Temporary Crown Came Off

Question:

“My temporary crown came off during dinner tonight.  I purchased some OTC dental cement and used it to replace the temp. Holy Toledo! Talk about hurt!!! It’s been 1 hr (& 1 pain pill) ago & it’s still hurting! (it IS seated correctly as my bite is fine)
My dentist is several hours away so I cannot make several trips back & forth to get answers.  #1- does this pain mean I need a root canal? #2 if he seats the perm crown is it possible to do the root canal later on? Thanks for your help – I’m afraid it’s going to be a L-O-N-G night!”

Answer:

It’s likely that the extended exposure of your prepared tooth may have caused you some sensitivity and pain.  Your enamel has been removed in preparation for your crown and your dentin is exposed.  Dentin communicates directly with the pulp/nerve tissue.  This means when air, cold, or any other sensation hits your teeth, it will be interpreted as pain!  It doesn’t necessarily mean that you will need to have a root canal therapy. Your temporary crown may not be adequately sealed, thus causing a condition called reversible pulpitis.  It will easily go away once your tooth is properly protected.  Your dentist will be able to examine your tooth’s condition and determine what is necessary. We encourage you to get back to your dentist as soon as possible, where you can be provided with the appropriate professional services.

Let’s take a more detailed look at dental crowns and temporary dental crowns.  Also, look below for our chart on tooth pain interpretation.

Temporary Crown

A temporary crown is placed to protect a tooth or teeth that have been prepared to receive a permanent crown. The permanent crown is a ‘cap’ that is shaped like a tooth to restore a tooth or teeth to proper function, form and esthetics. The preparation of the tooth or teeth essentially involves removing some of the tooth structure so that the crown can fit comfortably on the tooth or teeth. Reasons you may need a crown include:

• The provide coverage and support for a tooth that has a large filling, with not much tooth structure left.
• To cover a dental implant.
• To restore a badly broken or worn down tooth.
• To protect a weakened tooth (for example after a root canal therapy).
• As part of a dental bridge.
• To restore desirable esthetics in discolored teeth or awkwardly shaped teeth.

Temporary Crown came off

If the permanent crown isn’t ready to be placed immediately after the preparation, a temporary crown is placed to protect the tooth. In the situation where your temporary crown came off, it is important to get it put back in place (as you did) as soon as possible. Even when there is a temporary crown loose, it needs to be re-seated. The main reasons:

• To protect the prepared tooth from fracture or other damage
• To prevent decay
• Maintaining coverage protects the tooth from sensitivity and pain due to exposed dentin

We hope this was helpful to you!

Save My Smile Team

Help, My Root Canal Failed

Question:

Question 1:

Why do root canal treatments fail?… What will be the solution to save the tooth again? [Are there] any good options?
Please share the good thoughts.

Question 2:

If root canal treatment failed – what will be next option to save the tooth?

Answer:

Today we had two similar questions from readers so we will address both.

Root canal treatments do not have a 100% success rate.  The success rate actually varies between 68% -95% depending on several factors involved including the presence of bacteria, the vitality of the tooth, etc.  A root canal treatment is just an alternative method to save a tooth when its pulp has become infected with bacteria.

Why do root canals fail?

They can fail for several reasons.  Some include:

• Bacteria left in the canal
• A “leaky” filling
  • This leaves pathways for bacteria to reinfect the tooth
• Missed canals
  • Sometimes teeth have extra or sneaky canals that aren’t easily found on an xray.  If the canal is missed during root canal treatment, there is a possibility of failure
• Systemic conditions
  • Other illnesses such as diabetes or complicated medical conditions can affect the success rate of treatment
• The tooth is fractured or have a crack

What’s the next step after root canals fail?

The reason of failure will determine the next step in treating a failed root canal.  Here are some options:

• Re-treatment
  • This includes removing the old root canal material in the canals (gutta percha), recleaning the inside of the tooth, disinfecting the inside again, and placing new material
• Apicoectomy
  • This is a dental surgery that involves removing just the tip of the root.
• Extraction+ replacement
  • If all else fails, the tooth can be removed and replaced with an alternative including a bridge, implant, or removable appliance.

Root canal treatments are a great way to treat a seriously infected tooth.  Unfortunately, some fail and other treatment modalities have to be introduced.  We hope this information helps in your understanding for treatment failures and alternatives.

Good luck,

SaveMySmile Team

Good luck!

I have tooth pain

Question:

Hi, I have been experiencing some weird tooth pain.  It comes as quickly as it goes and does not seem to last long( a few seconds) and has happened three times in the last 2 days.  It is not a throb pain, more a constant pain if that makes sense.  It feels like someone is touching ice cream to my tooth in the whole tooth but 10x worse, and is one of the worst pains I have ever experienced.  I am going to the dentist, I am just curious on your opinions.  Had a cavity filled in the tooth a couple months ago so not too sure why it would hurt all a sudden.  Thanks in advance.

Answer:

Thanks for submitting your question with us.  Now, the main piece of information that will determine the diagnosis of your tooth is:

Is the Pain provoked?

• Does the pain have a trigger point?  For instance, is it painful when you eat hot or cold food or drinks.
• Does the pain occur sporadically and unprovoked?  Does the pain come and goes as it pleases with no trigger point?  For example, the tooth becomes painful randomly throughout the day.
• Does the pain come when you bite down into food?  Or does the pain come when you open your mouth after biting down on food?

You’re probably wondering, why all the questions?  But believe it or not, answers to these simple questions can guide us down the right path to a correct diagnosis.  Let’s examine each answer:

Yes, the pain is provoked by eating cold/hot food or drink.

Then you have reversible pulpitis.  This means that you have slight inflammation of your pulp inside of your tooth.  This is caused by

• Bacteria/decay
• A recent deep filling without a protective base (Deep restorations need a protective layer underneath it to protect the tooth nerve/pulp)
• Recent deep cleaning

Reversible Pulpitis Treatment

Luckily, this can be easily treated by making a slight adjustment to the filling

No, the pain is not provoked by anything and occurs on its own

You may have irreversible pulpitis.  This means the pulp is damaged beyond repair.  This means that bacteria have leaked into your tooth nerve/pulp and are now irritating the tooth and needs to be removed to avoid serious infection.  Some signs of irreversible pulpitis include:

• Spontaneous, unprovoked pain
• On and off pain
• Continuous pain
• Pain lasts even after food/drink/or stimulus is removed
• Lying down or bending over produces pain

Irreversible Pulpitis Treatment

The treatment for irreversible pulpitis is a root canal treatment.

I feel pain when I bite down

Again, this indicates reversible pulpitis and can be treated by adjusting your filling.

I have pain when I open up after biting down

This indicates a fracture of the tooth.

Fractured Tooth Treatment

Treatment for this depends upon the extent of the fracture and can include anything from a new filling, or a root canal, or even an extraction.

For more information on tooth pain, check out our article here.

Also, see below for a descriptive chart of how to diagnose tooth pain.

We hope this helps and good luck,

Save My Smile Team