Dr. Hall,
Some months ago I went to my dentist with sensitivity in one of my molars to hot, cold, and pressure. It was agreed that a Cerec crown would be sculpted to replace the offending tooth. An appointment was made for several months later. The appointment was for middle of July. I was very impressed. Several days later I was still experiencing a high degree of discomfort still with hot and cold and pressure. I came in so he could “ease the crown”. It was better but still very sensitive to everything. He assured me that a root canal was not necessary. (This dentist was awarded the young dentist of the year in the UK two years ago.) I was called two weeks later and advised that I should give it another 8 weeks. By now I was going on holidays. During my holiday the pain became excruciating spreading to my entire jaw and creating radiating pain in the adjoining tooth. So much so that I had to buy pain killers. I took these for the duration of the holiday! I am now back 2 weeks, have stopped taking the painkillers and gradually the discomfort has disappeared. Lately, last few days, I can chew hard foods again, toast, nuts etc with the afflicted tooth. Hot and cold is not a problem anymore but I cannot understand it. I have had an ordinary crown applied before with no such problems, it was instant relief. it leads me to suspect that there is something else about “Cerec” crowns that I have not been told. Now it is still slightly sensitive but improving everyday and it would seem that the 8 weeks was an accurate prognosis. Hve you an explanation or clarification. Thank you for taking the time to read nd reply. Yours sincerely,
Erick in Ireland
Erick,
I would have the tooth x-rayed by a different dentist. It’s worth checking to see if the tooth is okay or not.
A Cerec crown is an excellent option. I have one myself. That isn’t the issue here. I’m just not sure why a crown would be prescribed for a tooth that is sensitive to hot and cold. That kind of sensitivity occurs because a tooth is irritated, and a crown preparation is additional irritation. Generally, if I saw a sensitive tooth and it also needed a crown, I would first remove the old filling and any possible decay, and then put some bonded buildup material or glass ionomer and wait to see if the tooth settled down. That buildup would serve as a core for the crown once the tooth settled down. If the pain persisted or got worse, the tooth would need a root canal treatment.
It could be that the pulp tissue in the tooth has died, and this is why it is now feeling better. When a tooth is sensitive to hot and cold, it is irritated. When the tooth starts hurting with intensity all on its own, it’s a reliable indication that it is infected and needs a root canal treatment. It will then get better only when the pulp tissue dies. After that, it may be sensitive off and on to biting, or may not be sensitive at all.
I am not impressed with awards like “dentist of the year” unless I know the integrity of the awarding organization and then maybe the selection process.
Dr. Hall
About David A. Hall
Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.