A dental crown is a custom-made cap placed over a damaged tooth to restore its shape, size, strength, and appearance. This protective restoration is cemented into place, covering the visible portion of the tooth above the gum line. While crowns are effective for preserving a tooth, sensitivity in the area afterward is common. Sensitivity often manifests as a sharp, temporary pain in response to temperature changes, pressure, or sweet foods. Understanding the timeline and underlying causes helps determine if the issue will resolve naturally or requires professional attention.
Sensitivity Immediately Following Placement
Immediate sensitivity, occurring within the first few hours or days after the permanent crown is seated, is a transient side effect of the procedure itself. The drilling and manipulation required to prepare the tooth can cause temporary inflammation of the dental pulp, known as reversible pulpitis. This irritation makes the nerve tissue react intensely to external stimuli like hot or cold temperatures. This post-operative thermal sensitivity is typically short-lived as the pulp calms down and adjusts.
The cement used to bond the crown can also contribute to initial discomfort by irritating the gum tissues or the prepared dentin layer. Dentin contains thousands of microscopic tubules that lead directly to the nerve; when exposed during preparation, they are vulnerable to irritation from dental materials. Your bite may also feel slightly uneven immediately after the procedure due to the restoration’s shape, which can place temporary pressure on the tooth. This mechanical stress usually fades as the jaw muscles adapt to the minor change in alignment.
Structural Causes of Delayed Sensitivity
Sensitivity that develops weeks, months, or even years after placement often indicates a structural or biological problem. One common long-term issue is secondary decay, which occurs when a cavity forms in the remaining tooth structure beneath the crown. Decay typically begins at the crown margin—the seam where the cap meets the tooth—if the seal is compromised or oral hygiene is insufficient. Bacteria and food debris can seep into this gap, leading to deeper decay that irritates the underlying nerve tissue, causing sensitivity, especially to sweets or pressure.
Chronic malocclusion is another cause, involving a crown that is too high. This constant, excessive force when biting down irritates the periodontal ligament that anchors the tooth, resulting in persistent discomfort. Gum recession also exposes the root surface below the crown’s edge. This surface is not covered by enamel and is highly sensitive to temperature changes. A more serious cause is a vertical root fracture, a hairline crack extending from the crown downward into the tooth root. This fracture allows bacteria to invade deeper structures, leading to pain when chewing and potentially a localized infection.
Diagnosis and Professional Treatment
If sensitivity persists beyond a few weeks or is accompanied by severe, throbbing pain, an immediate dental visit is necessary to determine the underlying cause. Diagnosis begins with a clinical examination, including the use of articulating paper to identify high spots on the crown that indicate chronic malocclusion. The paper leaves colored marks on areas of excessive contact, allowing the dentist to precisely shave and polish the crown surface for relief.
Dental X-rays are essential to check for secondary decay, which may appear as a dark area beneath the crown margin, and to assess the health of the underlying bone. If decay is detected, the crown may need to be removed to clean the cavity and place a new restoration. If the tooth’s nerve has become irreversibly inflamed or infected, a root canal procedure may be required. This treatment involves making a small access opening through the crown, removing the diseased pulp tissue, and then cleaning, shaping, and sealing the root canals. The access hole is then permanently sealed with a filling material, preserving the existing crown if it is structurally sound.