Experiencing tooth pain under a crown that comes and goes can be a perplexing and frustrating issue. Dental crowns are designed to protect and restore damaged teeth, but sometimes, problems can arise that lead to intermittent discomfort or pain. Understanding the potential causes of this pain, the ways to address it, and the preventive measures you can take is essential for maintaining your oral health and ensuring the longevity of your dental crown. This comprehensive guide will delve into the various aspects of tooth pain under a crown that comes and goes, including its causes, treatment options, and preventive strategies.

Understanding Dental Crowns

Dental crowns are caps that cover a tooth to restore its shape, size, strength, and appearance. They are typically made from materials such as metal, porcelain-fused-to-metal, all-ceramic, or all-resin. Crowns are used to:

Protect Weak Teeth: Crowns can protect teeth that are weakened by decay or fracture.
Restore Broken Teeth: They can restore teeth that are already broken or severely worn down.
Cover and Support Teeth with Large Fillings: When there isn’t much tooth left, crowns can support and protect what remains.
Hold Dental Bridges in Place: Crowns can be used to anchor dental bridges.
Cover Dental Implants: They can cap implants for a natural appearance.
Enhance Cosmetic Appearance: Crowns can improve the appearance of discolored or misshapen teeth.

Causes of Tooth Pain Under a Crown

Tooth pain under a crown that comes and goes can be caused by various factors. Identifying the underlying cause is crucial for effective treatment. Here are some common reasons for this type of pain:

Tooth Decay: Even with a crown, the underlying tooth can still develop decay. If decay occurs under the crown, it can lead to intermittent pain. This decay can occur at the margins of the crown where it meets the natural tooth.
Loose Crown: A crown that is not properly cemented or has become loose over time can cause pain. This can happen if the cement wears away or if the crown was not fitted correctly in the first place.
Infection or Abscess: An infection in the tooth or surrounding gum tissue can cause intermittent pain. This is often accompanied by swelling, redness, and sometimes pus drainage.
Gum Recession: If the gums recede around the crowned tooth, it can expose the root, leading to sensitivity and pain, especially with temperature changes or pressure.
Bite Issues: If the crown is not aligned properly with the other teeth, it can cause bite issues, leading to intermittent pain. This can happen if the crown is too high or if there is an imbalance in the way the teeth meet.
Cracked Tooth: The tooth under the crown might have a crack that was not detected before the crown was placed. This crack can cause intermittent pain when biting or chewing.
Nerve Issues: Sometimes, the nerve inside the tooth can become inflamed or damaged, causing intermittent pain. This can occur if the tooth was not adequately treated before the crown was placed.

Diagnosing the Cause of Pain

To determine the cause of tooth pain under a crown, a visit to the dentist is essential. The dentist will perform a thorough examination, which may include:

Clinical Examination: The dentist will visually inspect the crown and surrounding gum tissue for signs of decay, infection, or gum recession.
X-rays: X-rays can help identify issues not visible to the naked eye, such as decay under the crown, infections, or cracks in the tooth.
Percussion Test: The dentist may tap on the crowned tooth and adjacent teeth to assess pain levels and identify the problematic tooth.
Bite Test: The dentist may ask the patient to bite down on a cotton roll or other material to evaluate pain during biting and identify any bite issues.
Thermal Test: A thermal test involves applying cold or hot stimuli to the tooth to assess sensitivity and identify potential nerve issues.

Treatment Options for Tooth Pain Under a Crown

The treatment for tooth pain under a crown that comes and goes depends on the underlying cause. Here are some common treatment options:

Decay Removal and Crown Replacement: If decay is found under the crown, the dentist will remove the crown, clean out the decay, and place a new crown.
Crown Recementation: If the crown is loose, the dentist will remove it, clean the underlying tooth and crown, and recement it properly.
Root Canal Therapy: If an infection or nerve damage is causing the pain, a root canal may be necessary. The dentist will remove the infected or damaged tissue, clean the root canal, and place a new crown if needed.
Gum Treatment: If gum recession is causing pain, the dentist may recommend treatments to address the recession and protect the exposed root, such as gum grafting or the use of desensitizing agents.
Bite Adjustment: If bite issues are causing the pain, the dentist may need to adjust the crown or other teeth to ensure proper alignment and balance.
Cracked Tooth Repair: If a crack is found in the tooth, the treatment will depend on the severity of the crack. Minor cracks may be treated with bonding or a new crown, while more severe cracks may require extraction and replacement with a dental implant or bridge.

Preventing Tooth Pain Under a Crown

Preventing tooth pain under a crown involves maintaining good oral hygiene and regular dental visits. Here are some tips to help prevent issues:

Good Oral Hygiene: Brush and floss regularly to keep the crowned tooth and surrounding gums healthy. Pay special attention to the margins of the crown where it meets the natural tooth.
Regular Dental Check-Ups: Schedule regular check-ups with your dentist to monitor the condition of the crown and the underlying tooth. Early detection of issues can prevent more severe problems.
Avoid Hard Foods: Avoid chewing on hard foods or objects that can damage the crown or the underlying tooth. Be mindful of hard candies, nuts, and ice.
Wear a Mouthguard: If you grind your teeth at night, wear a custom-made mouthguard to protect the crown and other teeth from damage. Bruxism can cause significant wear and tear on dental restorations.
Address Dental Issues Promptly: If you experience any pain or discomfort, don’t ignore it. Seek prompt dental care to address the issue before it becomes more severe.

Advances in Dental Crown Technology

Advances in dental technology have improved the quality and longevity of dental crowns, reducing the risk of complications such as tooth pain under a crown. Some of these advancements include:

CAD/CAM Technology: Computer-aided design and manufacturing (CAD/CAM) technology allows for the precise design and fabrication of crowns. This ensures a better fit and reduces the time needed for placement. Some practices offer same-day crowns, eliminating the need for temporary crowns and multiple visits.
E-max and Zirconia Crowns: These modern materials offer excellent aesthetics and durability. E-max crowns are made from lithium disilicate, while zirconia crowns are made from a type of ceramic that is incredibly strong. Both materials provide a natural appearance and are highly resistant to chipping and cracking.
Digital Impressions: Digital impressions eliminate the need for traditional molds, providing a more comfortable experience for patients and ensuring greater accuracy. This technology uses optical scanners to create a 3D model of the prepared tooth, leading to better-fitting crowns.

Living with a Dental Crown

Living with a dental crown should not involve discomfort or pain. If you experience tooth pain under a crown that comes and goes, it’s important to seek dental care promptly. Here are some general tips for living comfortably with a dental crown:

Monitor Your Bite: Pay attention to how your teeth come together when you bite and chew. If you notice any discomfort or misalignment, contact your dentist for an evaluation.
Maintain Good Oral Hygiene: Brush twice a day and floss daily to keep your crowned tooth and surrounding teeth healthy. Use an antimicrobial mouthwash if recommended by your dentist.
Avoid Habits That Can Damage Crowns: Avoid chewing on ice, pens, or other hard objects that can damage your crown. If you play sports, wear a mouthguard to protect your teeth and crowns.
Stay Hydrated: Drink plenty of water to keep your mouth moist and reduce the risk of decay and gum disease.
Follow Your Dentist’s Advice: Follow any specific care instructions provided by your dentist to ensure the longevity of your crown.

Conclusion

Experiencing tooth pain under a crown that comes and goes can be a sign of various underlying issues, including tooth decay, loose crowns, infections, gum recession, bite problems, cracked teeth, or nerve issues. Identifying the cause of the pain through a thorough dental examination and appropriate diagnostic tests is crucial for effective treatment. Treatment options may include decay removal and crown replacement, crown recementation, root canal therapy, gum treatment, bite adjustment, or cracked tooth repair.

Preventing tooth pain under a crown involves maintaining good oral hygiene, regular dental check-ups, avoiding hard foods, wearing a mouthguard if necessary, and addressing dental issues promptly. Advances in dental technology, such as CAD/CAM technology, E-max and zirconia crowns, and digital impressions, have improved the quality and longevity of dental crowns, reducing the risk of complications.

Living with a dental crown should not involve discomfort or pain. By following good oral hygiene practices, monitoring your bite, avoiding habits that can damage crowns, staying hydrated, and following your dentist’s advice, you can ensure the longevity and comfort of your dental crown. If you experience any issues with your crown, seek prompt dental care to address the problem and maintain your oral health. Understanding the causes and treatments for tooth pain under a crown that comes and goes will help you achieve the best possible outcome for your dental restoration.

Why Does My Tooth Crown Randomly Hurt?

Understanding Crown Pain

Tooth crown pain can occur for several reasons, ranging from minor issues to more serious underlying conditions. Understanding the possible causes of crown pain can help you address the problem effectively.

1. Bite Issues: One of the most common reasons for pain associated with a dental crown is an improper bite. If the crown is slightly higher than the surrounding teeth, it can create uneven pressure when you bite down, leading to discomfort or pain.

2. Tooth Sensitivity: After a crown is placed, the tooth underneath might become more sensitive to hot, cold, or sweet foods and beverages. This sensitivity usually decreases over time but can sometimes persist.

3. Nerve Irritation: During the crowning process, the nerves within the tooth can be irritated. This is more common if the tooth was significantly decayed or required a large filling before the crown was placed. This irritation can cause intermittent pain.

4. Gum Issues: Gum tissue around the crowned tooth can become inflamed or irritated, leading to pain. This can be due to poor oral hygiene, gum disease, or trauma to the gums during the crown placement.

5. Decay Under the Crown: Although the crown itself cannot decay, the tooth structure beneath it can. If decay develops under the crown, it can lead to pain and sensitivity.

6. Crown Damage: A cracked or chipped crown can expose the underlying tooth structure, causing pain. Crowns can be damaged by biting on hard objects, trauma, or regular wear and tear.

What to Do About Random Crown Pain

1. Visit Your Dentist: If you experience random pain in your crowned tooth, it’s essential to see your dentist. They can evaluate the crown and the underlying tooth to determine the cause of the pain.

2. Check Your Bite: If the pain is due to an improper bite, your dentist can adjust the crown to ensure it fits correctly with your other teeth.

3. Maintain Good Oral Hygiene: Proper brushing and flossing can help prevent gum irritation and decay around the crown. Use a toothpaste designed for sensitive teeth if you experience sensitivity.

4. Use Desensitizing Products: If sensitivity persists, your dentist might recommend desensitizing toothpaste or treatments to help reduce discomfort.

5. Address Potential Decay: If decay is found beneath the crown, your dentist will need to remove the crown, treat the decay, and possibly place a new crown.

How Do I Know If My Crown Is Infected?

Signs of an Infected Crown

An infection in a crowned tooth can occur if bacteria manage to penetrate the underlying tooth structure or if there is an issue with the root canal treatment performed before the crown was placed. Here are the signs that indicate a possible infection:

1. Persistent Pain: Continuous or throbbing pain around the crowned tooth is a common sign of infection. This pain may radiate to the surrounding areas, such as the jaw or ear.

2. Swelling and Redness: Swelling of the gums around the crowned tooth, accompanied by redness, can indicate an infection. The gum tissue may also be tender to the touch.

3. Pus Discharge: If you notice pus oozing from the gums near the crowned tooth, it’s a clear indication of infection. Pus can create a bad taste in your mouth and bad breath.

4. Fever: An infection in your mouth can sometimes cause a fever as your body fights off the bacteria. If you experience a fever along with tooth pain, it’s essential to seek dental care immediately.

5. Sensitivity to Pressure: An infected tooth may become sensitive to pressure, making it uncomfortable to chew or bite down on that side of your mouth.

6. Lymph Node Swelling: Swollen lymph nodes in your neck or under your jaw can be a sign of infection spreading from the crowned tooth.

Steps to Take If You Suspect an Infection

1. Contact Your Dentist Immediately: If you suspect an infection, make an appointment with your dentist as soon as possible. Delaying treatment can lead to more serious complications.

2. Take Over-the-Counter Pain Relievers: Non-prescription pain relievers like ibuprofen can help manage pain and reduce inflammation until you can see your dentist.

3. Rinse with Salt Water: Rinsing your mouth with warm salt water can help reduce inflammation and fight bacteria. Mix a teaspoon of salt in a glass of warm water and rinse your mouth several times a day.

4. Follow Prescribed Treatment: If your dentist confirms an infection, they may prescribe antibiotics to eliminate the bacteria. Follow the prescribed treatment plan and complete the full course of antibiotics.

5. Root Canal or Crown Replacement: In some cases, a root canal treatment may be needed to remove the infected tissue. If the crown is compromised, it may need to be replaced after the infection is resolved.

Why Does My Crown Hurt More at Night?

Understanding Nocturnal Crown Pain

Experiencing increased pain from your crown at night can be particularly frustrating and disruptive. Several factors can contribute to this phenomenon:

1. Decreased Distractions: During the day, various activities and distractions may divert your attention from the pain. At night, when you are trying to sleep, you may become more aware of the discomfort.

2. Blood Flow Changes: When you lie down, blood flow to the head and neck area can increase, which may exacerbate pain and pressure around the crowned tooth.

3. Teeth Grinding (Bruxism): Many people unconsciously grind or clench their teeth at night. This can put additional stress on a crowned tooth, leading to increased pain.

4. Sinus Issues: If you have sinus congestion or infections, lying down can increase sinus pressure, which can sometimes be referred to the upper teeth, including crowned teeth.

5. Inflammation: Inflammation can cause pain to intensify at night. If the crowned tooth or surrounding gums are inflamed, the pain may become more noticeable when you are lying still.

Managing Nighttime Crown Pain

1. Practice Good Sleep Hygiene: Maintain a regular sleep schedule and create a calming bedtime routine to help you relax and fall asleep more easily.

2. Use a Night Guard: If you grind or clench your teeth at night, wearing a night guard can protect your crowned tooth and reduce pain caused by bruxism.

3. Elevate Your Head: Sleeping with your head elevated can help reduce blood flow to the head and neck area, potentially decreasing pain and pressure.

4. Address Sinus Issues: If sinus congestion is contributing to your pain, using a humidifier, saline nasal spray, or decongestants before bed can help alleviate pressure.

5. Take Pain Relievers: Over-the-counter pain relievers like ibuprofen or acetaminophen can help manage pain and inflammation before you go to bed. Always follow the recommended dosage instructions.

6. See Your Dentist: If nighttime pain persists, consult your dentist. They can evaluate your crown and underlying tooth to identify any issues and recommend appropriate treatment.

How Long Does It Take for a Permanent Crown to Stop Hurting?

Expected Healing Timeline

After getting a permanent crown, some discomfort and sensitivity are normal, but this should gradually improve. Here’s what to expect:

1. Immediate Post-Procedure Discomfort: Right after the crown placement, you may experience some soreness or sensitivity in the area. This is usually due to the irritation of the gums and the tooth preparation process. This discomfort typically subsides within a few days.

2. Adjusting to the Crown: It can take a few weeks for your mouth to fully adjust to the new crown. During this time, you might notice mild discomfort, especially when biting or chewing. This should gradually decrease as your bite adjusts.

3. Sensitivity: Sensitivity to hot, cold, or pressure can persist for a few weeks after the crown is placed. Using desensitizing toothpaste and avoiding extreme temperatures in foods and beverages can help manage this sensitivity.

4. Gum Healing: The gums around the crowned tooth may take a few weeks to heal completely. During this time, you may experience some tenderness or minor swelling.

When to Seek Further Help

1. Persistent Pain: If pain persists beyond a few weeks or becomes more intense, it’s important to contact your dentist. Persistent pain can indicate an underlying issue that needs to be addressed.

2. Bite Issues: If your bite feels off or uncomfortable, your dentist can adjust the crown to ensure a proper fit. An uneven bite can cause ongoing discomfort and should be corrected promptly.

3. Signs of Infection: If you experience symptoms of infection, such as severe pain, swelling, pus discharge, or fever, seek immediate dental care.

4. Allergic Reactions: Although rare, some people may have allergic reactions to the materials used in the crown. If you experience unusual symptoms like rash or swelling in other parts of your body, contact your dentist or healthcare provider.

Tips for Managing Post-Crown Discomfort

1. Avoid Hard or Sticky Foods: In the first few days after getting your crown, avoid foods that are hard, sticky, or require a lot of chewing. These can put additional stress on the new crown.

2. Practice Good Oral Hygiene: Keep the area clean by brushing gently and flossing around the crowned tooth. This can help prevent gum irritation and potential decay.

3. Use Desensitizing Products: Desensitizing toothpaste and mouthwashes can help reduce sensitivity and discomfort.

4. Follow Up with Your Dentist: Attend all scheduled follow-up appointments to ensure the crown is fitting correctly and that there are no complications.

Conclusion

Tooth crown pain can be caused by various factors, including bite issues, sensitivity, nerve irritation, gum problems, and underlying decay. Recognizing the signs of infection, understanding why pain might worsen at night, and knowing the expected healing timeline for a permanent crown can help you manage and address any discomfort effectively. Regular dental visits and good oral hygiene are crucial for maintaining the health and longevity of your dental crowns.

What Are the Symptoms of a Bad Crown?

Recognizing Issues with Your Dental Crown

A dental crown can fail or cause problems for various reasons. Here are some common symptoms that indicate your crown might be compromised:

1. Persistent Pain or Discomfort: If you experience ongoing pain or discomfort around the crowned tooth, it could be a sign of an underlying issue. This pain can range from mild sensitivity to severe, throbbing pain.

2. Sensitivity to Temperature: Increased sensitivity to hot or cold foods and beverages may indicate that the underlying tooth is exposed or that the crown is not fitting properly.

3. Gum Inflammation: Swelling, redness, or tenderness in the gums around the crown can be a sign of gum disease, an ill-fitting crown, or an infection.

4. Loose Crown: If the crown feels loose or wobbly, it may not be properly adhered to the tooth. This can lead to discomfort and potential damage to the underlying tooth.

5. Visible Damage: Cracks, chips, or other visible damage to the crown can compromise its effectiveness and lead to pain or sensitivity.

6. Bad Breath or Unpleasant Taste: A bad odor or taste in your mouth can indicate that bacteria are trapped under the crown, leading to decay or infection.

7. Change in Bite: If your bite feels off or misaligned, the crown may not be fitting correctly, causing discomfort and potentially leading to further dental issues.

How Do You Stop a Crown from Hurting?

Addressing Crown Pain

If you experience pain or discomfort from a dental crown, there are several steps you can take to alleviate it:

1. Over-the-Counter Pain Relievers: Non-prescription pain medications like ibuprofen or acetaminophen can help reduce pain and inflammation.

2. Use Desensitizing Toothpaste: Specially formulated toothpaste for sensitive teeth can help reduce sensitivity and discomfort.

3. Avoid Extreme Temperatures: Steer clear of very hot or cold foods and beverages, as these can exacerbate sensitivity and pain.

4. Adjust Your Bite: If your bite feels uneven or uncomfortable, see your dentist. They can adjust the crown to ensure it fits properly with your other teeth.

5. Maintain Good Oral Hygiene: Regular brushing and flossing can prevent gum inflammation and decay around the crown. Be gentle around the crowned tooth to avoid irritation.

6. Rinse with Salt Water: A warm salt water rinse can help reduce gum inflammation and fight bacteria. Mix a teaspoon of salt in a glass of warm water and rinse your mouth several times a day.

7. Use a Night Guard: If you grind or clench your teeth at night, wearing a night guard can protect your crown and reduce pain caused by bruxism.

Can a Crown Infection Go Away on Its Own?

Understanding Crown Infections

A crown infection typically won’t go away on its own and requires professional treatment. Infections occur when bacteria invade the underlying tooth or the surrounding gum tissue. Left untreated, the infection can spread, causing more severe complications, including:

1. Abscess Formation: An untreated infection can lead to the formation of a dental abscess, a painful collection of pus that requires drainage and treatment.

2. Tooth Loss: Severe infections can compromise the integrity of the underlying tooth, potentially leading to tooth loss.

3. Spread of Infection: The infection can spread to other parts of the mouth, jaw, and even the bloodstream, leading to serious health issues.

Will Antibiotics Help an Infected Crown?

Role of Antibiotics in Dental Infections

Antibiotics can be effective in treating the bacterial infection associated with a crown, but they are often part of a broader treatment plan. Here’s how antibiotics can help and what to expect:

1. Reducing Infection: Antibiotics can help eliminate the bacteria causing the infection, reducing pain and swelling.

2. Temporary Relief: While antibiotics can provide temporary relief, they are not a standalone solution. The underlying issue, such as decay or a failed root canal, must be addressed to prevent recurrence.

3. Follow-Up Treatment: Your dentist may prescribe antibiotics to manage the infection initially, but further treatment, such as a root canal, crown replacement, or gum therapy, will be necessary to fully resolve the problem.

4. Completing the Course: It’s important to complete the full course of antibiotics as prescribed, even if symptoms improve before finishing the medication. This ensures that the infection is fully eradicated.

What Does a Damaged Crown Feel Like?

Identifying a Damaged Crown

A damaged crown can present various symptoms, depending on the extent and type of damage:

1. Sharp Pain: A cracked or chipped crown can cause sharp pain, especially when chewing or biting down. This pain can be intermittent or constant.

2. Rough or Jagged Edges: If the crown is chipped or cracked, you might feel rough or jagged edges with your tongue. This can cause irritation to the tongue and cheeks.

3. Sensitivity: A damaged crown can expose the underlying tooth, leading to increased sensitivity to hot, cold, or sweet foods and beverages.

4. Discomfort When Biting: If the crown is damaged or loose, you may experience discomfort or pain when biting or chewing, as the crown may not be providing adequate protection.

5. Visible Damage: You might be able to see cracks, chips, or other visible damage to the crown when looking in a mirror.

6. Feeling of Movement: A loose or damaged crown may feel like it moves slightly when you bite down or touch it with your tongue.

What to Do About a Damaged Crown

1. Contact Your Dentist: If you suspect your crown is damaged, make an appointment with your dentist as soon as possible. Early intervention can prevent further damage and complications.

2. Avoid Using the Tooth: Try to avoid chewing on the side of the mouth with the damaged crown until you can see your dentist. This can prevent further damage and reduce pain.

3. Temporary Fixes: If the crown is loose, you can use dental cement (available at pharmacies) as a temporary fix until you can see your dentist. Do not use glue or other adhesives not meant for dental use.

4. Pain Management: Over-the-counter pain relievers can help manage discomfort until you receive professional treatment.

5. Professional Repair or Replacement: Depending on the extent of the damage, your dentist may be able to repair the crown. If the damage is severe, the crown may need to be replaced entirely.

Conclusion

Understanding the symptoms of a bad crown, how to stop crown-related pain, and the seriousness of infections can help you take proactive steps to maintain your dental health. Recognizing the signs of a damaged crown and seeking timely professional care are crucial for preventing further complications and ensuring the longevity and functionality of your dental restorations. Regular dental check-ups and good oral hygiene are key to preventing issues and addressing them promptly when they arise.

tooth pain under crown comes and goes