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Toothache After Crown Preparation

Dr. Sumaiya Khan
Toothache could occur due to a number of reasons. This story provides some causes for a toothache after crown preparation and some ways to treat this condition.
Whenever a tooth is severely damaged due to tooth decay, there are chances that it will need a crown fitted over it. This is because when the structure of the tooth is such that it cannot bear masticatory forces, then it will most likely break when something hard is chewed from that side or with the help of that tooth.
Thus, in an effort to save the tooth, a crown is fitted over it. However, some of the affected people may experience a toothache after crown preparation. There can be many factors that could lead to this symptom. Here are some causes and ways to deal with this problem.

Causes and Solution

Heat from Drill

One of the most common cause of such a pain is the sensitivity that occurs due to the heat generated by the drill. If a person needs to fit a dental crown in the first place, then chances are that the tooth isn't necessarily in a very good shape to begin with. Hence, during crown preparation, there are high chances that the surface of the tooth is so thin that the heat which is generated by the drill could affect the pulp tissue.
This heat may lead to damage of the pulp, which is known as pulpitis (inflammation of the pulp). In most cases, this is a temporary reaction of the pulp, that is, reversible pulpitis which can be curbed with the help of some toothache medicines. To minimize the chances of landing with this condition, it is best to take extra care during crown preparation, like using low-rotational speed, using water sprays periodically to relieve the heat, etc.

Sensitivity in Nonendodontically Treated Teeth

In most cases, when a tooth requires a crown, it means that it is structurally damaged and cannot withstand force on its own. Hence, it needs a dental crown. In most cases, intentional root canal is done, so as to prevent any chances of sensitivity in the future.
However, at times, dentists prefer not to take the risk of doing an intentional root canal, because this not only increases the dental crown cost but also may harm and shorten the lifespan of the tooth.
In such cases, it is possible that the pulp, which has nerve fibers that are functioning become sensitive and lead to a toothache. In such cases, if the affected person experiences a lot of pain, then it is best to do an intentional root canal and remove the pulp tissue.

Faulty Temporary Crown

Whenever crown preparation is done, then an immediate temporary crown is seated in place for two reasons - to protect the prepared tooth structure, so that it does not chip and become structurally different from the final prepared crown and to prevent chances of sensitivity.
However, sometimes, a person may get a toothache. This pain could occur due to a crown that is faulty and so, it tends to 'leak' and cause sensitivity when there is intake of hot or cold substances. Thus, in such cases, it is best to get it repaired or redone.

Ill-fitting Crown

In some of the affected people, there may be not only severe toothache, but even after the final crown is fitted, the person may experience pain and sensitivity. Thus, he/she may have a toothache that arises after the crown is fitted.
This may occur because the crown is ill-fitting, that is, it is either too tight (due to which it impinges on the gums and leads to pain) or it is too loose (due to which it allows bacteria to lodge themselves in the space between the crown and the tooth, leading to an infection).
In either case, if the dentist suspects that the crown is ill-fitting, then he must take immediate measures to get it resized or redone.
These were the various causes and treatment options for dealing with this problem. In most cases, by going in for a root canal and a dental crown, a tooth can be saved from extraction. However, if the tooth cannot be salvaged even with the help of a crown, there is no option left but to go in for a tooth extraction. So, it is best to avoid landing in such a situation by ensuring that you visit the dentist every six months so that your dental health is in the best condition possible.
Disclaimer: This story is for informative purposes only, and should not be used as a replacement for expert medical advice.