Expert: Steven C. Scherr, D.D.S. - 7/4/2006

Question
I have two temporary growns on the left back molars. The "bite" was off on one of the teeth, which caused pain for 2 days before I went back and the temporary was sanded down.The bite was adjusted, but the tooth still ached.
I was fiddling with the tooth since it hurt and the crown fell off one of the teeth.
I took tho other one off thinking it would solbve the pain problem.
Anyway...now the "stubs" hurt worse, especially when I  eat or drink.
What happens if I leave the temporaries off until Wednesday, July 5th, I can't get them back on.
Are crowns supposed to hurt forever until the permanents are put on?


Answer
Helen,

I am sorry to hear that you have been in pain.  There are several possible causes of toothache after teeth have been worked on.  Each tooth has a central nerve core that has a limited capacity to heal.  A little of this healing ability is used up every time a filling is placed, when it is chewed on, it is exposed to extremes of temperature, or when grinding/ clenching occurs.  Preparation of a tooth for a crown and placement of a temporary crown is no exception.  Any of these events may be the last straw that excedes the nerves healing ability.

The discomfort experienced means that inflammation is present.  This inflammation may be reversible or irreversible.  If it is reversible, it will get better, but may require several days or weeks.  If it is irreversible, then the nerve begins to die and may become infected.  Root canal therapy is then needed to remove the damaged nerve and save the tooth.

If a filling or temporary filling has a high bite, this irritates the nerve and contributes to inflammation.  Other possible contributors include a loose temporary crown, a crack in the tooth, or incompletely removed decay.

It is important to keep the temporary crowns properly cemented on the teeth in order to protect the area until the final crown is made.  This seals out germs and keeps the tooth from drifting out of position.  If you go a day or two without the temporary crowns, the teeth are likely to be more sensitive.  There is a low risk of additional long term damage.  However, the temporary crowns should be replaced within a few days.

Helen, I wish you well.

Steve