Updated: Nov 17
Some discomfort can be expected after a crown is placed on a dental implant because you're not used to it. Try to recall the condition of your mouth without the crown and just the implant healing abutment. Now compare it to what is in your mouth with the crown on top of the implant.
Potential sources of discomfort:
Tight interproximal contact where you floss through.
High bite when you're chewing or eating.
Gum pressure such as the crown squeezing into the gums.
However the discomfort should be fairly mild and will go away after a few days on its own.
Although if the discomfort lasts more than a week, you may have an implant crown complication. Nonetheless, the culprit is usually from one of these two factors since the third one tends to go away on its own.
Do you want to know why there is momentary discomfort and what you should do if its a complication? Well, keep on reading.
Momentary discomfort is to be expected
The first thing that you need to understand that a lot of the perceived discomfort is because you're not used to the implant crown. It makes sense if you compare the before and after to having the crown placed on top of the implant.
Overall, the whole process should not hurt because you don't need anesthesia for it.
Before crown placement
Prior to getting the crown, the implant was completely submerged below the gums. You're not able to see it nor feel it. Basically what you're used to having is a wide open space where the implant is and where the tooth use to be.
The image above shows a small healing abutment that doesn't take up much space.
Essentially you're used to having nothing in that space at all. To make it worse, you've gone about your life with the implant in this state for the past 6 months or so. That is what you are now used to.
After crown placement
After you get the crown on the implant, it becomes a completely different story. Now you have this prosthetic object that fills in that missing gap. You've been used to having a gap for the past few months but now it is no longer there.
As you can imagine, the difference in size is going to take some getting used to. The actual crown is much bigger than the healing abutment.
How long does it take for the implant crown to feel normal?
It can take a few days or up to a week for the implant crown to finally feel normal. You can think of that time as an adjustment period that you have to go through. It is really no different than say adjusting to a new pair of shoes. It takes some time to break in and get used to.
Although you're probably curious as to what exactly is it that you need to adjust to. We will explain the sources of the discomfort in the next section.
Sources of implant crown discomfort
On the day you receive your implant crown, you can expect mild discomfort with the contact, occlusion, and gums.
Signs & Symptoms
Difficulty flossing; pressure against adjacent teeth
High bite; bite isn't even; pain when chewing
Gum tightness; tissue blanching; gum pain
The first source of discomfort can be due to tight interproximal contacts. This is essentially the space where you floss through. Your mouth could be used to not having a tooth there so all of a sudden you're feeling pressure between your teeth.
The x-ray above is marked to demonstrate to you where we're talking about when we say floss through. Either in front of the implant or behind it could feel tight. The pressure can come from the crown pushing on the adjacent teeth when it was inserted.
The second source of discomfort can be due to a high occlusion or a high bite. You will feel this when you bite your teeth together or when you're chewing food. If the crown is overbuilt and it is too big, it will generate a lot of pressure when you chew with it.
This problem stems from the dental lab which probably made the tooth cap too big. Although it isn't their fault because they only have stone models to work with. Your real mouth is different from a stone model so there was only so much they could do.
The third and last source for implant crown discomfort is from gingival pressure. Prior to having the crown put in, there was nothing on top of the gums. After it was put in, you now have this big prosthetic structure sticking out of the gums.
The image above shows how the crown has to squeeze into the gums, thus causing gum pain. Your mouth isn't used to having this brand new object inside of it.
The good news is that this source of discomfort usually goes away on its own within a week. Your body will naturally adjust to it. We've never had to make any adjustments for this condition on any of our patients.
How to treat complications
The gum pressure does not require any adjustments because it always goes away on its own. However the tight contact and high occlusion will need to be treated if it persists for a week. By that time your body has had enough time to adjust so it is now considered a complication.
Treatment for both of these two conditions will require a visit to the dentist.
Loosen up the contact
If the contacts feel tight, your dentist can relieve the tension by loosening it up. They just have to take the crown back off and adjust the sides of the crown.
Signs of tight contact:
Difficulty flossing through the teeth.
Feel pressure on the tooth in front or behind the implant crown.
Adjust the bite
For a high bite, your dentist can adjust the occlusion by polishing down the crown. First they will use articulating paper and have you bite down on it. It will leave blue marks on the crown for where the spots are "high".
All your dentist needs to do is to polish down these high spots. This adjustment is easier and faster than adjusting the contacts.
Signs of high bite:
Pressure when you close your teeth together.
Pain when you're chewing food.
Mild discomfort is to be expected after getting a new crown on your implant. Most of it has to do with the fact that it is new and you're not use to it. However if the discomfort persists after a week, you may have a complication such as tight contacts or high bite. Both of which will require a follow up visit with your dentist.