Sometimes it can be evidence of a high bite and sometimes it can be because the tooth in question needs a root canal, but sometimes there is another cause. Last week a patient came in with the following symptoms: her tooth ached immediately after eating. The tooth that was bothering her had what appeared to be a perfectly fitting crown. The radiograph did not show any pathology and the cervical of the tooth which wasn’t covered by the crown was sensitive when touched with an explorer ( so I knew this was a vital tooth).
In my gut I believed that the crown which had been bonded in place, possibly may have become partially de-bonded and when she used it for chewing it was moving microscopically and causing her pain. I suggested that we try and remove the crown and reprepare the tooth to better cover the exposed buccal cervical dentin ( to kill two birds with one stone so to speak). I explained that I would place a well fitting temporary crown on her tooth and see how she did before proceeding further. If her symptoms went away, we would just make her a new crown and if they didn’t she probably would need a root canal.
She agreed to my plan and we removed her old crown and make her a temporary and I kept my fingers crossed. She returned today and she reported that her tooth was now comfortable. As it turns out my “gut” feeling was correct and no root canal was needed! I am glad my patient let me remove her crown to help make the definitive diagnosis even though the outcome was not a sure thing. Sometimes patients do not let me remove a crown that is fitting and opt to go straight to my root canal specialist for treatment. Once the pulp is removed from a tooth it usually gets comfortable, but when a crown is bonded and bothering a patient, I like to know the tooth really needs a root canal, or just a new and better secured crown.
Posted 28th November 2015 by lspindeldds