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Dentistry/crown problems

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Question
Hello!
My new dentist replaced the filling that I've had for over 10 years, since it was pretty big and old. The tooth got extremely sensitive. She decided to do the crown on that tooth, it was the same deep pain after any kind of fruit or liquid I would drink, second crown within 2 months, felt the same, she's doing the third crown at this time... I'm really nervous, she told me if this feels the same, super painful, we'll have to do root canal. And this is all after she decided to replace a 10 year old filling that felt just fine and did not hurt at all...

Answer
dear ruta
the process of crowning involves trimming the tooth by nearly 30%. during this process the drill reduces the outer layers of the tooth by grinding because of which a) the nerve inside the tooth comes closer to the external surface, b) the nerve undergoes a lot of stress which is both frictional (due to the heat generated) and chemical (due to the adhesive used for sticking the crown).
now uncontrolled sensitivity can occur because of the following reasons:

1) the margins of the crown are not sealing the tooth on all sides.
2) the old filling may have caused a crack in the tooth which is yet undiagnosed
3) the drill nicked the nerve tissue during trimming.
4) the nerve of the tooth just died due to repeated treatment starting from the filling to multiple changes of crowns. a phenomenon called "stress pulp syndrome".
5) the nerve of your tooth is currently inflammed due to crowning procedure.
6) you have a metal crown thats conducting heat and cold temperatures very rapidly.
for 2,3,4 root canal is the answer
for 1: a better crown is the solution
for 5: reseating the crown with a clove oil containing temporary cement is the answer.
for 6: change the metal crown and get a ceramic crown.

discuss these with your dentist. take a print of my suggestions and explore the possibilities.

best wishes
dr mayank kaurani
india

Dentistry

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dr mayank kaurani BDS, MDS

Expertise

rootcanals, cosmetic dentistry, dental pain, cavities, tooth colored fillings, endodontic diagnosis, post & cores, ceramic veneers, composite fillings, dental whitening, bleaching etc. please remember: i cannot treat you online and neither can i touch your teeth or test their health! i can give you general suggestions and critically evaluate various treatments and offer my advice.

Experience

14 years of clinical experience. i am a professor in a postgraduate dental school, in the department of endodontics. my primary field of specialization is in endodontics and conservative dentistry. i am a consultant endodontist in private dental clinics and run my own clinic restricted to conservative dentistry & endodontics since 2006.

Organizations
DENTAL SPA, JAIPUR (INDIA). Mahatma Gandhi Dental College, jaipur(india)

Publications
new york state dental journal journal of contemporary dental practise

Education/Credentials
BDS, MDS (conservative dentistry & endodontics)

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