Dental

Ask a dentist. Get answers to your dental questions.

Ask an Expert,
Get an Answer ASAP!

My husband had a cap put on a cracked tooth last week, and…

Customer Question
My husband had a...

My husband had a cap put on a cracked tooth last week, and is still experiencing pain. It wakes him up at night. It isn't constant, but 3 or 4 times a day. Why would this be happening?

Doctor's Assistant: Is the pain consistent, or does it fluctuate?

Fluctuates

Doctor's Assistant: Please give me a bit more information, so the dentist can help you best.

He was experiencing pain in that molar. The dentist found a cavity and filled it. He was still experiencing pain so then the dentist told him he needed a crown, so he prepared the tooth for a crown. He told my husband the tooth was cracked. He put a temporary crown on, my husband was still experiencing pain during this time. The permanent crown was put on last week. He is still experiencing fluctuating pain

Submitted: 8 months ago.Category: Dental
Show More
Show Less
Ask Your Own Dental Question
Answered in 12 minutes by:
9/17/2017
Dentist: Beth Dorian, Dentist (DDS or equivalent) replied 8 months ago
Beth Dorian
Beth Dorian, Dentist (DDS or equivalent)
Category: Dental
Satisfied Customers: 22
Experience: DMD/Owner at Platteville Family Dentistry
Verified

Hello, I'm Dr. Dorian, and I'm currently reviewing your question. I'll be back momentarily!

Ask Your Own Dental Question
Dentist: Beth Dorian, Dentist (DDS or equivalent) replied 8 months ago

Unfortunately, this situation is very common. Even if a tooth has NO symptoms prior to a crown preparation, it can become symptomatic afterwards. However, in your husband's case, the tooth was symptomatic BEFORE the crown was placed.

The key question about a tooth is the status of the pulp of the tooth. The pulp is the innermost part of the tooth and houses the nerves and blood vessels. It's the part that causes all the trouble! If we see an abscess definitively on an x-ray, we will KNOW that the pulp is infected. However, the absence of a definitive abscess on an x-ray does not mean that the pulp is NOT infected. So, if the pulp is compromised (and we dentists don't know that because there is no definitive abscess) and we work on it, the pulp might become inflamed afterwards. The pulp inflammation may cause the tooth to hurt for a while. The key question is:

-Is the inflammation reversible, or irreversible. (The conditions are called "reversible pulpitis" and "irreversible pulpitis" respectively).

Spoiler alert - my hunch is that your husband has irreversible pulpitis

If you have irreversible pulpitis, there are only two choices to resolve the problem:

1.) Root canal

2.) have tooth removed

The nature of pain for the two types of pulpitis are described below:

Irreversible pulpitis: spontaneous throbbing pain (you're sitting around doing nothing, and the tooth is hurting) High pain levels (7 out of 10 or above). Pain lingers after a painful stimulus - like cold or chewing. (However, in many cases the pulp no longer registers cold sensation because it's dying. So sometimes, it's just pressure or chewing that causes the pain and not temperature)

Reversible pulpitis: pain only occurs upon stimulus - cold, sweets, chewing, etc. and the pain subsides quickly after the stimulus is removed. (however, this is not totally cut and dry. Very soon after a tooth is worked on, you can get some spontaneous pain for the first week or so. But, it should diminish)

Sometimes, a crown or filling preparation will also introduce a lot of oxygen into the pulp. The bacteria that have been residing in the pulp didn't have the chance to REALLY thrive until the influx of oxygen (these types of bacteria are called "facultative anaerobes") That's why sometimes teeth that are totally asymptomatic BEFORE the tooth is prepared can sometimes get a bad toothache afterwards. (Patients hate us for that! But, the underlying reason is that the pulp was already mildly infected. Cracks or other defects in the tooth allowed for some bacteria to find their way in there. Just not enough to cause symptoms yet. Then, a dentist opens things up and allows a lot of oxygen/energy to get to those bacteria!) However, your husband's tooth was symptomatic beforehand, so we know that there was a problem with his pulp from the get go.

If I saw your husband, and saw the original cavity, first, I'd like to understand the nature of the pain he had then:

1.) When does pain occur? Only after stimulus? OR spontaneously? (just sitting around doing nothing)

2.) After any offending stimulus hits the tooth, does the pain linger?

3.) On a scale of 1-10 what is the pain level at its WORST.

Those are the types of questions I'd ask (plus, I'd probably tap on his teeth, and do a couple of tests) to determine whether he likely had reversible pulpitis or irreversible pulpitis to begin with.

If the pain seemed like it could be reversible pulpitis, (for example, just a little sensitive to cold, but as soon as the cold went away, the pain went away) then, it's possible that the filling will resolve the problem. But, it's also possible that it won't.

If he was still having pain after the filling, I would not have done the crown. First, I would have tried to distinguish the symptoms once again, between reversible and irreversible pulpitis. If it seemed more like the reversible pulpitis, I would have advised some cautious waiting. If the symptoms sounded like irreversible pulpitis, I would have referred to a root canal specialist. (endodontist) to have the tooth evaluated. (and probably do a root canal). Placing a crown on a tooth NEVER solves the pain issue except in very specific circumstances. (for example, the tooth ONLY hurts when he bites on it in a certain way. Those are the symptoms of a more benign "cracked tooth syndrome" which would benefit from a crown).

Of course, once you have a root canal done on a molar, you need a crown. I know your husband has already had a crown. The good news is that he won't need to get a new crown. The root canal can be done straight through the crown. Then, the dentist puts a filling through the access hole.

ONE OTHER POSSIBILITY: the bite is too high on the crown. He's hitting the tooth too heavily when he bites. "Heavy occlusion" can also cause a lot of postoperative, and even spontaneous pain. That's always what I check first! But, I tend to doubt that's the issue because he STARTED OUT in pain. But, it's a possibility.

My educated guess is that your husband needs a root canal on the tooth. (unless he elects to have it removed instead)

I recommend going to an "Endodontist" (root canal specialist) for a root canal on a molar. Most general dentists don't do molar root canals (or should NOT be doing molar root canals, unless they devote a lot of their time and energy to root canals!) Endodontists see abscessed teeth with recent crowns ALL THE TIME, so nothing new to them!

I know that was a long answer to your question. I have two videos that I made about cavities, and toothaches. Both might be useful to you to fill in some of the understanding gaps. They were made for specific audiences, and your husband's situation doesn't fit either situation perfectly, but I think you'll still get the gist if you watch them. I'll forward the links to them momentarily.

Bot***** *****ne, very, very high chance that your husband needs a root canal. :(

Ask Your Own Dental Question
Dentist: Beth Dorian, Dentist (DDS or equivalent) replied 8 months ago

Here are the links to the two videos I mentioned:

https://screencast-o-matic.com/watch/cDlockQ0jp

https://screencast-o-matic.com/watch/cDX02wQ1jx

Ask Your Own Dental Question
Dentist: Beth Dorian, Dentist (DDS or equivalent) replied 8 months ago

After reading my answer, I noticed a possible area of confusion.

Irreversible pulpitis also means abscessed tooth (whether or not we can see the abscess on the x-ray). If we can see an abscess, then we don't bother doing anything until it's taken care of with a root canal. While not a fun finding to see an abscess, it sure makes the diagnostic process easier!

But, sometimes the tooth:

"is abscessed" "is infected" "has irreversible pulpitis" (all of those terms are synonymous) but we don't know that because the x-ray isn't showing it. We figure it out by asking questions about the symptoms, and doing a few tests. Again, guessing that your husband's tooth is infected (a.k.a. "abscessed"/"stricken with irreversible pulpitis" :) ).

But, there is the remote possibility that the bite is too high.

Ask Your Own Dental Question
Dentist: Beth Dorian, Dentist (DDS or equivalent) replied 8 months ago

Please let me know if there is anything else I can do for you. I am happy to answer more questions. If not, please be sure to offer a rating. That's the only way this service will work and the only way for experts to receive any compensation for their time. :) Thank you!

Ask Your Own Dental Question
Was this answer helpful?
Ask Beth Dorian Your Own Question
Beth Dorian
Beth Dorian
Beth Dorian, Dentist (DDS or equivalent)
Category: Dental
Satisfied Customers: 22
22 Satisfied Customers
Experience: DMD/Owner at Platteville Family Dentistry

Beth Dorian is online now

A new question is answered every 9 seconds

How JustAnswer works:

  • Ask an ExpertExperts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional AnswerVia email, text message, or notification as you wait on our site. Ask follow up questions if you need to.
  • 100% Satisfaction GuaranteeRate the answer you receive.

JustAnswer in the News:

Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.

What Customers are Saying:

I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much

Corrie MollPretoria, South Africa

I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well!

ClaudiaAlbuquerque, NM

Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion.

KevinBeaverton, OR

Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
I feel better already! Thank you.

ElanorTracy, CA

Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem.

JulieLockesburg, AR

You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions.

John and StefanieTucson, AZ

I have been dealing with an extremely serious health crisis for over three years, and one your physicians asked me more questions, gave me more answers and encouragement than a dozen different doctors who have been treating me!!

Janet VPhoenix, AZ

< Previous | Next >

Meet the Experts:

Mark Bornfeld, DDS

Mark Bornfeld, DDS

Dentist

5,765 satisfied customers

Clinical instructor, NYU College of Dentistry; 37 years private practice experience in general dentistry, member Academy of General Dentistry, ADA, American Academy of Oral Medicine

Dr. Alex

Dr. Alex

Dentist

1,607 satisfied customers

I am a General Dentist and founder of the American School of Dental Assisting

Dr. George McKee

Dr. George McKee

Dentist

1,392 satisfied customers

Licensed dentist with 30 years clinical experience in general practice and cosmetic reconstruction.

Dr. Girish

Dr. Girish

Dentist

788 satisfied customers

19 years of clinical experience in all phases of Dentistry.

Julian Chen

Julian Chen

Dentist

567 satisfied customers

Practicing General Dentist since 2002

Dr. Winterholler

Dr. Winterholler

Dentist

266 satisfied customers

4 years Private Practice, Heavy emphasis on Cosmetic Dentistry and Implants, Top 10% of Dental Class

Dr. Mitch

Dr. Mitch

Dentist

211 satisfied customers

DMD General Dentist Private Practice Over 20 yrs.

< Previous | Next >

Related Dental Questions
I just had a root canal on Saturday and was prescribed
Second opinion] I just had a root canal on Saturday and was prescribed clyndamycin. It seem to cause my gums to swell and to recede! I have gum disease, but this medicine seems to be accelerating the … read more
Lara Coseo
Lara Coseo
Owner
Doctor of Dental Surgery
522 satisfied customers
I had a root canal performed on one of my lower back molar
I had a root canal performed on one of my lower back molar many years ago. I recently had the porcelain chip on the crown but my dentist said the crown is still intact. Today I felt a random mild to m… read more
Root Canal Doctor
Root Canal Doctor
Doctoral Degree
2,222 satisfied customers
I had a root canal and crown with post performed 2 years
I had a root canal and crown with post performed 2 years ago. The crown and post have fallen out many times. I am lucky now if it lasts a month after recementing. I was told i don't have much structur… read more
Root Canal Doctor
Root Canal Doctor
Doctoral Degree
2,222 satisfied customers
Question had crown lengthening due to pain after root canal
Question had crown lengthening due to pain after root canal and placement of crown. Crown continue to hurt when I tapped on the crown. I notice when I leave thick floss in between tooth where the crow… read more
Root Canal Doctor
Root Canal Doctor
Doctoral Degree
2,222 satisfied customers
I have a upper molar that had root canal done last year and
I have a upper molar that had root canal done last year and just now part of it chipped off. From what I can tell it's just a small part of the cusp that broke off. There's no pain. Just feels weird … read more
Root Canal Doctor
Root Canal Doctor
Doctoral Degree
2,222 satisfied customers
I had a root canal done on my two front teeth. The Dentist
I had a root canal done on my two front teeth. The Dentist gave me a shot to numb the area, however He hit a nerve in the upper left gum which feels like he hit a bone and I'm still feeling the numbne… read more
Lara Coseo
Lara Coseo
Owner
Doctor of Dental Surgery
522 satisfied customers
I had root canal and crowns about 25 years ago and about a
I had root canal and crowns about 25 years ago and about a week ago my crown fell out and the dentist put the crown and post back into the socket. I immediately experienced pain and the next day took … read more
Lara Coseo
Lara Coseo
Owner
Doctor of Dental Surgery
522 satisfied customers
Gerard, I am still experiencing root canal pain 10 days
Hi Dr Gerard, I am still experiencing root canal pain 10 days after the first stage clean out procedure. Have had one round of antibiotics after a gum abscess developed. it was amoxicillin. Have been … read more
Root Canal Doctor
Root Canal Doctor
Doctoral Degree
2,222 satisfied customers
I had root canal treatment on a molar approximately 2 years
I had root canal treatment on a molar approximately 2 years ago. The dentist could only access one of the root canals and said in the future I might have to go for more specialist treatment to have th… read more
Dr. Katz
Dr. Katz
Dentist / Anesthesiologist
Doctoral Degree
3,882 satisfied customers
My dentist informed me that I need a root canal and then put
My dentist informed me that I need a root canal and then put a temporary filling in the hole in my tooth. Is that safe or can it exacerbate infection? … read more
Dr. Katz
Dr. Katz
Dentist / Anesthesiologist
Doctoral Degree
3,882 satisfied customers
I recently had a toothache that will result in a root canal
So I recently had a toothache that will result in a root canal in about 2 weeks. so far my dentist has mentioned that everything is ok besides that one tooth. but now I'm getting a toothache on another area it comes and goes every few months its dull but not sensitive to cold or hot temp … read more
Root Canal Doctor
Root Canal Doctor
Doctoral Degree
2,222 satisfied customers
I had a root canal on moral # 31, then a crown put on. But
I had a root canal on moral # 31, then a crown put on. But the back of tooth's gum still hurting, and now feels swollen the right side of face is hurting also. … read more
Just Dental Truths!
Just Dental Truths!
Dentist
Doctoral Degree
1,151 satisfied customers
A dentist told me to go to an endo for a root canal of #14.
A dentist told me to go to an endo for a root canal of #14. and that i need a crown and post as well. She recommended PFM. I want to know 1)Which material is best for crown at 14? and 2) What is a goo… read more
Root Canal Doctor
Root Canal Doctor
Doctoral Degree
2,222 satisfied customers
I had a tooth that had a root canal and also a cavity was
I had a tooth that had a root canal and also a cavity was removed and temporary filling put in. This was done by an endodontist. After that it became pressure sensitive. How likely is it if it is like… read more
Lara Coseo
Lara Coseo
Owner
Doctor of Dental Surgery
522 satisfied customers
I had a root canal on #10 (which has a porcelain crown).
I had a root canal on #10 (which has a porcelain crown). There is now gum recession, a tiny area above the crown margin and root exposed. Yikes. Would rather not replace the crown. Would the clamp for… read more
Just Dental Truths!
Just Dental Truths!
Dentist
Doctoral Degree
1,151 satisfied customers
My husband has stabbing pain in an abscessed root canal. It
My husband has stabbing pain in an abscessed root canal. It is two days until the appointment with the oral surgeon. He has been offered pain medication (prescription strength) from a friend. NO over … read more
Root Canal Doctor
Root Canal Doctor
Doctoral Degree
2,222 satisfied customers
Believe I am experiencing irreversible pulpitis. Have a
Believe I am experiencing irreversible pulpitis. Have a crown placed on Dec 14. Have had jaw pain that is relieved with 2-3 Advil daily. Went back to dentist on Jan 3 and was placed on Steroid pack fo… read more
Beth Dorian
Beth Dorian
Dentist (DDS or equivalent)
22 satisfied customers
I had a root canal done, that turned into abscess, i went on
I had a root canal done, that turned into abscess, i went on antibiotics for some time and it seemed to clear up and now it looks like i have a skin tag growing off the side of my gum on that toot. Wh… read more
Root Canal Doctor
Root Canal Doctor
Doctoral Degree
2,222 satisfied customers
Disclaimer: Information in questions, answers, and other posts on this site ("Posts") comes from individual users, not JustAnswer; JustAnswer is not responsible for Posts. Posts are for general information, are not intended to substitute for informed professional advice (medical, legal, veterinary, financial, etc.), or to establish a professional-client relationship. The site and services are provided "as is" with no warranty or representations by JustAnswer regarding the qualifications of Experts. To see what credentials have been verified by a third-party service, please click on the "Verified" symbol in some Experts' profiles. JustAnswer is not intended or designed for EMERGENCY questions which should be directed immediately by telephone or in-person to qualified professionals.

Disclaimer: Information in questions, answers, and other posts on this site ("Posts") comes from individual users, not JustAnswer; JustAnswer is not responsible for Posts. Posts are for general information, are not intended to substitute for informed professional advice (medical, legal, veterinary, financial, etc.), or to establish a professional-client relationship. The site and services are provided "as is" with no warranty or representations by JustAnswer regarding the qualifications of Experts. To see what credentials have been verified by a third-party service, please click on the "Verified" symbol in some Experts' profiles. JustAnswer is not intended or designed for EMERGENCY questions which should be directed immediately by telephone or in-person to qualified professionals.

Show MoreShow Less

Ask Your Question

x