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Teeth become extremely sensitive. It has a porcelain crown. Treatment?

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Dr. Bibhu Dutt Nanda

Dentist

Practicing since :2010

Answered : 395 Questions

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Posted on Tue, 12 Feb 2013 in Dental Health
Question: I have a lower jaw tooth that became extremely sensitive to hot/cold/touch after receiving pressure from grinding. After wearing my night guard, the sensitivity went away. Now there is large hard lump at the bottom of my gum below that tooth. If I press it I feel only a very mild tingling. There is no residual pain or sensation. The tooth has a porcelain crown.
doctor
Answered by Dr. Bibhu Dutt Nanda 1 hour later
Hello,
Thanks for writing to us,
I will be glad to answer your query,
First of all, I would like you to know that whenever a tooth with a crown has pain or sensitivity to heat along with swelling, it clearly states presence of infection.
I assume you got a root canal treatment (RCT) done on your tooth before getting a crown over it.
I will advise you to see an endodontist, he/she will take an x-ray of the tooth,
If required, a repeat RCT might be needed followed by a new crown.
Before starting with the treatment, your dentist will prescribe antibiotics and painkillers to resolve pain and infection.
Until you see you dentist, the following measures should help.
1. Do warm saline rinses 3-4 times/day,
2. Use an antibacterial mouth wash(twice/day),
3. Do not apply warm compresses over the swelling,
4. You can apply cold compresses if required.

I hope you will see your dentist soon.
If you have any further queries, kindly write back.
I wish you good health,
Take care.

Above answer was peer-reviewed by : Dr. Aparna Kohli
doctor
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Follow up: Dr. Bibhu Dutt Nanda 1 hour later
Thanks for your prompt response.

I do not believe this tooth had a root canal before placement of the crown. (It's been a while.)

For clarification.....if the tooth is currently not causing ANY pain, is infection still the most likely cause? I'm currently not experiencing any pain in that tooth or even the lump. The lump doesn't appear to change in size. I've been on antibiotic therapy in the last month on two separate occasions, for upper respiratory infection and also for other dental work. I'm scheduled to see my dentist again in about 10 days, but wanted to get as much info together as possible before my visit as I've never had a problem similar to this. That is, no major swelling or lumps associated with an infected nerve.

I wore the night guard and the grinding no longer bothered the tooth. For a few days the only pain I felt was if I applied pressure to the actual tooth. After a few days that pain went away. My dentist has "tested" the tooth with applications of hot and cold water with no effect, then a few days later the lump appeared.

I guess I'm confused because there is now no pain present even though the suggested problem seems to be infection and need of a root canal. Shouldn't there be overall swelling (not just a very localized lump), moderately intense pain, and sensitivity to hot and cold? I haven't experienced these symptoms in weeks.

Thanks for your patience and information.



doctor
Answered by Dr. Bibhu Dutt Nanda 20 minutes later
Hello,
Thanks for writing back,
I would like to let you know that whenever a tooth hurts on chewing or applying any sort of pressure, most probable cause is inflammation of the soft tissues that surround the tooth. This kind of inflammation can either be from infection or from trauma to the tooth from grinding or from sudden biting on a hard object.
Sensitivity and pain can be from exposed tooth nerves , either application of certain medications over the tooth will resolve this problem or if it is severe then root canal treatment might be needed.
Also, the swelling is localized during the initial stages, only when the infection spreads, swelling becomes larger.
I am glad to hear that you no more experience any pain or sensitivity. Still, I would advise you to see your dentist.
I don't think you need to be worried here. Kindly keep a check on the size & color of the swelling if present.

Let me know if you have any more questions.

Above answer was peer-reviewed by : Dr. Aparna Kohli
doctor
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Follow up: Dr. Bibhu Dutt Nanda 10 hours later
Thanks so much for your info. My dentist called today to see if the knot had changed and I am scheduling a root canal and new crown. Even though there is no pain right now, I cannot take a chance. I now realize it is only a matter of time before it does go "bad". Since I don't want to experience that, I'll have it done ASAP.

I wanted as much info as I could get because every root canal I've ever had was associated with a very painful tooth. This one was confusing because it isn't hurting.

Thanks again and have a great week.
doctor
Answered by Dr. Bibhu Dutt Nanda 6 hours later
I am glad to know that you have scheduled an appointment with your dentist for a root canal treatment.
I hope this forum provided you with the best possible answer.
I wish you good health.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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