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Mark Bornfeld, DDS
Mark Bornfeld, DDS, Dentist
Category: Dental
Satisfied Customers: 6016
Experience:  Clinical instructor, NYU College of Dentistry; 37 years private practice experience in general dentistry, member Academy of General Dentistry, ADA
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Severe Pain after temporary crown placement

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In order to provide a more appropriate reply to your question, please provide a little more information...

-I infer that you want to know something about this pain-- whether it is normal, what can be done to manage it, etc. Please specify precisely what you wish to ask, so that I can touch on all the significant issues

-Please elaborate more on the treatment-- the number of crown(s) being fabricated, what/when was last done by your dentist, whether your dentist was consulted with about your problem, whether the tooth had any additional treatment/problem, such as physical injury, root canal therapy, etc.

-Also, please describe the time line so that I can get a sense of the chronology of the events-- i.e. what was done, how long afterwards the symptoms began, etc.

The more information I have to consider, the more accurate and appropriate will be my response...
Customer: replied 9 years ago.

Yes, I would like to know why it is happening and what I can to relieve the pain. I will clarify more about thwat happened. I had a filling in that tooth that broke and came out about 3 months ago. He felt that it came out because of a faulty job because others came out done by this pevious dentst. The dentist then x-rayed the tooth can said that they decay wasn't to the root but he would have to put a crown on it to protect it from further decay. Last Friday, I went in and he clean out the decay and drilled it down. He then put on one temporary crown on that back tooth. That was all the work that was done on that tooth. Three days later, I started having severe pain in the front teeth on that same side of my mouth. I thought it was just from bighting on the treated tooth but the pain has gotten worse. Yesterday, I went and he adjusted the crown because he thought it was because it was too large and I was hitting it when I bite. Last night the pain became so severe that I couldn't sleep. I took tylenol which was no relief and applied ice packs and so on. Also, on they front tooth it hurt when I bite on it. I hope that is more understanding. The pain is terrible! Frown

Dear DearCustomer

Unfortunately, the symptoms you describe are non-specific, and it is not possible to reliably infer what is going on in your tooth. While I would like to take your dentist at his word that "decay wasn't to the root", I have personally witnessed quite a few teeth go on to show definite signs of pulp infection which required root canal therapy DESPITE only modest amounts of tooth decay. So, although there may be no discernible reason why the pulp in your tooth may be infected, one cannot yet rule out that possibility.

Regardless of the status of your dental pulp, there are quite a few other things that could be to blame for your symptoms. For example, if the temporary crown was too high as your dentist asserted, this could definitely contribute to your pain-- and even if your dentist sufficiently reduced the bite to eliminate this factor, it may take several days for your tooth to accrue the benefit of this adjustment. Also, if your dentist "prepared" (i.e., drilled) the tooth to a level below the gum line (as is customary), this can unavoidably inflict injury on the gum tissues and cause pain. Additional contributory factors that may be playing a role in your pain include a sensitivity reaction to either the acrylic composition of the temporary crown or the temporary cement.

In any case, the diagnostic process often cannot distinguish reliably between the many factors that may be contributing to your symptoms. Your dentist has addressed one of those factors by adjusting the temporary crown contours, and you may need to wait a few days to get a sense of whether any inroads have been made against your pain. If not, your dentist may need to address the other possibilities, one by one, until he hits on the root of the problem. In the meantime, you should prevail upon your dentist for assistance in controlling your pain. Even if the cause for the pain is eluding him, he should be able to provide you with some manner of pain relief, whether that consists of local measures or prescription-strength pain medication-- especially going into the weekend when he will probably not want to obligate either you or himself to make an unscheduled emergency visit to his office.

If all else fails, you may ultimately need to have a root canal in that tooth. I would discourage you from doing so unless or until there is good evidence that a root canal is an appropriate treatment. If you need additional corroboration, you may wish to request a referral to an endodontist (root canal specialist) for a more aggressive assessment of your tooth.

I caution you to wait until this pain issue is resolved before you move forward with your crown. If root canal is ultimately determined to be necessary, it will be easier to do if your crown has not yet been permanently cemented on the tooth.

Hope this helps...
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