Updated: Oct 15
Are you wondering why you're having pain underneath your dental crown? Presumably the purpose of the crown was to protect the tooth so is something wrong since you're having tooth pain? Is this something that you can fix at home or do you need to go see a dentist?
Our long island city dentists will deconstruct everything there is for you to know about pain after a crown. You'll know what you should do as well.
Table of Contents
What's a dental crown?
A dental crown is a full coverage restoration that protects the entire tooth. They're commonly referred to as a tooth cap or a fake tooth since it is synthetically made in a dental laboratory. The crown can be made out of a variety of materials but the most common being porcelain.
When are crowns needed?
After a root canal. The structural integrity of the tooth is weakened because a hole was drilled through it in order to remove the tooth nerve. The blood supply also gets removed along with the nerve so it no longer has any nutrients supplying it.
To fix a large cavity. If the tooth has a large cavity that is greater than 50% of the tooth structure, a dental crown is recommended for better protection. A large filling would be more prone to fracture and chipping.
Improve aesthetics. Crowns can be used to change the color or shape of the teeth. A use like this is similar to a dental veneer. Most commonly, a dead tooth will look grey and that is when you need the crown to mask the color.
Replace a missing tooth. Dental implants are a surgical procedure to replace a missing tooth and not everyone wants to go through it. Alternatively, a dental bridge can be used to replace a missing tooth. The bridge is just multiple crowns connected together.
Symptoms of dental crown tooth pain
Tooth pain coming from a dental crown can present in many different forms and also occur at different points in time.
Constant type of pain
Pulsating pain like a heart beat
Tooth pain under a crown that comes and goes
Throbbing tooth pain after a crown
Pain coming from a crown that was placed years ago
A dental crown may feel sore or tender the first few days after you get it but it shouldn't hurt. Sensitivity is ok but any type of moderate-severe pain is not normal. If you do experience it, something may be wrong with your crown.
Sometimes, the crown may not hurt you for years but suddenly start acting up. If you're having pain coming from a crown that was done years ago, it may mean that it got reinfected.
Why is your dental crown causing you pain?
There can be many reasons for the tooth pain under a dental crown. Some are more severe while others are mild inconveniences. The way to treat them would all differ depending on the source of the pain.
If you're having a toothache shortly after receiving the crown, the nerves may have been traumatized during the procedure. In order to prepare the crown, your dentist has to file down the entire tooth. All that drilling can cause the tooth nerve to be irritated or inflamed afterwards.
The traumatized nerve can have symptoms after the permanent crown is placed or even after the temporary crown is glued in. If your tooth hurts after the temporary crown, your dentist may need to give it 2-4 weeks for the nerves to calm down before putting in the permanent one.
If the pain starts getting worse, you may need to have the nerve removed with a root canal procedure. This is because the temporary crown shouldn't hurt if it is healthy.
Tooth decay under the crown
Just because your tooth has a crown covering it, it doesn't mean that it can't get a cavity underneath of it. The porcelain on the crown can't get a cavity but the margin where your crown meets your natural tooth IS susceptible to tooth decay. This is why it is important to angle the toothbrush towards the gum line when you brush to make sure the decay doesn't form on the margins.
Having a cavity form underneath of the crown will cause either pain or sensitivity. The sensitivity can be felt when foods that are hot, cold, sweet, sour, acidic, and spicy are consumed.
An infection can form inside of the crown where the nerve is or in the bone at the tip of the root. The abscesses that form can cause a lot of pain because they tend to swell up in size.
Since the tooth is covering over the abscess, the growing infection will cause you to feel a lot of pressure in the crown. That pressure will feel like excruciating pain. Other signs of an infection or abscess include:
Throbbing pain or pulsating pain
Pain that comes and goes
After the crown procedure the gums could be very sore due to collateral damage from the drill. It is often inevitable for the gums to get nicked during the crown preparation with a drill. This can cause the gums to be a little tender and sore afterwards.
The tender gums could also be potentially from the cord packing part of the procedure. This is when your dentist packs a small piece of cord to push the gums away from the prepared tooth so that they can take a more accurate impression of the tooth.
The dental crown is suppose to protect the tooth but if you bite down on something really hard the wrong way, you can cause a fracture to form underneath the crown. The crack can develop in the tooth and not the crown. When this crack gets larger and reaches the pulp, you'll start to experience an intense throbbing pain that comes and goes.
Instead of the tooth inside the crown getting damaged, the crown itself can be fractured. A fractured crown can come in many different forms such as having part of the porcelain chip off. In a more severe situation, half of the crown can even fracture off!
If you sustain a fracture that splits the tooth in half, you will need a new replacement. That means you will have to go through the entire procedure again.
Individuals who grind their teeth at night will put a lot of pressure on their crown. When this is done repeatedly night after night, the tooth can become irritated and inflamed. This will eventually lead to tooth pain. The type of pain you get from teeth grinding will come and go but it'll often feel worse when you wake up in the morning.
In order to address this, you can have your dentist make you a night guard to wear so that it can protect your teeth and take the pressure off of them.
The crown covers the tooth and protects it from external stimulation but the gums are the ones that cover the root of the tooth. If the gums recede, you can end up with an exposed tooth root which will be sensitive to temperatures and acidity.
Crown doesn't fit
If the shape of the crown is too bulky, it can impinge on the gums and cause pressure. Sometimes if the contours of the tooth is not harmonious with the adjacent tooth, it can also cause a food trap and that leads to bleeding gums.
There are some claims on the internet that a dry socket can cause pain after a crown is placed. That is untrue because a dry socket can only occur after a tooth has been extracted so you cannot have dry socket pain in a tooth with a crown. You can have dry socket pain if the tooth with the crown gets removed.
Dry socket pain from a dental crown is FALSE information and fake news. From this point on, we will start blatantly calling out false information. That has no purpose and room on our LIC blogs by LIC dentists.
How can you tell if the dental crown is infected?
Only a dentist can diagnose an infected dental crown but if you wanted to know beforehand, here are some signs and symptoms of an abscess.
Throbbing jaw pain that travels across your face
Nerve pain that will spontaneously come and go without anything triggering it
Swollen gums that are poofy and red
A parulis that is present next to the crown, which looks like a pimple but it oozes pus.
How to definitively treat dental crown pain
Only your dentist can permanently cure pain coming from your crown. The reason is because the crown will need to be removed in order to determine what the cause of the tooth pain is.
Is the pain coming from a fracture?
Is there tooth decay under the crown?
Is there a nerve infection?
Is there a dental abscess?
Does the crown have a poor fit?
If the cause of the toothache is from either of the five situations above, it will most likely require a root canal and then a new crown to be made afterwards. It is usually inevitable for the old crown to be damaged during the removal process, which is why you need a new one.
Alternatively if the pain is coming from teeth grinding, only your dentist can make you a night guard. In addition to the guard, you may also be given a referral for a massage therapist or a physical therapist to treat the muscular pain that is related to your grinding muscles.
Home Remedies to treat pain after a dental crown
If you are unable to make it to the dentist, there are home remedies which can delay the infection or at least temporarily alleviate the tooth pain. These natural home remedies will give you some pain relief and the best part is that they're easily accessible at your local market.
Salt water rinse
Avoiding problematic food
You can always take over the counter pain medication to get some pain relief.
For a mild toothache you can take 600 mg of ibuprofen or 650 mg of acetaminophen every 8 hours.
For a moderate-severe toothache you can take 600 mg ibuprofen in addition to 1000 mg of acetaminophen. Studies have shown that taking both of them together can offer pain relief that is equivalent to taking opioids. PLEASE BE AWARE THAT YOU SHOULD ONLY TAKE THIS SO THAT YOU CAN GET SOME SLEEP. You should not be taking this for more than a day unless directed by a medical professional because that amount of pain killers is hazardous to your health. This remedy is only to hold you off until the next day for when you can see the dentist.
Salt water rinse
Salt has a natural antiseptic and anti-inflammatory properties. Rinsing with a teaspoon of salt in a glass of water can help reduce the amount of plaque formation and also reduce swelling. This can certainly help you slow down the rate the infection can spread.
Rinsing with a 6% concentration of hydrogen peroxide can kill half of the bacteria within 15 seconds. If it is bacteria that is causing you tooth pain, this rinse will certainly help keep the population of bacteria under control.
There are a lot of herbal remedies such as cloves, garlic, tumeric, ginger, chamomile, peppermint tea, and oregano oil that can help alleviate tooth pain. Most of them also have antibacterial properties as well.
Avoid problematic foods
If you're having sensitivity due to hot, cold, sweet, acidic, sour, and spicy foods it may be in your best interest to avoid eating them until you have the problem fixed. It doesn't help you to keep aggravating the issue and causing yourself discomfort.
How to prevention dental crown pain
The best way to prevent pain is to maintain a strict oral hygiene regime so nothing bad happens to your crown. You should brush for at least 2 minutes twice a day. You should also floss before you go to bed. Don't forget to use a mouthwash at least once a day
Rinse with listerine for 30 seconds.
Alternatively you can use coconut oil for oil pulling but you have to rinse for 15-20 minutes.
Last but not least, it is in your best interest to get a dental check up every 6 months or twice a year. This way you can catch problems while they're small and have them treated.
When to seek help
You should definitely get professional help from a dentist if the dental crown tooth pain disrupts your quality of life and the home remedies aren't helping. Your dentist may be the only one that can relieve your toothache.
Another situation where you may need to seek help is if you're having a throbbing toothache or if the pain randomly comes and goes. Both of these indicate that there may be a problem with the nerve of the tooth. Only your dentist can fix a tooth nerve problem.
Hopefully that answers all the questions that you may have on why your dental crown may be causing you a toothache. If you have any further questions you should schedule an appointment with your dentist for a consultation. Most of these problems need to be fixed by a dentist. There is simply no way around it.
As you can see, there can be a wide range of possible causes of dental crown pain. There is no way for you to tell what is causing the pain on your own. So what are you waiting for? Go make that appointment.
If you're ever in a pinch, you can always find an emergency dentist that can take you. That'll be your fastest route towards pain relief.