Inflammation under a crown
Grinding a tooth for dentures always carries the risk of inflammation of the nerve tissue within the pulp. When grinding, the entire upper layer of enamel, which protects the tooth thermally and mechanically, is usually removed and the pulp is surrounded only by the underlying layer, the dentin. The dentin has many small canals that have access to the pulp, so that the pulp is in more contact with the oral environment than before.
This means that bacteria can now reach the pulp more easily and consequently inflame it. The inflammation of the pulp causes the nerve tissue to die and the bacteria to metabolize these nerves. This produces gases that lead to an unpleasant feeling of pressure, the so-called acute pulpitis, an inflammation of the tooth pulp.
The pain can become so severe that the tooth chamber must be opened to remove the inflamed nerve tissue and relieve the pressure. The crowned tooth must then be treated with root canal. Usually, the crown can be removed without damaging it, so that it can be reattached after the root canal treatment is completed. If it is not possible to loosen the crown after the final insertion, a hole can be drilled through the crown, which is then closed again with plastic without a gap. In both cases, the crown does not fall out and can be worn further.
Toothache under the crown
Toothache under a crown can have multiple causes. If the cement under the crown has washed out, the tooth can hurt because the crown no longer seals tightly everywhere and protects the tooth. In this case, the crown and the stump are cleaned and permanently fixed with new cement and the discomfort disappears.
Furthermore, caries may have formed under the crown, which leads to complaints. The dentist must remove the crown and treat the caries, but it is possible that the old crown may not fit after treatment. If the tooth under the crown is not treated root canal, it is quite likely that the nerve within the nerve chamber will become inflamed, which can lead to severe discomfort. Either the crown is taken down and the nerve removed or, if the crown cannot be loosened, a hole is drilled through the crown, which can be completely covered with plastic after the root canal treatment is completed. Another reason for pain can be a fractured tooth.In this case the tooth is no longer worth preserving and must be surgically removed (tooth extraction).
