Experiencing tooth pain under a crown that comes and goes can be incredibly frustrating. This intermittent pain often signals an underlying issue that needs attention. Ignoring it could lead to more significant problems and potentially the loss of your tooth. This comprehensive guide will explore the common causes of this type of pain, explain potential treatments, and offer preventative measures to protect your crowned tooth.
What Causes Tooth Pain Under a Crown That Comes and Goes?
Several factors can contribute to intermittent pain under a dental crown. The pain may be sharp, throbbing, or a dull ache, and its intensity can vary. Let's examine some of the most likely culprits:
1. Irritation or Infection Under the Crown:
This is a primary reason for intermittent pain. Bacteria can infiltrate the area between the tooth and the crown, leading to inflammation and infection (periapical abscess). This often manifests as a dull, persistent ache that may intensify with pressure or temperature changes.
2. Decay:
Even with a crown, decay can occur on the remaining tooth structure or at the margins where the crown meets the tooth. This undetected decay can trigger sensitivity and pain, which may be intermittent initially.
3. Cracked Tooth:
A crack in the underlying tooth, even a microscopic one, can cause intermittent pain, particularly when biting down or chewing. The crown may mask the crack, making it difficult to diagnose.
4. Pulpitis (Inflammation of the Tooth Pulp):
If the infection extends to the tooth's pulp (the soft tissue containing nerves and blood vessels), pulpitis can result in significant pain. This pain is often more intense and may be constant rather than intermittent.
5. Periodontal Disease (Gum Disease):
Inflammation or infection of the gums surrounding the crowned tooth can contribute to pain and discomfort, especially if the infection extends deeper.
6. Sinusitis:
While less common, sinus infections can sometimes radiate pain to the teeth, particularly the upper molars. This pain may mimic tooth pain and be intermittent.
7. Bite Problems (Malocclusion):
An improper bite can put excessive pressure on a crowned tooth, leading to pain that comes and goes.
How is Tooth Pain Under a Crown Diagnosed?
Diagnosing the underlying cause of pain under a crown requires a thorough examination by your dentist. They will likely use several techniques, including:
- Visual Examination: A careful examination of the crown and surrounding gum tissue.
- X-rays: To identify cracks, decay, or bone loss.
- Percussion Test: Gently tapping on the tooth to assess its sensitivity.
- Palpation: Feeling the area around the tooth to check for swelling or tenderness.
- Cold and Heat Sensitivity Tests: Applying cold or warm stimuli to check for pulp involvement.
What are the Treatment Options for Pain Under a Crown?
Treatment will depend on the underlying cause identified by your dentist. Options may include:
- Root Canal: If decay or infection has reached the pulp, a root canal may be necessary to remove the infected pulp and seal the tooth to prevent further infection.
- Crown Replacement or Repair: If the crown is damaged or ill-fitting, it may need to be replaced or repaired.
- Antibiotics: If an infection is present, antibiotics may be prescribed to combat bacteria.
- Gum Treatment: If gum disease is involved, periodontal treatment (scaling and root planing) might be recommended.
- Bite Adjustment (Occlusal Adjustment): If bite problems are contributing to the pain, an occlusal adjustment may be performed to correct the bite.
Can I Prevent Pain Under My Crown?
Maintaining good oral hygiene is crucial in preventing pain under a crown. This includes:
- Brushing and Flossing Regularly: Thorough brushing and flossing are vital to remove food particles and plaque.
- Regular Dental Checkups: Routine visits allow your dentist to detect potential problems early.
- Avoiding Hard or Chewy Foods: Avoid biting down on excessively hard or chewy foods that could put stress on the crown or underlying tooth.
Is Tooth Pain Under a Crown an Emergency?
While intermittent pain may not always be an emergency, persistent or severe pain should be addressed promptly. Contact your dentist immediately if you experience:
- Intense pain that doesn't subside.
- Swelling or tenderness around the tooth.
- Fever or chills.
- Difficulty opening your mouth.
Ignoring the pain could lead to serious complications, including tooth loss. Seek professional dental care without delay if you suspect a problem.
By understanding the potential causes, seeking timely diagnosis, and adopting good oral hygiene practices, you can significantly reduce the risk of experiencing tooth pain under your crown. Remember, preventative care is key to preserving the health of your teeth and maintaining a confident smile.
