs some time to settle down.
2. The tooth will need a root canal.
3. The crown is slightly too high and your chewing on it is causing pain.

These are the main reasons that a tooth hurts after a crown. The reasoning for each can depend on your situation.

Tooth hurts after crown because the tooth needs time to settle down.

If the pain is not too severe, the tooth may just need some time to calm down. We would classify this as reversible pulpitis and the pain should be gone in a few days. Each day the pain should be less. Anti-inflammatory medication like Advil (ibuprofen) can be taken and will usually eliminate the pain for a few hours.

Tooth hurts after crown because the tooth needs a root canal.

This is more severe than the case above. The pain is either more intense and or lasts longer after a stimulation like cold or chewing. We classify this as irreversible pulpitis. The pain does not go away after a few days and may even get worse. The nerve of a tooth will only take so much trauma before it gives up and starts to die, thus needing a root canal. Although your dentist will do their best to tell you before cementing the crown on if you will need a root canal, the reality is when dealing with living tissue one can never truly predict when a nerve will decide to die on you. Much of this has to do with your bodies ability to heal itself and with your anatomy.

Tooth hurts after crown because the crown needs an adjustment.

This is an easy fix. Have the dentist recheck the bite while you are not numb. Typically if this is the case after the bite adjustment you will immediately feel like you are biting together better. If the bite adjustment was the only issue the pain will disappear within a few days after the dentist adjusts it.

Typical situation of a tooth hurting after a dental crown. Tooth has large filling and large decay. Tooth feels fine at crown seat and then acts up days or weeks later.

 

What if my tooth hurts after a dental crown but I have already had a root canal?

That can happen for several reasons as well.

1. If the root canal is recent then the area needs time to heal.
2. The root canal could be failing or unsuccessful.
3. One of your tooth roots could have a crack in it.
4. The crown is slightly too high and your chewing on it is causing pain.

If the root canal is recent then the area needs time to heal.

It takes 2-3 days for the inflammation around the roots of a tooth that has had a root canal done to calm down. Advil (ibuprofen) will help this pain.

The root canal can fail or never be successful and thus a tooth with a new crown will hurt.

Messing with a tooth that has a root canal can stir things up and cause an infection to flare up. Root canals are only about 90-95% successful and the rate goes down the older the root canal is. If the tooth has a new infection after a root canal then you may lose the tooth. We can retreat a root canal or we can remove the infection through another procedure known as an apicoectomy. I personally feel if a root canals is failing one must consider a dental implant, but this is a case by case issue.

One of your tooth roots could have a crack in it.

If this is the case you will lose the tooth. These cracks are hard to detect and unfortunately often receive expensive dental work before we can determine they have the crack. The tooth in my cracked tooth syndrome post was a tooth that a root canal was done on knowing that a significant crack was there. However, we can not always know this, in fact usually we do not.

The crown is slightly too high and your chewing on it is causing pain.

This is an easy fix. Have the dentist recheck the bite while you are not numb. Typically if this is the case after the bite adjustment you will immediately feel like you are biting together better. If the bite adjustment was the only issue the pain will disappear within a few days.

 

Why wasn’t a root canal done before the crown was put on?

This is a reasonable question for a patient to ask. To be honest it always sounds foolish to your dentist though. It would be like asking a cardiologist why a heart transplant wasn’t done before congestive heart failure started. We can not determine when your nerve tissue is going to die. We certainly aren’t going to start telling everyone that is about to get a crown that they need a root canal as well because most people do not. To do so would be over treating you. If you end up needing a root canal after a new crown is put on it’s just bad luck, bad healing, or a combination.

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