Because the tooth under the dental crown is still alive, tooth decay or a new cavity can form at the border of the tooth and the crown. This can lead to persistent pain in the area. If a tooth cavity grows large enough and affects the nerve, you might need a root canal procedure.
If you are experiencing pain or sensitivity in your tooth, the cause is likely related to your dental crown. The feeling could range anywhere from a sharp pain that just started a few days ago to a constant ache that you've noticed for months or even sometimes years.
The number one sign that there is an issue with an old dental crown is a toothache. The underlying tooth under the crown may be porous or have damage, which is likely why the crown was placed to start with. If the crown is not properly sealing the tooth, you may start to experience some pain.
Tooth sensitivity to temperatures (hot or cold) or sugary foods and drinks. Pain or tenderness in the areas surrounding the crown. Increasing redness at the area of crown placement. A discharge of yellow, green, or clear fluid or pus that appears to be draining or leaking out around or under the crown.
Sometimes this can be caused by your tooth's reaction to the dental cements used. Pain that comes up unexpectedly after successful use for many months may indicate decay that has advanced well after the crown treatment, or it could indicate a problem with the crown.
It may be that the crown has not bonded properly to your tooth, or has become infected due to improper placement. Either way, you should seek the attention of your dentist if pain persists or gets worse after two weeks.
It is very rare that an old crown can be saved or reused since it will typically need to be cut into sections as it is removed from the tooth. For your comfort, the tooth and gum tissue will be numbed with a local anesthetic during this procedure.
A faulty crown is usually hard to miss, often causing mild to severe tooth pain, inflammation, and tooth decay. Over time, this can lead to infections and further symptoms. If you have a faulty crown, you may notice: Dental overhangs that are difficult to clean.
Unfortunately, as you are trapped in an unusual predicament, the sole option available to you is to have the decay under the crown treated by a dentist by getting the restoration removed, the infection treated, and the dental crown replaced over your tooth to protect it.
You Experience Pain or Swelling
As soon as you notice pain, swelling, or inflammation surrounding a crowned tooth, it's time to see a dentist. For example, if you notice increased pain or sensitivity when chewing, your crown could be too high on the tooth, damaged, old, or in need of replacement.
In some cases, the restorative material may need to be completely cut through with high-speed rotary instrument and then pried off with a narrow-ended tool. If the crown is made out of gold or metal, then removal becomes even more difficult because the material is harder to penetrate.
If you've been dealing with tooth pain under your crown that comes and goes, you just might be suffering from a dental infection, cavity, gum recession, or an improper fitting.
Cosmetic Reasons
When dental crowns break or chip due to wear, they can lose their aesthetics and become unattractive. Aging and receding gums can cause porcelain fused to metal crowns to form a dark line on the tooth surface and leave it looking less attractive.
Alleviating Tooth Sensitivity after Dental Crown Treatment
Anti-inflammatory medications: When tooth sensitivity is caused by inflammation from the dental crown procedure, over-the-counter anti-inflammatory medications, such as ibuprofen, are often effective at treating dental pain until the inflammation resolves.
Brushing your teeth twice a day will help remove the pellicle layer that forms on the crown and attracts stains. Use a soft toothbrush to thoroughly clean the teeth. You can also add a fluoride rinse and fluoride toothpaste or gel to your cleaning regimen.
Fixing a Cavity Under a Dental Crown
If a cavity is along the margin of a dental crown and does not go very deep into the tooth, it might be able to be fixed with normal dental filling material. In most other cases, the dental crown probably will need to be removed, the cavity filled, and a new crown placed on top.
The average lifespan for a well-maintained dental crown is typically around 15 years. However, when taken care of properly, it is common to see them last upwards of 25-30 years.
Most crowns last between five and 15 years before needing to be replaced (or at least repaired). In some cases it is obvious that you need to replace a crown because it has fallen out or suffered extensive damage; in other circumstances, it is less obvious that there is a problem with a crown.
Dental crowns should last around 15 years with proper maintenance. If patients take good care of the crown, they can last up to 30 years. Crowns made of porcelain can endure anywhere from 5 to 15 years.
If your dental crown is too high or improperly positioned, that may result in moderate to severe pain in your tooth when biting down. If your bite feels off after getting a crown and you feel pain when biting down, you may want to consider asking a dentist if the crown is loose or if it needs to be adjusted.
It is very challenging to remove dental cement with dental crowns. For this, the dentists tend to gently move the crown until the adhesive seal is wholly broken. Although dental cement removal is a painless procedure, it requires a slow evaluation of your oral health conditions.
The safest and least traumatic means of removing a cemented crown is to destroy it by cutting a slot and prying it out, thereby avoiding procedures that could harm the underlying tooth.