Think twice before crowning a tooth with a large filling.

Updated: Dec 15, 2021

I had a neighbor come to me recently complaining of a toothache he had been dealing with for 8 months. |The tooth was sensitive to temperature and to eat on. His dentist had told him he needed to get a root canal and referred him to an endodontist. The endodontist also agreed he should get a root canal and suggested he make an appointment soon. He came to me to see what I thought. I asked about the past history with his tooth and heard an all to familiar story. 

His previous dentist did an exam and noticed a large filling on his upper molar. "This is a pretty big filling on this tooth and looks like it is breaking down. We need to put a crown on it". He accepted the treatment trusting the dentist opinion even though he had no problem before. The crown was prepped and a temporary crown was worn while the permanent crown was made; no problems noted. It was after the crown was seated that the tooth became sensitive to temperature and biting pressure. He visited his dentist to have him fix the tooth. Everything looked fine with the tooth the dentist said. He adjusted the bite just in case even though the bite felt perfect to my friend. After a few weeks with the discomfort unresolved he visited the dentist again and was told he needed a root canal. Sometimes these things happen he said. 

Getting a crown placed on your tooth is a fairly involved procedure and can be traumatizing to the tooth. Significant tooth structure is removed to make room for the crown, which exposes the tooth and often leads to sensitivity. Typically, the sensitivity is temporary and after a few weeks the tooth returns to normal. My friend had gone 8 months and was looking for some answers. 

Since all his problems started with the cementation of the crown. My suggestion was to remove the crown and place a new temporary with a special sedative cement to help the tooth sensitivity resolve and for the tooth to return to normal. After going so long with this problem I told him he had a 50/50 shot and that it would take a week or two but hopefully we can avoid a root canal. He agreed and we placed the temporary crown. 

I check on him a few days later and he was happy to say the tooth felt a lot better already but was still sensitive. Two weeks later the sensitivity was gone and he was chewing on it with no problems. Our plan is to go another month or so and then have a new crown made and cemented with the same sedative cement. He should be good to go. Stay tuned for an update.

Update 12/15/2021

Success!! We placed a new crown in September without complication. Its been three months now and my friend says his tooth feels perfectly normal now and that he can chew on that side with zero problems. I'm happy for him. An unneeded root canal averted with proper treatment. 

Would this happen every time? Well, no. But if something doesn't seem right with your dental treatment, ask questions and find out why. If it still doesn't seem to add up its always good to get a second opinion. 

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