Dental Education Lecture: Pain after Crown
Occasionally you experience two types of pain after placement of crown (C in Fig.1): sharp and dull. Sharp pain suggests nerve infection. We need to take out the nerve by doing root canal (R in Fig.2). This happens to Ms. Pan. After root canal, she asks the doctor to make a new crown. Unfortunately, she has the second type of pain: dull, with bleeding gums. Compare Fig. 1 and 2, the new crown is longer (compare two arrrowheads) and bulkier, pressing against the gums (red line). The dull pain is not going to kill you, but it is pretty nagging. Finally Ms. Pan agrees to have a third crown made. Careful preparation of the tooth and execution takes away discomfort immediately, even during procedure, when her mouth is still numb. The new third crown is shorter and skinnier (Fig.3 as compared to 2). Anyway, the third crown has normal shape (as compared to Fig.1). It does not press the gums. After long journey, Ms. Pan does not experience any pain: dull or sharp. She is very grateful.
Zarinah's lower tooth is sensitive. Exam shows that there is a cavity (white arrowhead in Fig.4) underneath old crown. So we need to remake crown. However, she cannot chew on that side. The gums are tender. X-ray shows that the crown is also too long and pressing against the gums (compare Fig. 4 and 5). Eventually we also need to remake the crown for the second time. This time we trim off the gums a little bit using Laser, making easier for tooth preparation and impression taking. When Zarinah returns to office for crown cementation, she is also more than happy. There is not any discomfort with temporary crown. Cementation of the permanent crown is the most wonderful experience for both the dentist and the patient (Fig.6).
Wei, DDS, PhD, MS 1st edition 07/31/2010, last revision 08/01/2010