Agony after temporary crown... should I get the permanent one?

[mbc1963]

I think I cracked a tooth last week, and went to the dentist. He said the molar needed a crown because it was so much filling, and likely to break further. They numbed me up and ground the tooth down, then put a temporary crown on it. For a couple days, I had what seemed like normal discomfort: some soreness of the gum, the familiar soreness from the injections. Still had pain when biting down. The crown is lower than the teeth around it.

After three or four days, though, the tooth began to ache agonizingly. It's been getting worse and worse - to the point that if I'm between pain relievers, I almost can't function. The right side of my face hurts, my jaw, etc., etc.. My stomach doesn't do well when on ibuprofen for a long time... so this has me very concerned.

I went back to the dentist today, and they felt that the temp. crown was impinging on the gum, causing this pain. They numbed me up again, removed the crown, trimmed it back, and recemented it. During this procedure, the picking out of the old cement and messing with the tooth was INCREDIBLY painful. They had to blow air in the hole before the set the temp in again, and I could feel it very sharply. The novocaine wore off after a while, and the pain came back, stronger than ever.

They have set up an appointment in 3 days to attach the permanent crown, which the lab was able to rush.

I'm very worried! I've had two temporary crowns in the past, and no pain at all. If they install the permanent crown and there's something more wrong with the tooth, will I have to go through this agony again? I honestly can't do my job well if I feel like this - I'm a teacher, and need to be 'on' when school starts next week.

What are some possibilities for the root cause of this pain? Should I get a permanent crown put on a tooth that hurts this much? They don't think the temp. will stay on very well, because it's been trimmed back so far.

Thanks in advance for any assistance you can give!

Mary

 

[brit]

Hi Mary
I am not a dentist but I wouldn't want a permanent crown putting on in the circumstances you describe. It sounds like the nerve has maybe 'given up' and it is time for a root canal and then crown - I don't get why you had pain at last appt, they should have topped your anaesthetic up so they do not deserve to keep you as a patient. Is it a Corporate Dental Chain you are attending?
It would be best to get the root canal done by an endodontist for the best chance of success especially if it is a molar tooth.
If they place the crown and the pain remains you will have to do root canal through crown or face extraction. Don't know if temporary cement would be an option but seriously it sounds like the nerve has had enough and root canal done properly will get you out of pain without causing you any more.
Good luck.

Root Canal Treatment FAQs

Get detailed answers to FAQs: Is root canal treatment painful? Why am I sore afterwards? Why do I need a crown? And many more!

www.dentalfearcentral.org

 

[mbc1963]

OK!

I called my dentist this morning, and he agreed that this was likely more than the temp. crown not being right. He took me in and did phase 1 of the root canal. Don't read beyond this point if it's going to traumatize you.

Seriously.

Maybe

you

don't

want

to

know!

I

gave

you

fair

warning!

They couldn't get the tooth numb again, just like yesterday. So he said he'd have to go in there and apply novocaine directly to the root canals. Which he did... but for a few minutes, I could STILL FEEL THEM FILING THE NERVES.

This conversation, while I was lying there.

Dentist: Have you ever seen a tooth this bad?
Nurse: I've never seen anything like this.

I go back Friday for the second part of the root canal, and the permanent crown. I'm glad I trusted my judgment and didn't let them cement a crown onto a "hot" tooth. At least I feel like I was justified in complaining about the pain I've been having.

And for tonight and tomorrow, I've got a prescription for Vicodin, to get me to sleep.

Thanks for listening and letting me vent. This is scary stuff.

 

[brit]

Hmm am I the only one getting the impression you might be taking our fragile little community for a 'dental nightmare' ride here...such prank posts are very very rare....don't worry though I am not traumatised as I wouldn't return to someone who didn't care that I wasn't numb.
Apologies if you are genuine . No doubt instalment 3 will reveal the truth.

 

[vicki]

Hmm am I the only one getting the impression you might be taking our fragile little community for a 'dental nightmare' ride here...such prank posts are very very rare....

Hmmm... Maybe Maybe not

From personal experience, earlier this year, I had a similar situation where a tooth with irreversible pulpitis was unbelievably painful and so my dentist removed enough pulp and nerve tissue to get me out of pain until I had the root canal done by an endodontist. My tooth wouldn't go numb despite quite a few injections (including a couple of very painful intrapulpal injections). Realistically, I knew that the only way to get rid of my pain was to go through with the procedure, but he couldn't get it properly numb so it was very painful. My dentist kept asking whether I wanted to stop and made it very clear that he would stop at any time because he didn't want to cause me any pain. I managed to get through it by having regular breaks and despite the pain during the procedure, it was worth it because it did get rid of the horrendous pain I'd had beforehand. The endodontist who eventually did the root canal a couple of months later commented that my dentist had done a good job. The key difference here is that my dentist actually wanted to stop treatment when he realised that he couldn't get things properly numb - it was me that *chose* to carry on because I knew that if I could get it over with, then I would be out of pain properly. I think he was actually quite upset that he was causing me pain, but every time he stopped to give me a break, I told him to continue when I felt ready. Never in a billion years would my dentist have carried on if I had been in pain and I had not actually asked him to continue.

So... maybe maybe not. Let's see what the next installment brings.

 

[mbc1963]

No intentional dental nightmare-giving. This is the only forum on the Internet that I could find that had regular traffic and people answering questions about dental problems, and I was truly desperate when I made my first post - I didn't know what to do.

Now, I took a single Advil after the work yesterday, and the pain has decreased dramatically. So, whatever was going on in the tooth was apparently taken care of by the root canal. Stage 2 is tomorrow, then the permanent crown.

For what it's worth, a "hot" tooth apparently causes the local anesthetic to be much less effective. (And, as I've learned, so does being a redhead or being of Scandinavian descent - go figure!) I sure as hell wasn't lying about what happened to me yesterday. If you Google around, you can see lots of exampes of resistance to locals. For me, it's not genetic - I usually numb up quite well.) I do think that if I need a lower molar root canaled in the future, I'll request sedation.

Dentist prescribed me a few Vicodin to help me sleep. I took half of one... and waking up now I feel weird and a little sick. Won't take those again.

 

[vicki]

Now, I took a single Advil after the work yesterday, and the pain has decreased dramatically. So, whatever was going on in the tooth was apparently taken care of by the root canal. Stage 2 is tomorrow, then the permanent crown.

It sounds like you've had similar problems to me which is why I posted about my experiences of not being fully numb. I've had 6 root canals over the past few months (4 on lower molars and 2 on upper molars) and they've all been done by a very experienced endodontist. Even so, I've still had problems with the lower molars not being sufficiently numb from the usual injections and so I've had to have extra injections into the ligaments surrounding the teeth which thankfully did work and the root canals were pretty painless.

In theory, if all the nerve has been removed, then stage 2 of your root canal shouldn't be painful. If you do feel anything, make sure you let your dentist know so that they can give you more local anaesthetic. Don't just tough it out - let them know if it hurts. They shouldn't continue if you're in pain.

If you Google around, you can see lots of exampes of resistance to locals. For me, it's not genetic - I usually numb up quite well.) I do think that if I need a lower molar root canaled in the future, I'll request sedation.

It might be that you maybe just need a different type of injection - like I did. I had one of the root canals on a lower molar finished a couple of weeks ago and I had loads of injections to make absolutely sure that I was numb including; 2 nerve blocks, 2 infiltration injections (into the gums either side of the tooth) and about 4 or 5 intraligametal injections down into the gum surrounding the tooth (Yes, I know it's sad that I counted , but after the first injection, I didn't feel the rest and things were very very numb )

Dentist prescribed me a few Vicodin to help me sleep. I took half of one... and waking up now I feel weird and a little sick. Won't take those again.

Did you take it on an empty stomach? Some painkillers are better if you eat something first .

 

[brit]

For what it's worth, a "hot" tooth apparently causes the local anesthetic to be much less effective..

Yes, as per our 'Can't get numb' link but actually this is not always the case - it just can sometimes be an issue, it isn't always an issue and too many lazy dentists hide behind 'you can't easily get a hot tooth numb' quip - as happened to you it seems - to just carry on regardless of your pain - as Vicki pointed out there are all sorts of different places they can inject and different brands of local they can use.
She has been extremely unlucky but her endo has found a cocktail of multiple injections that work for her, not just expected her to put up with it.

Sedation for future could be an option for you but better/cheaper to just find a dentist willing to experiment more with different LA techniques so you can receive painfree care unsedated. Discontinuing if numbing is an issue and taking antibiotics to bring infection down is also a common approach. It is very common for dentists to miss block injections even without any infection - they simply don't get it in the right place as anatomy varies. Patients need to know this and not just put up with unanaethetised treatment. The red hair affected people definitely need more LA up front.

It should be easier next appt if all nerve is pretty much out anyway as Vicki said.
Good luck and apologies.