Sensitivity and Pain After a Crown: Normal Adjustment vs. Signs You Need to Go Back

Is sensitivity after a crown normal, or has it failed?

In a tooth whose nerve was kept, sensitivity right after placement is not unusual and does not by itself mean failure [1]. When dentin is irritated during trimming, the tooth can become sensitive to cold. This commonly fades over time, though how long varies from person to person [1]. Sensitivity that appears only after the final crown is cemented, when the temporary crown felt fine, can also be related to irritation from the bonding process [3].

When DentStat analyzed 1,500 patient comments on sensitivity and pain, it was the largest theme among problems after restorations, with repeated questions asking where normal adjustment ends and a problem begins [4]. A pattern of anxious searching at night or on weekends, when people could not see a dentist right away, also stood out [4].

Why does it hurt only when I chew?

A common cause is a new crown sitting slightly high so that force hits one spot first [3]. In this case, many are solved by bite adjustment, and it is checked first before jumping to a nerve problem [3]. Doing the bite adjustment over several visits is within the normal process, but if pain continues after repeated adjustment, the cause may not be the bite, so it is re-examined [3]. The comment analysis showed many anxious questions from people whose pain remained after several adjustments [4].

What does it mean if it throbs even when I am not doing anything?

Pain without any trigger or pain that gets worse at night (spontaneous or nighttime pain) is known as a sign that pulp inflammation needs to be ruled out, rather than temporary sensitivity [2]. Unlike a brief twinge from cold, severe pain with hot things, pain that lingers long after the trigger, or ongoing pain when the tooth is tapped call for checking the nerve [2]. With these signs, the next step is to go back and find the cause with X-rays and other tests rather than wait [2].

I even had a root canal. Why does it still hurt?

Even a tooth with a completed root canal can have lingering discomfort from healing of the tissue around the root, the bite or gum irritation [2]. Contrary to the expectation that removing the nerve means no feeling at all, the tissues around the tooth still have sensation, so discomfort or a pressing feeling when chewing can continue for a while [2]. However, if pain worsens or comes with swelling or pus, root tip inflammation and similar problems need to be checked, and retreatment or root tip surgery may be considered [2]. In the comment analysis too, many reacted anxiously, assuming pain after a root canal meant failure [4].

When should I go to the dentist right away?

The following signs are summarized as cases that need to be seen rather than waited out as normal adjustment [1][2].

• Sensitivity or pain that does not ease and keeps getting worse [1]
• Throbbing without any trigger, or pain that wakes you at night [2]
• Gum swelling, pus or odor [1]
• Severe pain with hot things, or lasting pain when the tooth is tapped [2]

If symptoms start at night or on a weekend, you can find clinics open by region at night dental clinics and Sunday dental clinics.

The overall distinctions between crowns and inlays and the insurance rules are covered in the crown and inlay guide, and regional clinic data in Find a dentist.