You've royally screwed me...

June 29, 2012 4:09 PM

Is is normal for a dental crown to be so painful?

About two weeks ago I asked a hypothetical dental question - well here's an actual one.

I had a tooth that felt perfectly fine, but after my dentist looked at the x-rays a crown was recommended. I'd never had one, so I said, "okay."

I got the temporary put on and after about a week it started aching (constantly, not a hot/cold sensitivity thing, just all the time).

I go to get the permanent crown and as the dentist is pulling off the temporary it hurt so bad I was literally in tears and the doctor finally gave me Novocaine (about 90% of the way through it :-/ ). Now the permanent is on and it felt fine at first, except when I bit on it - then it would press and hurt. ...but now it's back to hurting all the time, just like the temporary.

It's been a week since I got the permanent. I was told the crown would hurt a bit in the beginning, but wasn't really given a time frame? I'm assuming that since the pain is getting worst, I should call the dentist (and will do so absent other info).

My question is....are all crowns this bad? Also, the dentist mentioned another crown being needed on a bottom tooth and now I'm wary. The tooth isn't bothering me in any way, shape, or form. It's mostly filling at this point (it's the lower molar I mentioned in my previous question) - do you think I could just request more filling if there's something wrong with the tooth? When I was doing my research on what crowns actually are and when they're needed, it was mentioned quite a bit that dentists may over-recommend them because they pay so well .... I'm not an "all doctors are just trying to rip you off!" kinda person, but I'm in absolute misery and don't want to even risk going through this again if there's another way.

Your experience/advice?

posted by Lt. Bunny Wigglesworth to health & fitness (19 answers total)

It seems to me that the crown on top needs to be adjusted - likely the bite is not even, which is putting pressure on the tooth, which results in pain.

If the lower tooth is mostly filling, it will likely need a crown. Have you had a root canal on the lower tooth?

Anyway, I would get the upper tooth taken care of as soon as possible. I'm not sure how crowns can get ground down to improve bit, but maybe someone else can chime in here.
posted by KokuRyu at 4:14 PM on June 29, 2012

They file off bits of the metal....but sometimes the pain means somethings wrong with the nerve and you'll need a root canal. Get back to your dentst pronto
posted by brujita at 4:18 PM on June 29, 2012 [1 favorite]

You might be sore for a day or two as your gums heal, but after that you shouldn't notice it is there.
posted by Monday at 4:25 PM on June 29, 2012

I've had several crowns put in (ugh), and I'm impressed you actually got through 90% of the permanent placement without novacaine! I have to get pumped full of that stuff to even begin going through any permanent crown placement. Anyway...

I have experienced a dull, aching pain that lasts a week or two so after a permanent (or temporary) has been placed. But the real pain I always experience is from sensitivity, especially with the temps. I can't get anything that isn't within a couple degrees of my actual body temperature anywhere near a temp/new crown without extreme pain.

But if you're experiencing a general pain that is increasing over time, I'd guess that KokuRyu is right in that it may need to be adjusted. If that doesn't solve the problem, you might need a root canal (sorry to deliver bad news). My dentist actually requires me to sign a "waiver" type document that says a root canal may need to be done if pain is still experienced after the crown is placed. I once had my extreme sensitivity last more than the usual 1-2 weeks, and the only solution my dentist could offer me was a root canal, which I did not spring for.
posted by dede at 4:29 PM on June 29, 2012

Confirming: a properly done crown should feel like a real tooth, or not far from it. Soreness from the trauma caused by putting it in is normal, but not for over a few days.

My daughter just had to have her crown adjusted due to pain; it was too high. The dentist adjusted it with no charge.
posted by The Deej at 4:30 PM on June 29, 2012 [1 favorite]

Oh--sorry for the second post, but I also did have a dentist who over-"prescribed" crowns like CRAZY (and got a good few thousand dollars out of me for them). I switched dentists and was told the additional crowns they had planned for me were completely unnecessary. If you have any doubt, get a second professional opinion.
posted by dede at 4:31 PM on June 29, 2012 [1 favorite]

I've never had a crown hurt, unless it was too tall/long. If it's too big in this direction, it hurts only when you bite on it. It doesn't hurt otherwise. If this is your problem, it's an easy and common fix. You go in and they ask you to bite down on a special piece of paper (like carbon paper). It makes some sort of mark that tells them where they need to file down the crown so that it is not so jarring when it hits the other teeth when you bite or chew. This may take several visits as you try out the new height because they file off the tiniest of pieces. At least for me, these minor adjustments were free, and didn't take much time.
posted by Houstonian at 4:32 PM on June 29, 2012

I had a crown done that hurt like mad until I got it adjusted and then intermittently for at least a month after that. My dentist explained that the tissue that holds the root in can sometimes end up bruised and can take awhile to heal. Definitely go back to your dentist and explain-this is really common and they should help you out.

Hope it feels better soon. I was amazed at how much mine hurt.
posted by corey flood at 4:41 PM on June 29, 2012

Yes, it sounds like you need your crown adjusted. You should be able to go back to your dentist and get it adjusted for free, and the dentist will probably just fit you in in between appointments since it only takes a few minutes.

I had a crown done, then moved to a new city and a dentist I had never seen before adjusted it for no charge when I stopped in to ask about what I should do.

Also...everything that corey flood said.
posted by lulu68 at 4:44 PM on June 29, 2012

Nthing that it needs to be filed down. I had a cavity filled three weeks ago and had throbbing pain like you describe for a week after. I went back to the dentist and he found that it was too high and he filed it down a bit. One week after that it was still sore so I went back a second time. There was nothing wrong the second time, but it still hurt like a mofo so I thought maybe I had an infection in the gums. The dentist said that the trauma from the bite being off would take some time to go away. Three weeks later and it has gotten better, but hasn't totally gone away. Call the dentist tomorrow and take some Aleve in the meantime.
posted by Sal and Richard at 5:56 PM on June 29, 2012

I would not be thrilled about going back to the same dentist, but it's really hard to say because he should fix it with no charge. But if you had a tooth that wasn't bothering you at all, and now it's got pain that sounds like abscess pain, after the doctor ground down your tooth for the crown, I would think he caused the problem. I'm not saying he definitely did, because I am not a dentist and I have no idea, but that's what I would think if I were in your position.

I suppose I would call and see what he says. I might also consider asking for another dentist in the office to look at it. Of course it seems like the majority opinion here is that you need to go back to him for either a root canal or crown adjustment, and I seem to be the only suspicious one in the bunch. But I feel for ya. Tooth pain is just horrible and totally unfair. I mean seriously, a tooth is such a small thing!(I've had seven root canals.)

A tooth that is mostly filling can crack very easily, so I think most dentists would recommend a crown to help protect it. But I wouldn't have this guy do it. If it were me.
posted by Glinn at 6:06 PM on June 29, 2012

I might also consider asking for another dentist in the office to look at it..... and I seem to be the only suspicious one in the bunch

No, I was pondering this - and if I have to get another crown I will get it done by someone else. However, I wasn't sure if I should stick with the same person in a kind of - you broke it, you fix it kind of deal.
posted by Lt. Bunny Wigglesworth at 6:47 PM on June 29, 2012

1) I always tell them up front I want novocaine -- you should do the same. I don't care if it's a tiny spot of drilling or a 10-second procedure! It takes a few more minutes to get started, but I'm much more relaxed during the event. So if there are more crowns in your future, don't let them put the permanent on again w/o it. There is NO REASON to be in pain during a dental procedure.

2) Have you tried taking ibuprofen regularly for a couple of days to help with inflammation as well as pain? Sensitive toothpaste can also help settle things down, if you're not already using it.

3) Keep calling the office - sounds like an adjustment is in order at the very least, and you could probably get through one adjustment appointment to see if it helps. In the meanwhile, start shopping for another dentist.

4) I also have a molar that may need a crown soon. My dentist said it's mostly filling, and he doesn't want to see it break off. The filling has also worn down over time, and trying to do more fillings might be difficult. I'm not keen on going through another torture session... the worst part for me is that horrible paste they use to make the mold... makes me gag. Ugh.
posted by hms71 at 7:47 PM on June 29, 2012 [1 favorite]

1) I always tell them up front I want novocaine -- you should do the same. I don't care if it's a tiny spot of drilling or a 10-second procedure! It takes a few more minutes to get started, but I'm much more relaxed during the event. So if there are more crowns in your future, don't let them put the permanent on again w/o it. There is NO REASON to be in pain during a dental procedure.

This place has been pretty bad - as he was pulling out the temporary I told the tech (assistant? are they nurses in dental?) that it hurt and he waved it off ("oh it doesn't hurt that bad" "why are you making that face?") - it wasn't until the dentist came in and tried to put in the crown and the tears were rolling down my face that the dentist stopped and gave me a shot. Also, this dentist doesn't give/wait for topicals to take effect before giving the shot and usually goes to work almost immediately after the shot, which sucks. I think she relies on patients using gas, which I can't stand.


2) Have you tried taking ibuprofen regularly for a couple of days to help with inflammation as well as pain? Sensitive toothpaste can also help settle things down, if you're not already using it.

I actually have some prescription-strength ibuprofen and Vicodin (leftover from the wisdom teeth) that I've been taking - it does help quite a bit - I can sense that it's still throbbing, but it doesn't actually hurt as bad.

Definitely searching for a new dentist....also, not waiting until the end of a plan year to get work done....
posted by Lt. Bunny Wigglesworth at 8:12 PM on June 29, 2012

This place has been pretty bad -

Runnnnn! Bad vibes about a medical establishment are no joke. You should feel the competence all around you, little things and big things. If he's being stingy with Novacaine (I may have known this guy), run. Novacaine is something that in my experience when I've had good dentist is there for the asking. I think it is important to say 'that hurts, I want more Novacaine' as opposed to just 'that hurts' though.

A good thing to watch for in dentists office is expensive equipment. The dentist who I have now, who is possibly the world's most competent dentist, has a fully integrated computer system through which all records and scheduling are available in any procedure room, everyone is fully trained and can access any records or make any appointment on the fly and you don't have to out and spend ten minutes searching for an appointment with Janice in reception. And they have a cool camera thing where he can take pictures of teeth and monitor procedures on a display above the chair (which I make him point away from me, because ew) but among other things that means he and the tech can have a chat about my teeth in detail without the two of them staring into my gaping maw. He also knows how to juggle, which is a nice bonus.

it wasn't until the dentist came in and tried to put in the crown and the tears were rolling down my face that the dentist stopped and gave me a shot.

No way. Big fat no.

To your question: I'm a crown veteran and I think what you're describing is weird. It's possible that he put the crown on because the tooth had a hairline crack, underestimated the lack of structural integrity, and broke the tooth in a way that will require a root canal. I have no love for incompetent dentists, and I knew one very, very well, but if the tooth was so wonky to start with it is possible that it was a good faith accident -- trying to do the minimally invasive thing to save a tooth that couldn't be saved and would have eventually required a root canal anyway. It might not be possible for you to know that for certain.

If you go to that dentist, it's possible he'll fix it for free, but if you've got bad vibes....get out of there. At most, call them, tell them what's going on and they'll likely prescribe antibiotics. If the antibiotics fix it, they know it was an abscess, and yes -- probably a root canal in your future. You don't want a root canal from him. I'm also a root canal veteran! You can discuss with them "how you can make this right financially" and talk to your insurance company as well.

Lastly, I hope I'm not scaring you about the root canal. It's possible it's just a nerve thing and having the surface corrected to be in alignment with your other teeth is going to be the thing that fixes it. If that isn't it, while people make a big deal out of root canals they're primarily boring, more than anything, and I'll give you as a bonus my standard suggestion for that which is: iPod with loud music plus an application of an official doctor-sanctioned Xanax.

*Answer entirely based on anecdotal evidence from my five root canals and seven (two replacement) crowns. Yes, I floss, damn it.
posted by A Terrible Llama at 2:07 AM on June 30, 2012

I have a number of crowns (some on 'live' teeth, some on teeth that have been root canal'd). Some of them are a little tender and sore at first, some ache a bit. But it shouldn't be severe, constant pain.

I once had a similar problem, a crown that just hurt like a mofo nonstop, and it turned out that the tooth was a goner and needed a root canal and not just the crown. I saw a number of dentists of varying quality during my quest to end the constant pain, until I finally got referred to a great endodontist who immediately saw what was wrong and did the root canal. It was pretty much immediate relief. That's my anecdote, for whatever it's worth.
posted by Arethusa at 3:14 AM on June 30, 2012

Oh, wow, Wrong Dentist! Wrong Dentist! My only complaint about my dentist is that he gives me so much novacaine it numbs half my face. He'll pause at the slightest twitch from me and ask if something hurts, and is very sensitive to my comfort. I've had two crowns and never felt any more pain than the novacaine injection.

I'd be concerned that if this guy is enough of a numbskull, he might have missed that you need a root canal. I'd never darken his door again.
posted by Devils Rancher at 5:55 AM on June 30, 2012 [1 favorite]

My dentist does a follow-up call 72 hours after procedures to check and see if there's any pain, so I associate 72 hours with reasonable expectation of pain.

I've never had a crown without a root canal - I thought they had to do that and mount a post for the crown to fit. The thought of a live nerve under a crown is making my eyes water thinking about it. I would call and get back in there pretty much immediately.

Check if you can get a ceramic inlay to replace the fillings in the other tooth - I've had very good results from those while replacing old military fillings. They can save a nominally healthy tooth that way and they look and feel completely natural. If your current dentist can't do them, I'd say look for one who can.
posted by halfbuckaroo at 7:07 AM on June 30, 2012

You might want to try a prosthodontist. I have several crowns on live teeth all done by a a prosthodontist and none of them ever hurt, except for a little cold sensitivity.
posted by interplanetjanet at 10:03 AM on June 30, 2012