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Constant ache following a new gold crown

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Diggler

Junior member
Joined
Jun 29, 2011
Messages
4
Location
UK
At the beginning of June I had had a large molar prepepared for a gold crown. The temporary crown fitted fine and gave me no problem whatsoever. However, when I went to have the gold crown fitted a week later, the dentist had trouble removing the temporary crown, and had to use a drill to help dislodge it. He then proceeded to work on the tooth (without LA). The experience was awful, eyes watering, beads of sweat on my brow and an awful lot of pain. It is now almost 3 weeks since the crown was fitted and I am still in pain. I popped back to my dentist almost a week ago, and was put on a course of antibiotics - no change. This dull ache is right across my my jaw and radiating up my cheek. I have been taking Ibuprofen and paracetamol which have worked quite well. I suppose my question is, is it normal for pain to last so long? Thanks in anticipation.
 
brit

brit

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6,963
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In My Dental Happy Place
Sorry to hear about your awful experience. Why didn't you stop the dentist and insist on local anaesthetic? It's not that expensive.
I'm not a dentist but i.m.e. the temporary crown should pop off easily (both mine did) so I do wonder if maybe permanent cement was used in error (pure supposition on my part).
I have heard of drills being used to remove permanent crowns but not temporary ones.
Is this a dentist you have previously had good experiences with?

Given that you had no issues wearing the temp even though the nerve was still live i.e. you did not have a root canal first (i am assuming), I would have thought there's a good chance it will settle down in time.

However if you have had pain for 3 weeks that does sound like a long time. To have given antibiotics he must think an infection is present.

The worst case scenario is that the pulp in the tooth has been irritated beyond the point of no return and that it now needs a root canal to save it - these can sometimes be done through the crown but I don't think I'd be trusting that dentist to do one on me. If he can't seat a crown without making your eyes water, you don't want him doing a root canal.
How about getting a second opinion?

Finally I have a horrible feeling you are going to tell me this was a UK NHS Associate dentist. If I am wrong I will be very pleased.

http://www.dentalfearcentral.org/faq/root-canal/
 
D

Diggler

Junior member
Joined
Jun 29, 2011
Messages
4
Location
UK
Sorry to hear about your awful experience. Why didn't you stop the dentist and insist on local anaesthetic? It's not that expensive.
I'm not a dentist but i.m.e. the temporary crown should pop off easily (both mine did) so I do wonder if maybe permanent cement was used in error (pure supposition on my part).
I have heard of drills being used to remove permanent crowns but not temporary ones.
Is this a dentist you have previously had good experiences with?

Given that you had no issues wearing the temp even though the nerve was still live i.e. you did not have a root canal first (i am assuming), I would have thought there's a good chance it will settle down in time.

However if you have had pain for 3 weeks that does sound like a long time. To have given antibiotics he must think an infection is present.

The worst case scenario is that the pulp in the tooth has been irritated beyond the point of no return and that it now needs a root canal to save it - these can sometimes be done through the crown but I don't think I'd be trusting that dentist to do one on me. If he can't seat a crown without making your eyes water, you don't want him doing a root canal.
How about getting a second opinion?

Finally I have a horrible feeling you are going to tell me this was a UK NHS Associate dentist. If I am wrong I will be very pleased.

http://www.dentalfearcentral.org/faq/root-canal/
Thanks Brit. I am new to this forum so hopefully my reply comes through OK. I did mention to the dentist through various hand gestures that I was in some discomfort, he just apologised and said he would soon be finished! No root canal work was mentioned, and he is not sure if there is an infection. He only offered antibiotics once I had questioned whether there could be an abscess. He took an x-ray but said it would be difficult to see an abscess as it would be in the "dark area" of an x-ray. Yep... you guessed right it is an NHS dentist. I am going back early next week to find out what his next move will be.
 
brit

brit

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Staff member
Joined
Mar 23, 2006
Messages
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In My Dental Happy Place
Thanks Brit. I am new to this forum so hopefully my reply comes through OK. I did mention to the dentist through various hand gestures that I was in some discomfort, he just apologised and said he would soon be finished! No root canal work was mentioned, and he is not sure if there is an infection. He only offered antibiotics once I had questioned whether there could be an abscess. He took an x-ray but said it would be difficult to see an abscess as it would be in the "dark area" of an x-ray. Yep... you guessed right it is an NHS dentist. I am going back early next week to find out what his next move will be.
Then sue him for assault - that is outrageous. Has he not heard of local anesthetic?
OK next question - was he UK trained? Even I still believe that UK dentists are still trained to avoid causing their patients unnecessary pain...even in Western European cultures in the nearest countries (eg Holland) there are varying attitudes to the need for pain relief in dentistry.

You are very brave to go back - he'd have lost me. I reckon you'll have to go private (not with the same dentist) to get this tooth sorted out painlessly and professionally. NHS dentist will likely want to extract as soon as he encounters problems. It probably needs an endodontist to save it. http://www.dentalfearcentral.org/faq/root-canal/

It really annoys me that we tell posters about painless dentistry which is entirely doable and then people go off and meet incompetent (in the comfort dept) NHS dentists like that.
BTW it is usual to do a crown seat with no LA if the tooth has had a successful root canal first then there is no nerve to cause pain but in your case it is extremely common where the nerve is still alive to numb up for a crown seat. What you are asking is not unreasonable. The GDC wouldn't consider it unreasonable. He hasn't given you quality comfortable care which even the NHS guidelines claim you have a right to.
 
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N

norwegianchick

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Joined
Feb 13, 2011
Messages
194
Location
Norway
I'm not a dentist, but teeth with an inflamed nerve can hurt a lot even when there are no signs on the x-ray. I know this from first hand experience, they looked so good on the pictures, but took away my sleep and appetite.

Putting on a crown on a live tooth can mean trauma to the nerve, and if the pain is still persistent after weeks, then you should go back to your dentist.

Good luck and hope you'll feel better soon :)
 
D

Diggler

Junior member
Joined
Jun 29, 2011
Messages
4
Location
UK
Then sue him for assault - that is outrageous. Has he not heard of local anesthetic?
OK next question - was he UK trained? Even I still believe that UK dentists are still trained to avoid causing their patients unnecessary pain...even in Western European cultures in the nearest countries (eg Holland) there are varying attitudes to the need for pain relief in dentistry.

You are very brave to go back - he'd have lost me. I reckon you'll have to go private (not with the same dentist) to get this tooth sorted out painlessly and professionally. NHS dentist will likely want to extract as soon as he encounters problems. It probably needs an endodontist to save it. http://www.dentalfearcentral.org/faq/root-canal/

It really annoys me that we tell posters about painless dentistry which is entirely doable and then people go off and meet incompetent (in the comfort dept) NHS dentists like that.
BTW it is usual to do a crown seat with no LA if the tooth has had a successful root canal first then there is no nerve to cause pain but in your case it is extremely common where the nerve is still alive to numb up for a crown seat. What you are asking is not unreasonable. The GDC wouldn't consider it unreasonable. He hasn't given you quality comfortable care which even the NHS guidelines claim you have a right to.

Thanks again Brit. I have managed to get an appointment this lunchtime to see the dentist, as the antibiotics have had nil impact. Really not sure what to expect. :o
 
D

Diggler

Junior member
Joined
Jun 29, 2011
Messages
4
Location
UK
I'm not a dentist, but teeth with an inflamed nerve can hurt a lot even when there are no signs on the x-ray. I know this from first hand experience, they looked so good on the pictures, but took away my sleep and appetite.

Putting on a crown on a live tooth can mean trauma to the nerve, and if the pain is still persistent after weeks, then you should go back to your dentist.

Good luck and hope you'll feel better soon :)

Thank you for your good wishes. I too have lost my appetite, and was woken somewhat abrubtly at around 3am with pain. Just watching the clock tick down to my lunchtime appointment. :o
 
C

comfortdentist

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Verified dentist
Joined
Jul 19, 2009
Messages
2,881
Location
Miami, Fl
Antibiotics absolutely do not help with nerve type pain from a tooth. It is wrong to
prescribe them for this.
You need a root canal and if properly done you have about a 90+% chance of being fine.

Temporary crowns some time hold tight and partially cutting into one toweaken it is very reasonable. If it hurts then just get local anesthesia.
 
D

David

Member
Verified dentist
Joined
Feb 1, 2011
Messages
89
Location
Edinburgh
Hi,

I agree - sounds like root canal treatment required here.

p.s I will regularly use a drill to section a temporary crown before placing the 'crown proper' (under local anaesthetic though).



Antibiotics absolutely do not help with nerve type pain from a tooth. It is wrong to
prescribe them for this.
You need a root canal and if properly done you have about a 90+% chance of being fine.

Temporary crowns some time hold tight and partially cutting into one toweaken it is very reasonable. If it hurts then just get local anesthesia.
 
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