Crown Pain at Five Months

[Michael Thomas]

Hello,

I had a zirconia layered with porcelain crown placed on a molar in October of 2022. I'm still having pain when I chew, sensitivity to cold and an occasional dull ache. My dentist (who has gold crowns) told me it could take six months for the sensitivity to subside. I know that metal conducts temperature but my crown isn't metal. My dentist does not think a root canal is necessary but the only feedback he's offered is to be patient. My concern for the tooth is growing. It feels like the healing process has slowed, stalled. Should I continue waiting? Could waiting be problematic? I've considered consulting a different dentist. Feedback, thoughts are appreciated.

Thank you.

 

[Dr M]

It can always be helpful to get a second opinion. Has the bite or occlusion been checked? Do you have any x-rays of the involved tooth?

 

[MattKW]

A few things to consider:

1. A tooth that has got to the point of needing a crown has usually been filled a few times, and the pulp accumulates the damage.
2. Then you get a crown prep which is a further insult. About 5-10% of crowned teeth end up needing root canal therapy (RCT) because of 1. and 2.
3. All ceramic crowns require greater cut-back than a good gold crown, so there is more damage to the tooth than a gold crown.
4. Bonding to zirconia is more tricky than other ceramics (or gold)
5. There may be other issues e.g. poor margins
6. If a crown isn't starting to settle within 2 weeks, I get concerned.