Permanent crown nerve pain

[Sheena]

When my temporary crown was placed it caused a lot of pain due to the crown not being cemented correctly and sitting too high. The dentist adjusted the temporary and re-cemented it and it felt 100% better. Today I had the permanent crown placed and felt so much nerve pain during the whole process. Now about 10 hours later I still feel constant nerve pain. My bite doesn’t feel off. The gums around the tooth don’t feel sore it’s just this intense nerve pain. I’m taking 800mg of ibuprofen every 6 hours just to manage. Is this normal? Why didn’t the temporary feel this bad? How long can I expect this nerve pain? It’s giving me the worst headache and I’m not even applying any pressure to the tooth.

 

[MattKW]

Temporary crowns are usually glued with a soft cement containing eugenol, which also helps soothe tooth pain. The permanent cement for the real crown is different, and usually an acid-based reaction, and may also generate a bit of heat during setting, so can set off the sensitivity again.
There is about a 5-10% chance of crowned teeth not settling down, and requiring a root canal therapy. You'll just have to dose for another day and hope it settles more.

 

[honestdoc]

How you know you need a root canal is if the pain is waking you up at night and or you notice swelling around the crown. Getting crowns involve drilling around the tooth which traumatizes/injures the nerve (pulp). The nerve will hopefully get better or get permanently damaged or dies.

 

[Sheena]

The gums aren’t swollen but still need to take 800 ibuprofen every 6 hours to eleviate the pain. How long does it usually take for the nerves to recover?

 

[honestdoc]

It is hard to predict the duration and intensity of your pain. A last resort idea may be to discuss the possible use of corticosteroid dose pack like prednisone, medrol, or decadron with your dentist. What these medications do is reduce inflammation of the nerves in your tooth more effectively than ibuprofen. However, there are many contraindications and side effects for these agents because it suppresses your immune system and if you have any pre-existing conditions, it could be risky/dangerous.

If your pain is significant, you may need a root canal to remove the damaged nerves in your tooth.

 

[Sheena]

So it’s been over a week. I went back on Tuesday to get the crown adjusted. Now the pain is less but I still get the nerve pain that travels to my head and ear if I don’t take something. I don’t have to take as much pain medicine as I was but I’m still taking Tylenol every 6 hours. Does it sound like it’s on the track of healing or potential root canal? What’s so frustrating is my tooth had no pain prior to this whole crown procedure. I have a crack in my tooth and now pain

 

[honestdoc]

Hopefully the tooth feels cold of short duration (nerve is vital) and not waking you at night (nerve is damaged). Damaged nerve presents as intense unbearable pain.

 

[Sheena]

Could I have an abscess? When my tooth hurts it hurts pretty bad and spreads to my ear and temple on the same side of my toothache. Ibuprofen and Tylenol successfully relieve the pain but it is strongest when I’m eating something that requires a lot of chewing.

 

[Sheena]

Sorry for some many questions but my dentist isn’t very helpful. I may find another dentist for a 2nd opinion.

 

[MattKW]

If you're getting hot or cold sensitivity then you have an angry pulp (nerve), but no abscess. However, here we are nearly 2 weeks post-op and you're still dosing with painkillers. You're almost certainly going to need an RCT; this is not going to settle down.