Another common question I that commonly see is....my tooth is really sensitive even after the crown has placed (i.e. cemented)...is it supposed to be sensitive and if so, how long?

This is a difficult question to answer because there are a great deal of factors that influence sensitivity from the time leading up to the procedure, the procedure itself, the length of time the patient is in a temporary, and certainly the placement of the crown. I have attempted to list the most common reasons for why a tooth may be sensitive following crown placement...again this is not an all inclusive list but an attempt to explain the most encountered issues:

1. Bite--if the bite is off (i.e. too "tall" or too "high") either on the temporary or the permanent crown, you may develop some slight bite tenderness that can slowly evolve into cold/sweet sensitivity.

2. The temporary- depending on what the temporary is made out of, it can influence how sensitive the tooth as far as how well it buffers the tooth from hot/cold or from bite. An example is a metal temporary will likely be more sensitive due to the transfer of hot/cold. A plastic temporary appears to do better with temperature but can wear down or chip faster which could lead to bite sensitivity and/or gum soreness.

3. Remaining tooth structure- the remaining tooth that the crown is to be put over can also influence sensitivity...i.e. how much decay was present before the procedure, where does the filling or buildup placed on the tooth sit in relation to the nerve. The closer the filling is to the nerve(deeper), the more likely to have sensitivity. Note that a root canal treated tooth should NOT have cold/sweet sensitivity.

4. Root exposure- Is there any tooth or root structure below the crown that is visible. This can possibly make the crown sensitive, but you need to know why there is exposure such as having receding gums or the gum being slightly receded after the crown preparation procedure.

5. Referred pain- while much less likely, sometimes the sensitivity can actually come from an adjacent tooth that has issues or the opposing tooth that the crown bites against. I encourage to have all teeth around the area evaluated to rule that the sensitivity is coming from another teeth.

There are other factors that could lead to sensitivity with crown placement but some sensitivity is expected HOWEVER, you should begin to see improvement with 1-2 weeks. Improvement in bite and cold sensitivity should gradually diminish which can sometimes take a couple weeks even to several months. The goal is to see gradual improvement.

Red flags that something is not right!

1. Increased sensitivity to cold

2. Lingering sensitivity

3. More frequent sensitivity

4. Sharp biting pains

5. Severe gum tenderness/swelling

6. Throbby pains in the tooh as if you can feel your heartbeat!

See you soon!

Dr.G