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FAQ:  Crown Pain

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Painful Crowns Ask The Dentist  Corinne Scalzitti Question:
Gold Crown Pain: About 6 weeks ago, I had prep work done for a gold crown on my back left molar. 4 days later the temporary fell off. The dentist glued it back in, but it fell off again within 24 hours.

The dentist advised to leave it off until permanent until the permanent crown is ready. I continued to take ibuprophen and tylenol for pain management. Two weeks go by and the permanent gold crown is placed. Within 8 days the crown required adjustment and the dentist recommends yet another new crown.

Several days go by before the crown is removed and replaced with a new temporary. Nine days afterwards I get my 2nd new gold crown placed. The pain symptoms return that same night... and has continued now for about a week, with the pain getting worse each day.

I have been taking 400mg Ibuprophen and 2 Tylenol every 6 hours. The pain wakes me up at night. What is going on? ...Visitor from CO

Some crowns go uneventfully and some are problematic. This one seems to have been particularly problematic.

I, too, have had problems with crowns, but this is a lot of problems. I would not have allowed a patient to go without a temporary crown for more than a day or two.

Why? Because teeth continue to grow until they meet another tooth. So, your shorter tooth with a crown preparation would have the possibility of growing higher or tipping forward in the time that the temporary was off.

The impression for the permanent crown was taken in the tooth's original position and any changes could make the permanent crown not fit properly. I will guess that this is why the permanent crown needed to be replaced. I will also guess that the next crown was made to a higher prepared tooth and that this crown is now taller than the rest of your teeth and may be hitting first. Your bite has thousands of pounds of pressure when you close your mouth. If this is distributed among all of your teeth, this is fine. When all of the biting pressure is on the first tooth to hit, it causes pain to the tooth from trauma and will also cause the muscles of your jaw to spasm.

This should be able to be solved by adjusting the crowned tooth so that it hits the opposing tooth properly, but if the preparation were too tall in the first place for the second crown, the crown can only be adjusted so much until the gold is too thin.

I would advise a second opinion soon. If the trauma to the tooth and spasms of the muscles are for a short time, they should be able to be solved fairly easily. The more chronic the condition becomes, the more complex the solution will be.

Corinne Scalzitti, DMD, MAGD

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