Severe toothache under the crown what to do. What to do if a tooth hurts under a crown? Prevention of toothache under a crown

Soreness of a tooth under a crown is a fairly common occurrence. To begin treatment, you need to understand what led to the development of unpleasant symptoms. Not always the pain occurs through the fault of the doctor, but in any case, you need to quickly get to see him. It hurts to bite

Causes of tooth pain under a crown

As a rule, before installing a crown. An artificial cap is attached to the tooth, which is deprived of sensitivity. It fulfills the aesthetic and functional properties of the missing element.

There are situations when, before prosthetics, the doctor does not perform depulping. There are certain indications for this, which depend on the type of tooth-replacing structure chosen, age and health status. This is fraught with inflammation in the neurovascular bundle, which is called pulpitis.

Often, a dead element in which a nerve was previously removed begins to hurt under the crown. The main reason for this symptomatology lies in the tissues surrounding the tooth:

• the space between the tooth stump and the crown;
• poor-quality endodontic therapy;
• gum disease and;
• pathological changes at the root of the element.

Tooth with nerve removed, if performed quality treatment, has no sensitivity. Therefore, he cannot provoke pain. There is a pain syndrome from the periapical tissues, which are concentrated in the depths of the jawbone and can become inflamed.

This occurs for the following reasons:

1. Not the entire nerve was removed from the canal. The root system can take on an atypical structure, while consisting of small branches or be curved. If such an arrangement of the nerve takes place, then it is difficult to remove it completely, as a result of which annular fibers remain in the canal. They cause pain. More details, you can read.
2. Poor filling quality. If the root canal was not filled tightly, into it from oral cavity or periradicular tissues seep pathogenic microorganisms that lead to the development inflammatory process.
3. Perforation. If the channels are bent from the outside, then there is a violation of the integrity of the wall. Most often this occurs when the doctor uses inappropriate tools, does not follow certain recommendations.
4. Periodontitis. The presence of a constant source of infection and periodontal pockets leads to the fact that through the edge of the gums pathogenic microflora seeps into the tooth. The patient experiences itching around the gums. If you do not take any measures, then after a while the cheek will begin to swell.
5. Cyst at the root. This neoplasm, which is located at the top of the root, contributes to the development of pain during exacerbation and the addition of a purulent infection.

Pain on pressure

Pain syndrome occurs most often as a result of breaking off the instrument. This happens due to inaccurate and inaccurate work in the canal of the tooth. It is impossible to remove the chip and the foreign body does not allow the root system to be hermetically filled. If you press on the tooth, then, while in calm state the patient is not worried.

What to do

Before prescribing a method of treatment, the patient must visit a doctor who can take a panoramic or targeted picture. Once the x-ray image is carefully examined, the doctor will be able to find what influenced the development of pain. Based on this, he will effective methods therapy.

You need to know that retreatment of a tooth is a long and difficult process, so you have to be patient. If you leave the tooth under the crown without medical intervention, then in the future you can lose it, as the subsequent development of the purulent process will lead to serious complications.

Dental treatment

You can eliminate pain with the help of the following dental procedures:

1. Unsealing root canal and thorough cleaning of necrotic oils. After the performed manipulations, the dentist will re-fill dental cavity. To confirm the quality of treatment, it is necessary to conduct an x-ray, and only then proceed to turning and manufacturing a new crown.
2. Root apices resection. This method of therapy is effective when pain occurs in the presence of a cyst or cavity with purulent contents. The advantage of this treatment is to preserve the integrity of the crown. Resection is surgery which is held under local anesthesia. First, the doctor will cut the gum and exfoliate from the tooth. An incision is also made in bone tissue to get to the cyst. At the second stage, the neoplasm is removed, and to restore the bone tissue, insert artificial materials (analogues of human living bone) into the resulting space. The operation is completed by suturing.
3. . This method of therapy is used for complex and advanced cases, for example, if previous treatments do not work. Removal is often performed for those patients who have had a crown on their tooth for many years, but they did not apply for treatment in a timely manner.

Treatment at home

Pharmacy medicines

To stop the pain syndrome that arose from the tooth under the crown, drugs from the NSAID group are used. These are non-steroidal anti-inflammatory drugs. But it is impossible to apply them uncontrollably, since a wide range of side effects which adversely affect the stomach and digestive system.

If the pain syndrome is moderate, then the following means should be used:

• Acetylsalicylic acid;
• Metamizole.

If it hurts a lot, and the pain is paroxysmal in nature, then the following medicines are suitable for its elimination:

• ibuprofen;
• Nise;
• Ketorolac.

If during the examination the dentist detects the presence of pus, then they are used for treatment antibacterial drugs. Most often antibiotics a wide range actions related to the penicillin group.

Folk remedies

If the tooth under the crown hurts, then you can stop the unpleasant symptom with the help of proven means. traditional medicine:

1. Gargling with salt and soda. To prepare the solution, take 10 g of each component and pour a glass of warm water. Mix everything thoroughly so that the salt and soda dissolve. Apply the rinse solution 3-4 times a day.
2. herbal decoction. It is necessary to grind the dried chamomile flowers, take them in an amount of 10 g and pour a glass of boiling water. Wait 1 hour, filter and use for oral sanitation. Carry out the procedure 2-3 times a day.
3. Kalanchoe juice. The leaves of this plant must first be washed with water, squeeze the juice using a garlic press. Moisten in a bandage and apply it to the affected gum. Conduct this procedure 3 times a day.
4. Aloe leaves. Cut the sheet in half, and then attach the juicy surface to the problem area.
5. clove oil. Must be soaked in oil gauze swab, attach to the inflamed mucosa. If this product is missing, then it is enough to chew the fruits of the clove and the pain will decrease.

Applying any of the above methods, it is important to understand that it does not guarantee a cure for the disease. To provide full assistance, you need to contact a dentist.

Possible Complications

If you do not treat the pain that has arisen in a timely manner and do not eliminate the cause that provoked it, then the inflammatory process will progress, affecting other teeth. This, in turn, will lead to their loss.

Preventive measures

Quite often, tooth pain under the crown occurs due to the fault of the patient himself. To prevent this from happening, it is necessary to observe all preventive measures:

1. Brush your teeth 2 times a day, and after each meal, rinse your mouth with a special rinse. This is the minimum maintenance that is required for an artificial structure.
2. Use an irrigator. Thanks to this device, you can remove food debris from those areas where Toothbrush unable to penetrate. If the oral cavity is bridge prosthesis, then the most “dirty” place remains the area that is located between the abutment teeth.
3. Use for mouthwash herbal decoctions, use floss and tongue brushes. This reduces microbial contamination, reducing the likelihood of their penetration under the crown.
4. Regularly visit dentists, notice the beginning changes in time and treat them in a timely manner.

The service life of crowns is 5 years, depending on the type of design chosen. If the crown does not fit well, has defects and signs of wear, then the likelihood that an infection will penetrate inside and pain will occur.

Conclusion

Pain in a tooth under a crown, a symptom that occurs different reasons. So before prescribing treatment, it is important to determine what led to the development of pain. If you start therapy in a timely manner, you can not only stop the pain, but also prevent the development of complications.

Dear readers of our site! In this article, you will learn about one of the classic problems of dentures. Very often, patients come to dentists who have a toothache under the crown. Pain may appear immediately and then pass. But sometimes discomfort worries the patient for years, and doctors only shrug their shoulders, inventing excuses so as not to redo the tooth.

But do not underestimate the danger of such a situation. Very often this can lead to complications. Also, do not rely on recipes on the Internet. So you delay the trip to the doctor, but you can aggravate the condition.

In this article, we will talk about why pain occurs, how to treat its causes and, most importantly, how not to harm yourself. It is customary to think that in such circumstances, only the doctor who put the crown can be the culprit of the problems. But it is not always the case. It often turns out that the patient himself is to blame for the situation. It's hard to figure this out, but it's possible.

About the causes of pain

• put on the processed tooth stump separately;
• used in bridge prostheses.

The main task of this product is to protect the processed tooth remains from further destruction and ensure a normal chewing load. Immediately after installation, soreness is normal. The patient needs to go through an adaptation period. Pain under the crown is associated with the process of processing the tooth with special nozzles. Another question is if the discomfort does not go away in a week or a month. This suggests that there are some processes that require the intervention of a specialist.

Therefore, if a tooth hurts under a crown, you need to figure out what causes pain.

1. Option one - inflammation of the dental nerve (pulp), if the doctor left it. Why does it occur? Sometimes it happens that an infection has entered the chamber where the nerve is located, causing inflammation. Then the crown is removed, treated (the nerve is removed).
2. The second option is overheating. It is not uncommon when during the processing of a tooth (turning) its surface becomes very hot. This is due to the fact that not all dental clinics the procedure is carried out with water cooling. This leads to nerve burn. First it inflames and then dies.

Treating a tooth from all sides as carefully as possible is not an easy task. The doctor must be very careful to avoid overheating. To do this, it is important to provide water and / or air cooling, to know exactly how deep the bur can go without the risk of damaging the pulp.

If these two simple rules are not respected, overheating and subsequent pain in the tooth are guaranteed. In some cases, the problem does not go away on its own. The pain persists, aggravated at night and interfering with sleep.

1. Inflammation of the pulp can cause bacteria that provoke the development of caries. As long as there is enamel on the tooth, it protects it from caries. But after turning, the bacteria begin to actively destroy the stump. As soon as the last layers of dentin are passed, nerve damage begins.
2. The tooth may hurt even if the nerve is removed. This means that the endodontic procedures were not performed correctly.

Let's consider the second option in more detail. For example, the channels may have a complex specific shape. It is difficult to clean them qualitatively. Therefore, particles of necrotic pulp, bacteria often remain inside. It is not uncommon for a channeling tool to break off inside. Also, doctors often pierce the canal being cleaned (root perforation).

Another common problem is that many dentists cannot fill the canals with high quality. In some cases, the material does not completely fill the space, in others it shrinks after solidification. When perforated, the filling paste is within the periodontium. The result of such treatment is inflammation and. As a result, pain can be both constant and with pressure.

It should be understood that one doctor, the therapist, is engaged in the processing of the tooth, and another orthopedist is engaged in the installation of the crown. And they are not responsible for each other's mistakes. If the orthopedist is experienced, he can detect a colleague's mistake and send the patient to retreat the tooth. In some situations, the problem is so serious that you have to insist on removal.

Video - Toothache under the crown

Error when installing a crown

Orthopedists are not gods and, unfortunately, not perfect. They, like any person, are prone to mistakes. One of the most common is overbite. In this case, the patient simply cannot fully close his jaw. At the same time, the doctor refuses to admit his mistake and sends the person home to adapt to an artificial tooth.

This tactic is not only wrong, it is harmful to the patient. Indeed, over time, inflammation of the root or TMJ occurs. At first, pain may be felt when biting, then they become permanent. This symptom does not appear immediately. It often takes several months.

Video - Why does a dead tooth hurt without a nerve under a crown

If the gum hurts

Patients with a newly installed tooth often feel like a newly prosthetic tooth hurts. But in fact, this is a phantom sensation. After all, at this moment, the area of ​​\u200b\u200bthe gums, on which the edge of the crown presses, shows pain. There are two options.

1. The sharp edge of the product constantly damages the periodontium, causing inflammation and pain. The pain intensifies and begins to radiate to the tooth. Very often in such circumstances it is difficult to understand where the source of pain is actually located.
2. If the margin of the crown is higher than the margin of the gum, food debris will clog into the gaps. Over time, this leads to the decomposition of these particles, the mass reproduction of bacteria, and inflammation. The tooth really begins to collapse along the crown. It rots, pulpitis begins and, as a result,. Thermal and chemical reactions. So, if you could not understand why a tooth can hurt from hot or cold, here is a logical answer for you.

Folk and pharmacy remedies to eliminate pain in a tooth under a crown

Let's talk about what are safe folk remedies and medicines from a pharmacy that you can safely use to save yourself from torment. The situation is simple, but at the same time complex. You don't know if your pain is temporary. If yes, then going to the doctor is a waste of time and effort in queues. Therefore, many think how to proceed further, how to relieve pain without outside help.

We are treated with herbs

Do not forget that immediately after the installation of a crown, pain may be part of a natural adaptation process. But doctors warn that normally this can last no more than three days. Approximately so much the gum needs to get used to the presence of foreign body. If the tooth under the crown hurts for a week or more, it is better not to postpone the visit to the doctor. But we will assume that everything is fine and you just adapt to installed prosthesis tooth. So, how to rinse your mouth to relieve the condition?

It is no secret that sage has been the most popular remedy at all times. it medicinal plant was used by healers even before the baptism of Russia and remains effective tool even now, with the development of pharmaceutical technology. Rinsing with a decoction and infusions of this herb helps eliminate bleeding, soreness, and others. unpleasant symptoms. Also, sage contains vitamins, trace elements that are useful for periodontal tissues. To prepare the infusion, you will need 1 tbsp. l. dry grass (leaves), which can be bought at any pharmacy. Pour them with 200 ml of boiling water, cover and hold for 15 minutes. Rinse your mouth with the strained solution. If the problem is really inflamed gums, you can easily fix it.

The third popular remedy for pain and inflammation is baking soda. It not only helps to reduce inflammation, but also significantly reduces the amount of harmful bacteria in the oral cavity. Soda has no contraindications, it is in every home, it is cheap. It is versatile, practical and effective. For rinsing, you will need a glass of warm water and a teaspoon of baking soda. Stir the powder thoroughly and use for baths on the sore area in the mouth. You don't need to rinse your teeth with baking soda. Just hold warm water in your mouth over the place where you feel the pain. As soon as the water in your mouth cools down, spit it out and fill the glass with fresh water. Repeat until the pain subsides.

If the problem is in the gum, after 10-15 minutes you will feel relief.

Home first aid kit

If, after installing the crown, your tooth hurts, and rinsing does not give the desired result, you should take advantage of the achievements of modern pharmaceutical science. Fortunately, they are numerous and varied. The main thing at the same time is to read contraindications so as not to harm yourself.

Dentists themselves often prescribe various pills to patients that relieve pain after an intervention that is traumatic for the teeth and gums. These are Ketorolac and its derivatives - Ketorol and Ketanov, as well as Nurofen (Ibuprofen) or Tempalgin. In most cases, it is impossible to buy Ketorolac without a prescription. However, this drug is the most powerful tool from pain. It is prescribed even after bone fractures.

Some patients try to save themselves with analgin. But its efficiency is too low, and side effects too serious to use toothache tablets. The USA, Canada, Japan, Denmark and a number of other countries have long banned analgin, because it causes a decrease in neutrophils in the blood. Physiologically, this condition is manifested in a decrease in the body's resistance to bacteria and fungi.

Also, doctors often prescribe antiallergic drugs - antihistamines. The fact is that bacteria in the oral cavity, causing inflammation, secrete substances that the body perceives as strong allergen. Hence the swelling of the gums, pain, and other problems. There are many receptors in the human body. Each of them affects certain substances, types of exposure. One type of receptor senses histamines released by bacteria. AT this case inflammation is the response of the immune system.

The most common remedies for eliminating such unpleasant symptoms are Suprastin, Diazolin, Tavegil, Claritin, Zirtek, Diphenhydramine, etc.

Some of these drugs have side effects or affect the reaction. For example, Diphenhydramine causes drowsiness, and is often considered a sleeping pill. It is also important to follow the dosages indicated by the drug manufacturer. If you buy a separate plate without instructions, ask your pharmacist how to drink the tablets correctly.

What you should definitely not do is buy antibiotics at the pharmacy. Not only will they not help relieve pain, but they will also lead to such a harmful phenomenon as dysbacteriosis. Restore the flora in the mouth and digestive tract will take a long time. In addition, candidiasis or can develop.

10 effective drugs if the tooth hurts under the crown

Name	Description	Price
Ketanov	An effective pain reliever different nature relieves inflammation in 30 minutes when pain are characterized by acute	110 rubles
nise	It has the ability to block pain, relieve inflammation and act as an antipyretic component.	220 rubles
Nurofen	Affects puffiness, inflammation, relieves fever. The main advantage of the anesthetic is fast action(15-20 minutes after taking)	110 rubles
Baralgin	The drug has an antispasmodic, anesthetic, antipyretic effect, it is prescribed from the age of 15. Helps relieve minor pain	255 rubles
Analgin	The drug is rational to use with a weak pain syndrome. The effect is noted 30 minutes after taking the pill.	28 rubles
Dexalgin	It is rational to use with mild pain. For toothache, it is recommended to take 1 tablet. The effect comes in half an hour, lasts 4-5 hours	319 rubles
Paracetamol	The action is not inferior to Analgin, but is considered less dangerous. Suitable in cases where you need to get rid of mild pain	50 rubles
Pentalgin	The composition of the drug is multicomponent, in addition to paracetamol contains: caffeine, naproxen, pheniramine. It helps to effectively eliminate severe toothache.	150 rubles
Ibuprofen	The wide spectrum of action and properties of ibuprofen make the remedy effective for severe toothache.	20 rubles
	Effectively used for moderate or mild toothache. The tablet is taken before or after meals with an interval of at least 45 minutes. The drug begins to act in 30-40 minutes, the effect lasts about 1.5 hours	120 rubles

A tooth hurts under a crown - treatment in the clinic

Any, even the most expensive, is not eternal. Under it, the tooth may begin to deteriorate. This, unfortunately, natural process. The service life of crowns is from 10 to 20 years, depending on the material used. If after some time your teeth hurt under them, then you need to go to the dentist, take a picture, treat the tooth. Otherwise, you can easily lose it. And this means that you will have to put a bridge or implant a titanium rod into the bone. This prospect suits few.

The question is when exactly the tooth got sick - immediately, after a while or after many years. In most cases, the prosthodontist will refer the patient to have the tooth retreated to a general practitioner or, if there is a problem with the crown, rework it.

It often turns out that while wearing the prosthesis, the stump began to collapse and developed. It is necessary to prepare the tooth, remove the destroyed nerve, and clean the canals. In some cases, it may turn out that during the time the crown was worn, purulent inflammation developed under the tooth, a granuloma / cyst appeared, which must be removed. Sometimes the problem can only be solved by removing the causative tooth. The plan of treatment and further prosthetics depends on the results of the diagnostics.

It is most difficult to eliminate such problems during pregnancy. Half of the drugs, including anesthesia, are contraindicated. It is necessary to use the least dangerous means for the fetus. It is often recommended to reschedule procedures to a later date.

Preventive measures

What to do so that the teeth under the crown do not hurt through your fault?

1. Clean your teeth well. Use a brush dental floss, conditioner. Remove food debris from spaces between teeth.
2. Avoid heavy loads on the crown. Gnawing on seeds, nuts is not worth it. As well as trying for strength, opening beer bottles.

If pain occurs, you need to go to the doctor immediately, and not when the cheek is swollen due to purulent inflammation in the tooth. However, the absence of pain is also no reason to relax. Regular inspection is carried out every six months. Don't neglect these simple advice. They will save you not only money, but also time, nerves and health!

This concludes the article. We hope that our material has allowed you to fully understand the issue and now you know exactly how to help yourself if you have a toothache under the crown. Do you have any questions? Write them in the comments to the text!

Video - A tooth hurts under a crown, should I remove it?

If a tooth hurts under a crown, the reasons can be very different - from poor quality training before prosthetics until a foreign body enters the canal being sealed. It is most often possible to detect a problem only some time after the manufacture and installation of the prosthesis. Sometimes sharp pain under the crown may appear only after a few years, but whenever it occurs, an urgent visit to the dentist is a must.

Why does a tooth hurt under a crown: poor-quality preparation

Before installing a bridge or crown, the tooth is usually depulped, that is, the nerve bundle is removed at the root, and then the canals are filled.

Two problems can arise with poor-quality work of the dentist:

• Firstly, the canal may initially not be fully cemented, that is, purulent contents accumulate at the root apex during inflammation (periodontitis). This leads to the fact that a depulped tooth hurts under the crown, despite the previously removed nerve. This situation occurs when the dentist is not qualified to work with anatomically curved roots;
• Secondly, the cause of periodontitis may be low-quality materials, despite the complete filling of the canal. Over time they change their physical properties and sag, as a result of which many voids and pores are found in the filling, into which the infection easily enters.

Pain under the crown due to perforation of the walls of the root canal

Another defect in prosthetics, which explains why the tooth hurts under the crown, is the perforation of the canal being sealed, which is quite common. Its essence lies in artificial creation opening, which is a gate for infectious agents. This can happen in the following cases:

• With the mechanical expansion of a curved canal, when the dentist's tool, as a result of pressure, passes through the tissues of the tooth, perforating them. In this situation, the patient, even after installing the prosthesis, will feel pain under the crown, although the root canal is completely sealed along the entire length;
• If the pin is not installed correctly, which leads to inflammation in the deformed area and tangible pain in the restored tooth.

A tooth hurts under the crown due to the ingress of a foreign body

In the process of expanding the channels, the tip of the instrument may break off, and the doctor unintentionally or intentionally seals the hole with it. Therefore, when a tooth hurts under a crown, the reasons may be:

• Violation of the rotation technique of dental instruments that cannot be rotated more than 120 ° inside the canal. Usually, as a result of ignoring this paragraph of the rules, a breakdown of the expander is provoked due to the natural curvature of the tooth canals;
• Reuse of disposable instruments, which doctors resort to in order to save money. Expanders after sterilization can be used by the dentist several times, although they are intended for single use;
• Tool breakage due to anatomical anomalies of the tooth itself, when the roots are strongly curved and have difficult channels.

Regardless of the reason, when taking hot or cold food, the patient will feel that the tooth hurts under the crown, characteristic pulsation and exacerbation are also possible. discomfort when chewing, biting, pressing or tapping.

Before installing the prosthesis, it is necessary to make X-ray jaw to make sure that there are no canal defects, cysts and instrument fragments.

When a tooth hurts under a temporary crown

As mentioned above, preparation for prosthetics includes the preparation and grinding of hard tissues, as a result of which the root canals are exposed, which increases the risk of infection. Therefore, in order to avoid problems during the manufacture of a permanent prosthesis, a temporary crown is placed, the task of which is to protect the tooth from external influences and bacteria. In addition, it relieves the patient of inconvenience while eating and maintains aesthetics when smiling and talking.

If a tooth hurts under a temporary crown, this indicates untreated caries, poor-quality canal filling, improper fitting of the prosthesis, damage or loosening of the wall, as well as irregular oral care.

Treatment of toothache under a crown

The tactics of treating a tooth, both with permanent and with temporary crown individual and selected separately in each case.

The simplest option is the removal of the prosthesis and subsequent sanitation, but in this case it is impossible to put on the same crown again, as it is irreversibly deformed.

To date, there are methods of treatment in which it is not necessary to break the denture:

• Pain in a living tooth. In this case, there is a sharp pain, as well as a strong sensitivity to cold or hot food which means development carious process. The doctor removes damaged tissue through a hole drilled from the chewing side in the prosthesis, and then closes it with a permanent filling;
• Pain in the prepared tooth. If a depulped tooth hurts under the crown, then there are aching sensations that radiate to the temple and ear, which is an exacerbation of chronic periodontitis. In this case, the treatment tactics depends on the presence or absence of a pin. If the root canal is simply sealed, then by opening the crown, you can clean it, put the medicine, and when you visit the doctor again after removing the inflammation, install permanent filling. When the tooth is attached to the pin, periodontitis can be cured only with the help of an operation to resect the root apex. With this surgical procedure an incision is made in the gum, through which the focus of inflammation is removed.

If food gets under the prosthesis, this indicates its unsuccessful installation or deformation. The tooth hurts under the crown, and the gum becomes very inflamed. It is possible to alleviate the symptoms without removing the prosthesis only for a while, but in order to completely get rid of the problem, it will take complete removal crown, and possibly the entire tooth.

So, these are the main treatment options. However, it is worth noting that the dentist, depending on the tactics chosen, may encounter some problems. For example, with the inability to remove the pin without damaging the tooth, tissue perforation during refilling, or the duration of treatment, which, if chronic periodontitis can last up to three months.

Video from YouTube on the topic of the article:

Despite the high quality dental services in modern clinics, there is still a risk of inflammation of the tooth after crown prosthetics. In such a situation, it is important to find out what exactly caused the inflammatory process, and how to get rid of it with minimal losses.

Causes of inflammation under dental crowns

The statistics of inflammatory processes that form under the crowns are disappointing. The main reasons for the formation of inflammatory processes are as follows:

• Poorly fixed prosthesis, allows pathogenic bacteria to penetrate under the crown and act on the turned and receptive stump.
• Insufficient fitting of the prosthesis to the stump is the presence of gaps between the edge of the crown and the base of the tooth. This is a "wonderful" place for collecting organic food residues, their decomposition and "transformation" into pathogenic flora.
• Poor quality of endodontic treatment, in which the canals are not completely sealed or there are root perforations.

Symptoms of the inflammatory process developing under the crown

After the prosthesis is installed on the prepared stump, each patient dreams of trouble-free operation of the restored tooth for years. However, cases when the inflammatory process under the crown makes itself felt is not uncommon. You can suspect a similar problem by the following symptoms:

• Tooth pain under the crown, especially when pressed;
• Swelling of the gums in the projection of the prosthetic tooth;
• The appearance of a fistula;
• Root cyst, which a doctor can recognize from an x-ray or orthopantomogram.

What to do if a tooth hurts under a crown?

The unequivocal answer is to see a dentist as soon as possible. On the one hand, this way you can count on the maximum effective treatment, on the other hand, the ability to save the crown, which is especially important for expensive prostheses.

Treatment of the inflammatory process that has developed under the crown is possible different ways. Ideally, it is necessary to carefully remove the crown, preserving its integrity, treat the tooth, and then install the crown in place. However, it does not always work out that way, because well-cemented ceramic crown very difficult to remove without damage.

After the crown is removed (regardless of whether it remains intact), it is necessary to determine the cause of the inflammation. Usually, we are talking about the need for unsealing and treatment of the focus of inflammation. At the same time, it is impossible to immediately install the “old” or new crown - it will take 2-3 months for treatment, after which you can start re-filling the root canals. If all the procedures are carried out with high quality, but the photo of the teeth that “survived” the treatment of the inflammatory process under the crown is completely invisible

According to statistics, about 30% of root canals are processed with errors. Symptoms of the development of inflammation of the abutment tooth can be various states:

• - aching, acute, paroxysmal or constant, arching, most often associated with or. Pain under the crown with pressure occurs if the tissues surrounding the roots of the tooth become inflamed. The nature of the discomfort depends on the phase of inflammation - with a long course, the symptoms can be erased and mild.
• Swelling of the gums, swelling in the area of ​​​​the diseased tooth - such a sign indicates pathological processes and periodontal or gingival lesions around the crown.
• The appearance of a fistula is a hole in the gum from which fluid or pus is separated. This is due to inflammation of the root and surrounding tissues, when a fistulous canal is formed to evacuate the purulent discharge.
• Reaction to cold and hot - indicates a possible caries under the crown or pulpitis.

Causes of inflammation of the tooth under the crown

There are several main reasons that provoke discomfort under the crown. Acute toothache, which occurs independent seizures characteristic of pulpitis - inflammation of the pulp of the tooth. In some cases, it is possible to keep the tooth alive without removing the pulp before placing the crown. Under the influence of certain factors, for example, the carious process, the neurovascular bundle becomes inflamed, causing severe pain attacks.

However, a pulpless tooth can also hurt. In this case, the cause is often poor-quality root canal preparation before installing the crown. Many mistakes can be made:

• Inadequate cleaning of the canals, leaving infected tissue.
• The pulp is not completely extracted, channels are missed.
• Tool break.
• Perforation of the wall of the root canals.
• Removal of filling material beyond the top of the tooth or, conversely, filling is not up to the top.

If the inflamed tooth hurts periodically when pressed, does not respond to temperature stimuli, aching pain - the reason is inflammation of the periodontium.

Apart from inflammatory response pain may be associated with incorrect installation crowns - overbite and chronic gum injury also cause discomfort. And, finally, poor hygiene provokes the accumulation of plaque under the crown, which is fraught with inflammation of the periodontium.

What to do if the tooth under the crown has become inflamed?

It is important to understand that any crown has its own service life, so when pain symptom develops after 10-15 years of operation, you should think about the need to replace the structure. Pain in the first few days after installation is normal.

If the tooth begins to hurt some time after the installation of the crown, it is important to identify the cause of this condition. It is almost impossible to carry out a full-fledged diagnosis on your own at home, since in order to decide what to do and how to treat a tooth, you usually need to take an x-ray. On the pictures, you can evaluate the quality of canal filling and the condition of the periapical tissues. Most often, treatment involves primary or re-treatment of the canals.

It is always more difficult to re-treat a tooth, since for this you first need to remove the crown and unseal the root canals, that is, remove them from filling material. This can be accompanied by certain difficulties:

• Often placed in the root canals to strengthen the structure. It is sometimes quite difficult to extract them without breaking the root of the tooth and without creating a perforation.
• Modern materials for filling root canals are durable, so their removal is a laborious and lengthy process.

After unsealing root canal in the presence of inflammatory focus anti-inflammatory therapy is required. To do this, special temporary material is introduced into the channels, which should be there for 2-3 weeks. Next visit subject to availability positive results carry out permanent filling up to the top of the root. The crown part is restored with a new crown, which is strengthened if necessary.

In some cases, when it is impossible to heal the canals for one reason or another, they carry out surgical intervention– . To do this, access is created on the gum through the bone alveolar process to the affected roots, the top of the root is removed, carried out and tightly sutured.

In case of inflammation of the gums due to improper fit of the crown, or overestimation of the bite, it is also necessary to replace the structure - the old crown is removed and a new one is made, taking into account all the nuances.

What can not be done with inflammation of the tooth under the crown?

It is highly undesirable to ignore unpleasant symptoms - prolonged pain and inflammation can ultimately lead to tooth loss due to bone atrophy, an increase in the size of the focus at the roots and the spread of the purulent process to nearby structures.

Do not try to remove the crown yourself, as this may lead to a split or fracture of the tooth. It is not recommended to ignore the reception medicines, giving preference only to the methods of traditional medicine. Forbidden self-deletion disturbing tooth - at home it is very easy to infect.

When is it necessary to visit a doctor?

You should contact your dentist if you experience any of the following symptoms:

• Acute paroxysmal pain in the tooth.
• Aching pain when biting, which appeared some time after the installation of the crown.
• Swelling of the gums, swelling of soft tissues in the area of ​​the disturbing tooth, the appearance of a fistula (non-healing pimple) on the gum.
• Feeling of a grown tooth, the appearance of mobility.

Prevention

In order for the tooth under the crown not to hurt, you must follow all the doctor's recommendations for care. , as well as natural teeth, need daily brushing at least 2 times a day. It is important to carefully remove plaque from the interdental spaces and in the area of ​​​​the neck of the tooth, where the crown and the tooth are connected - in these places it accumulates especially intensively. After that, it is not recommended to gnaw nuts and other hard foods, as this can cause the crown to break off and cause pain.

Even if there is no discomfort after the installation of the crown, it is recommended to visit the dentist twice a year to monitor the condition of the prostheses and the oral cavity as a whole.

Useful video on what to do if a tooth hurts under a crown