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Dentistry/Tooth pain following crown lengthening

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Expert: - 8/21/2006


Question
About 10 months ago, 12+ year old crown fell off badly decayed tooth, which had already had root canal. A new crown was put on but never seemed to "fit" right -always uncomfortable - felt a lot of pressure under the crown and began have episodes of pain in the tooth. The dentist would adjust the bit and I would experience temporary relief. After 6-8 months of this, dentist refered me to endodontist for review and possible retreatment of root canal. Endo said saw no evidence for retreatment, provided steriods for relief of pain and referred me to periodontist. Periodontist felt crown was compressing gums and and was deep against bone and performed "reverse" crown lengthening. Althouth I am still recovering (procedure was last week) same familiar pain is back. Pain with pressure under tooth, jaw hurts, hot and itchy on skin near jaw and pain radiating up near ear. Will familar pain go away as tooth area heals or should I consider a differnt *ugh* treatment? Tooth did not hurt at all prior to loosing crown.  

Answer
Hi,
It is difficult for me to give you a diagnosis without seeing you, but I suspect that the tooth might be fractured. Fractures are very difficult to diagnose, but pain on a root-canaled tooth upon biting is indicative of a fracture. I think that sending you to a root canal specialist was a good idea, and having a periodontist do "reverse" crown lengthening also was a good idea if indeed the crown was too close to the bone. However, if the symptoms do not get better, I would highly suspect a tooth fracture which may or may not be fixable. Talk this over with your dentist, or get a second opinion.
I hope this helps.

Best of Luck,
Joseph Zelig, DDS

Dentistry

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Joseph Zelig, DDS, D.ABP www.smileinthecity.com

Expertise

Dr. Zelig is a board-certified Periodontist and an expert on dental implants. Dr. Zelig can answer any and all questions you have about complex dental problems, dental implants, gum disease, treatment of gum recession, and treatment of a "gummy smile".

Experience

Dr. Zelig has personally placed over a thousand implants with excellent success and has worked with many dental specialists and educated them on full mouth reconstruction, esthetic dentistry, and dental implantology.

Organizations
American Dental Associateion, American Academy of Periodontology, American Board of Periodontology, North-Eastern Society of Periodontitis, New York State Dental Association, New York County Dental Society

Education/Credentials
I received both my dental degree (DDS) and my certificate in the specialty of Periodontics from New York University College of Dentistry. Dr. Zelig graduated among the top 10% of the graduating class. As a result of outstanding academic achievements, Dr. Z was elected into the membership of Omicron Kappa Upsilon- the national dental honor society. In addition, Dr. Zelig has lectured to general dentists and specialists on periodontal treatment and dental implants. He is a Diplomate of the American Board of Periodontology which recognizes periodontists who have made significant achievements beyond the educational requirements of the specialty. Board-certified periodontists have been examined by a panel of internationally respected peers and has been awarded Diplomate status. By successfully completing this challenge, Dr. Zelig has demonstrated a robust knowledge of periodontics, Continued professional development, Critical review of results of therapy, and interest in providing the best, most up-to-date care.

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