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Why does pain often occur in a temporary crown?

the causes of tooth pain from a dental crown
A temporary crown is a small crown attached to a tooth or implant for a limited period.
Although temporary, it is very important because it protects and restores the shape, function, and aesthetics of the damaged tooth.
When the temporary crown is placed, the pain is often felt just after the numb sensation disappears.
Find out in this article everything you need to know about temporary crown pain.

What happens to the tooth that will receive a temporary crown?

tooth structure
Once the decision to crown the tooth is made, your dentist will begin to prepare the tooth.
He or she will administer a local anesthetic to numb the area around the affected tooth, which will increase your comfort throughout the procedure. Then he or she will begin to trim the tooth.

But do you know what happens to the tooth during preparation?

First, you need to know that the tooth has three layers: the enamel, which is the outermost layer, the dentin, which is the layer underneath, and the pulp, which is the soft tissue containing the nerves and blood vessels.

During preparation, the enamel will be removed, leaving the tooth with only two layers (dentin and pulp). Only a layer of dentin remains to separate the pulp from the outside.

Moreover, dentin is not an impermeable tissue. It is composed of numerous canals called dentinal tubules, representing an easy entrance for bacteria to the pulp.
A tooth with exposed dentin is therefore more sensitive, and can trigger pain in contact with hot and cold foods.

The pulp being innervated and vascularized can feel the constraints applied by the instruments used during the preparation, this will trigger in return an inflammation which explains the pain felt after the numb sensation disappears.

The preparation of the tooth will therefore trigger directly a stress on the tooth by the instruments used, and indirectly by exposing the dentin, making the tooth more vulnerable.

The different causes of pain after the temporary crown placement

The trimmed tooth with exposed dentin, being more vulnerable, needs protection, hence the role of the temporary crown.
Note that it is normal to feel localized pain on the tooth, it is a natural response of the pulp that will gradually decrease after 1 to 2 weeks.
However, sometimes pain can be triggered by other factors, among them:

Cavities


If a small cavity is left untreated or if a new one has formed under the crown due to a lack of hygiene, it can evolve and reach the pulp. The tooth will be sensitive to temperature and pressure when you bite.

The crown doesn't fit correctly


The temporary crown should exactly replicate the natural function and shape of the tooth:
Signs that the crown does not fit properly:
  • Your temporary crown is loose or comes off the tooth;
  • Sensitivity and discomfort;
  • Your bite doesn’t feel right;
  • Accumulation of food debris between your teeth;
  • The spaces between the teeth are too wide or too tight.

Infection


Whether the tooth is alive or not, an infection can occur, especially if decay persists under the crown or if the infected tooth pulp is not completely removed during the root canal treatment. In case of infection, you will feel intense, pulsating and radiating pain.

Gum disease


The natural shape of the tooth plays an essential role in protecting your gums. When the shape of the tooth changes, it can be an aggravating factor for gum disease. However, it is normal for your gum to be irritated after receiving the temporary crown, as your dentist must have accidentally injured it during the procedure. This discomfort is temporary and should not last more than two weeks.

Cracked tooth


It is not uncommon for the tooth with a temporary crown to fracture, especially if a root canal is performed, because the treated tooth is more fragile than a normal tooth. You should feel pain when chewing hard foods and sensitivity to cold and heat.

Recessed gums


Gum recession will expose part of the root. The root, unlike the crown, is not covered by enamel, which makes it more sensitive. Therefore, you may feel more pain when your gums recede.

Bruxism


If you have a habit of grinding your teeth, this is probably the cause of the toothache you are currently experiencing. The forces triggered by bruxism will overload the tooth. As a result, the pulp and tissues surrounding the tooth react with inflammation, leading to pain.

When should you talk to your dentist?

It is normal to feel pain after the temporary crown is placed, it is temporary, and the pain will gradually subside after 1 week. The sensitivity should be localized to the tooth and should not be radiating (pain that spreads to the jaws), spontaneous (triggered by itself), pulsating (that beats at the rhythm of the heart). If it is the case, it could be a sign of an infection that must be treated quickly.

Treatment of temporary crown pain

After making an appointment with your dentist, you can try some home remedies to relieve the pain:
  • Chew on a clove, both soothing and disinfectant;
  • Make a mouthwash with baking soda: 1 teaspoon of baking soda in a glass of water
  • Put an ice pack in contact with your cheek, where it hurts, for about ten minutes.
  • Try over-the-counter pain relievers like ibuprofen (Advil) or acetaminophen (Tylenol). They may help temporarily relieve the pain.

If the pain persists for more than three to four weeks or if you notice any infection signs, visit your dentist immediately. He or she is the only one who can know the cause and the treatment right for you.

Your dentist may suggest you:
  • A root canal treatment if it is not already done.
  • Correct the tooth preparation if the crown doesn't fit properly.
  • Readjust the shape and height of the dental crown.
  • A mouth guard, especially if you grind your teeth at night.

Finally, remember that tooth extraction is the last option. Get two different opinions if necessary.
What makes an extraction necessary is often severe destruction of the bone and root. But, in most cases, the tooth can be saved.