My dentist put a permanent crown on my tooth without a root canal and there's pain... Now what?

Part of my back molar broke off and there was pain. I had a filling on the tooth from years back. Part of the filling and a corner of the molar broke off. My dentist drilled around the tooth to shape it for a crown, and also did a pulp cap. Now that he put the permanent crown on, it is very sensitive to heat, cold and pressure. It also hurts out of the blue for a while and then goes away... and then comes back. My dentist almost did the same thing to another molar... I came in for the permanent crown on that tooth... my dentist was out that day. Another dentist did a root canal on it and scrapped the crown. I had to get a new crown after the root canal. I'm thinking my dentist screwed up on my current tooth problem just like he almost did on the previous one. I'm just wondering if the pain is normal and will dissipate after time, or will it need a root canal. Can you get a root canal after a permanent crown is already on the tooth?

My dentist put a permanent crown on my tooth without a root canal and there's pain... Now what?
It is customary to place a crown with a build up on a tooth that has sustained a fractured cusp; this is to keep it from fracturing more cusps or splitting completely making it non-restorable. This is usually due to an old restoration and a weakened cusp that may possibly have been undermined with decay due to microleakage over the years.





Occasionally the tooth has suffered too much trauma, or decay has reached the pulp or very close to it, allowing it to slowly cause the nerve to die. This isn't always evident on an x ray.





Your saying a pulp cap was placed tells me this was very close to the nerve with a slight exposure of one pulp chamber. Your dentist probably placed the pulp cap and a build up and proceeded with the prep placing you in a temporary crown, allowing time to pass, making sure the tooth settled down or healed prior to seating the permanent crown. The build up material is always placed to restore the missing tooth structure and then prepped, or reduced on all sides and top for the crown placement. This is normally done and if the tooth doesn't settle down, then he would proceed with the root canal. This in no way effects the permanent crown placement. The tooth is opened from the occlusal surface to reach the pulp chambers for the root canal treatment to be preformed. So the crown could still be used unless the actual margins (at the tissue) of the prep were changed. This change happens occasionally when the tooth has several fractures or weakened cusps and another cusp or portion of the tooth breaks affecting the margins during the root canal procedure. This would then require a new impression and crown to be fabricated. This is possibly why the dentist, who filled in for your normal dentist, had to have the crown re-made.





It is possible that your dentist was looking out for your best financial and dental interest by trying to save your natural tooth along with the cost of a root canal procedure by placing a pulp cap, which is what is what most try to do first. There are some that prefer to go ahead with the root canal therapy rather than take the conservative path.





The sensitivity you are having now leads me to believe that you may have been hitting heavy on this new crown from the initial seating, causing additional trauma to the nerve. Once a crown is placed it should feel the same as your natural tooth did, not like there is something new or foreign in your mouth. If a tooth is hitting heavy or "first" when a patient bites down and chews, left this way or un-adjusted for too long can actually cause the nerve to die thus requiring a root canal procedure to be performed.





Or it's possible that the tooth has suffered an irreversible trauma from the fractures and the near exposure even with the pulp cap and will require the root canal procedure after all. This would be the more likely scenario since it appears that your dentist has exhausted all measures to prevent this from happening. This alone does not demand new impressions be made, or a new crown to be fabricated with any additional cost added to this crown, only the expense of the root canal. This crown won't be removed, it would be nearly impossible to tap it off unless it's been placed with temporary cement, which is highly possible if he thought it may not recover. The root canal procedure will be performed by cutting a hole through the porcelain and the top of the crown, then filing and filling the canals through this opening and once when finished, will again have a permanent build up material placed where the tooth structure was removed.





The symptoms that you are experiencing now are that of a dying nerve and need to be addressed by your dentist as soon as possible with an antibiotic treatment and pain medication if needed, preferable prior to the initial opening of the root canal procedure for optimal anesthetic results. No, these symptoms are not ordinary for just a crown cementation and it appears they will not dissipate with time and that the only options you have will be that of a root canal treatment or extraction, which the later isn't really a good option to use.





So, from what you’ve stated, the only conclusion I can derive at is that you have an excellent dentist who is looking out for your best interest, financially and with your dental health. Go back and let him take an x ray and examine this tooth to make a proper diagnosis. He very well may tell you that this was what he was expecting, but hoping for different, that this tooth would reverse it's self and save you from having a root canal preformed.





I hope I've been of some help and that you will take my advice as quickly as possible to prevent an abscess from developing due to the nerve dying, which with the symptoms you mentioned; this tooth is displaying those now. Good luck and I hope all works out for you.
Reply:You can get a root canal if you have a crown already on it. You may run the risk of the crown being damaged during the root canal - if it is, you'd need a new crown. If the crown stays in one piece and was recently placed, sometimes you can just put a filling in the hole where they do the root canal.





How long you wait for the pain to subside is up to you. Best answer here is maybe it'll get better, maybe not.
Reply:maybe you went to a fake dentist(happened to me too)



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