Pain after crowns

[Why Me]

Got a bunch of crowns inserted as part of a full mouth rehab. Soon after started a constant pain lower right at the end (region of tooths 45-48). My prosthodontist has tried a bunch of things to fix the problem: Extracted 48, wisdom tooth, as it was the first suspect. Then removed the crown on 46, did some gum work there followed by an RCT. Now he has prescribed muscle relaxant tablets in case it's a ligament issue.

 

I don't see any improvement. Still have to control the pain with a lot of Tylenol. Anyone had a similar issue? Obviously the problem is a  consequence of the crown insertion procedure. The prep work he did prior was long and at times painful so my guess is that something or other got impacted/traumatized. Hopefully, not a serious thing, just need a correct diagnosis. So a reco for an experienced prosthodontist in Bkk would be appreciated too.

[Swimfan]

Sorry to hear of your difficulties. Considering you had the work done by a prosthodontist I am very surprised they did not do root canal on all the teeth having crowns. As you can see now it is false economy to skip the root canal therapy prior to placing a crown. I have had extensive crown work done and all root canal performed as part of the whole treatment plan. It sound to me that you have an alignment issue that is causing pressure on your jaw.

[clivebaxter]

They can't always do root canal work, mine had closed up, happens sometimes in older people. I had similar last year when temp crown was on it never hurt but started to hurt a few days after the real one was fitted. Eventually it wore off but not until after I almost went in and asked him to take the tooth out. Took about a month to wear off. Oh I did have him grind it a bit lower as well.

Edited June 21, 2021 by clivebaxter

[Why Me]

18 minutes ago, Swimfan said:

As you can see now it is false economy to skip the root canal therapy prior to placing a crown.

Interesting you say that because the original treatment plan had 45 and 46 slated for root canal but then when he took a closer look the prosthodontist decided against it.

 

So when they ended up taking off the 46 crown and doing an RCT anyway I asked the endodontist wouldn't it have been better to have done it first like the original plan. She said an aggressive treatment like RCT is advised only when it is absolutely necessary. It would be "immoral" (her words) to do it otherwise. She said sometimes can happen that it's needed later and we have to deal with it.

[Why Me]

10 minutes ago, clivebaxter said:

Eventually it wore off but not until after I almost went in and asked him to take the tooth out. Took about a month to wear off. Oh I did have him grind it a bit lower as well.

Glad to hear of your improvement. Yes every visit, once a week past month, he's been grinding and doing this and that to me as well. Did some electric surgery on the gum too. But the damned pain is not improving which pi**es me off. It can't be anything crazy serious but just not being diagnosed accurately. 

[CharlieH]

I feel your pain literally ! I am part way through RCT and I wish I just had it removed than go through this for weeks.

[perconrad]

I have had pain in a tooth with crown, but it had root canal treatment. The reason for the pain was that the tooth had a fine crack in it which the prosthodontist did not see before I complained of pain in the tooth several times.

 

So out it went.

[clivebaxter]

12 minutes ago, Why Me said:

Interesting you say that because the original treatment plan had 45 and 46 slated for root canal but then when he took a closer look the prosthodontist decided against it.

 

So when they ended up taking off the 46 crown and doing an RCT anyway I asked the endodontist wouldn't it have been better to have done it first like the original plan. She said an aggressive treatment like RCT is advised only when it is absolutely necessary. It would be "immoral" (her words) to do it otherwise. She said sometimes can happen that it's needed later and we have to deal with it.

No need to take the crown off to do RCT after, they can normally drill though the crown and do it, so I was told by my dentist. Some seem to want to always do RCT, even without an xray, others are more cautious.

Edited June 21, 2021 by clivebaxter

[Why Me]

14 minutes ago, CharlieH said:

I am part way through RCT and I wish I just had it removed than go through this for weeks.

Yep, got a big lecture about extraction as the last resort, "too aggressive", bone loss, blah blah. But, hey, how about severe tooth ache that won't go away freakin' 24 hrs day in day out? I am popping 4-5 Tylenols a day which brings its own set of problems.

[1FinickyOne]

17 minutes ago, clivebaxter said:

No need to take the crown off to do RCT after, they can normally drill though the crown and do it,

I don't think that can be done...

 

You can try the dentists at BNH on Soi Convent... it is really tough to live w/that kind of toothache but you shouldn't have to.. a decent dentist can take care of it... they will start by tapping on the tooth/or crown to determine where the problem is... 

[Surelynot]

I feel for you......I had a double osteotomy to remove wisdom teeth that were still inside the jaw and had to broken up inside the jaw to remove them.........terrible pain, and it took over a year to go completely ......might not be much comfort, but maybe the pain will go....eventually.......fingers crossed for you.

[Swimfan]

just out of curiosity. Did they use a laser to map your bite ?

[kynikoi]

1 hour ago, Swimfan said:

Sorry to hear of your difficulties. Considering you had the work done by a prosthodontist I am very surprised they did not do root canal on all the teeth having crowns. As you can see now it is false economy to skip the root canal therapy prior to placing a crown. I have had extensive crown work done and all root canal performed as part of the whole treatment plan. It sound to me that you have an alignment issue that is causing pressure on your jaw.

 

Had a crown prolly 30+ years no problem.

 

Crown with root canal (infected due to crack in filling). Minor abscess at times, discomfort. Months ago I thought sure I would lose the tooth needing to have it pulled. It's got much better.

 

Your theory makes no sense to me at all

[riclag]

Over the years I have contributed handsomely to many a endodontis !

Get to the root of the matter! You probably already been to a few specialists !

Try a private hospital Dentistry department ! Thailand  ,especially in the rural areas have unique ways of practicing their Dentistry trade.

[riclag]

11 minutes ago, 1FinickyOne said:

I don't think that can be done...

 

You can try the dentists at BNH on Soi Convent... it is really tough to live w/that kind of toothache but you shouldn't have to.. a decent dentist can take care of it... they will start by tapping on the tooth/or crown to determine where the problem is... 

I had this done in the states,a crown without a Root Canal !  Can it be done in Thailand ! I don't know

[kynikoi]

All the research I did here in Bangkok to have a post and crown put in appears to be quite a bit more expensive than what I would pay in the United States.

 

My elderly mother was quoted us $1,7 00 for titanium post and crown the whole shot. This sort of work done in Thailand is now a scam for foreigners.

 

Prices range from 55,000 to 110,000 b does not include all of the scare tactics which drive the price up as well.

[1FinickyOne]

1 minute ago, riclag said:

I had this done in the states,a crown without a Root Canal !  Can it be done in Thailand ! I don't know

Yes. if you don't need a root canal you can just get a crown... as far as I know, the root canal is for when the root has a problem... I have had teeth break and just needed a crown

[chalawaan]

I've been very lucky, a number of root canals, in different countries, including renovating one of the original Aussie ones done years ago, which was some brilliant work by my Thai doctors, and I thought it might not work out.

Also had impacted wisdoms broken up in the jaw and removed, all with minimal pain and complications.

 

I also go every 6 months like a goody two shoes, its so cheap here to get checked and cleaned up B800, plus I think that pays dividends later in less complex work, and other issues needing work to begin with.. 

 

Saving teeth is always the best option if it can be done. 

 

Be careful with Tylenol it's paracetamol -and a very insidious liver destroying drug.  This may sound counterintuitive,, and it is NOT medical advice, but IMO opiate based painkillers widely available here on prescription, are way safer, overall.

Especially if you are not an addictive personality to begin with.

There's way too much hysteria and misinformation around opoids right now. It's not the drugs it's the criminality that prohibition has created around them. All too long to go into here. But Tylenol is way worse IMO as a short term moderate to severe pain management regime.

Edited June 21, 2021 by chalawaan

[clivebaxter]

21 minutes ago, 1FinickyOne said:

I don't think that can be done...

 

You can try the dentists at BNH on Soi Convent... it is really tough to live w/that kind of toothache but you shouldn't have to.. a decent dentist can take care of it... they will start by tapping on the tooth/or crown to determine where the problem is... 

Dentists seem to think it can

Can You Do a Root Canal Through a Crown | Directions in Dentistry Blog

[chalawaan]

16 minutes ago, kynikoi said:

All the research I did here in Bangkok to have a post and crown put in appears to be quite a bit more expensive than what I would pay in the United States.

 

My elderly mother was quoted us $1,7 00 for titanium post and crown the whole shot. This sort of work done in Thailand is now a scam for foreigners.

 

Prices range from 55,000 to 110,000 b does not include all of the scare tactics which drive the price up as well.

There are better options elswhere. Chaing Mai for instance. My dental clinic has been excellent and prices are very reasonable.

 

They offered me a selection of crowns with varying price points, AND my dentist even discouraged me to have whitening done. 

 

I know a young lady (foreigner) whose Thai female surgeon politely told her to go away when she wanted breast surgery, and to reconsider after children.

 

There are some skilled and very ethical medical people here, ask around for recommendations.

Edited June 21, 2021 by chalawaan

[lopburi3]

11 minutes ago, kynikoi said:

Prices range from 55,000 to 110,000 b does not include all of the scare tactics which drive the price up as well.

The most expensive crown, high grade gold, is not more than about 25k in my experience.

https://www.bangkoknewsmile.com/fee-table.php

[bkk6060]

Probably a cracked root I have had 5 of them.

Extract and get an implant.

Edited June 21, 2021 by bkk6060

[DavisH]

1 hour ago, clivebaxter said:

They can't always do root canal work, mine had closed up, happens sometimes in older people. I had similar last year when temp crown was on it never hurt but started to hurt a few days after the real one was fitted. Eventually it wore off but not until after I almost went in and asked him to take the tooth out. Took about a month to wear off. Oh I did have him grind it a bit lower as well.

Pain from the real crown can last a while until it "settles in". They do feel tight for a while. I have that with most of my crowns. 

In retrospect, If I was going to get my last tooth crowned, and it needs a root canal, I'd rather pull in and do an implant. I have one implant, and another to finish at the end of August. 

[clivebaxter]

1 hour ago, DavisH said:

Pain from the real crown can last a while until it "settles in". They do feel tight for a while. I have that with most of my crowns. 

In retrospect, If I was going to get my last tooth crowned, and it needs a root canal, I'd rather pull in and do an implant. I have one implant, and another to finish at the end of August. 

How much was the impant?

[Sheryl]

A couple of possibilities come to mind:

 

1 - crack in the tooth itself, perhpas below the gum line and hard to see on Xray

 

2 -  pain from another tooth nearby (it can be hard to localize source of tooth pain)

 

3- failed root canal

 

In any case clearly you need a second opinion.  There is an older man at the Dental Hospital that I liked but unfortunately I don't have his name. http://www.dentalhospitalbangkok.com/about_us.php

[impulse]

Okay,  I'll admit my ignorance...

 

Who has 48 teeth?

Edited June 21, 2021 by impulse

[CygnusX1]

I’ve had four gold crowns, without root canals, done in Thailand. Three were fine, but I was in a lot of pain from the fourth for a couple of weeks, enough for me to take Nurofen for the first time in my life. It stayed sore for a few months, but now a couple of years later, it feels fine.

[Why Me]

2 hours ago, Swimfan said:

just out of curiosity. Did they use a laser to map your bite ?

I dont think so. But might be wrong. They have fancy gadgets and my face was covered. Now come to think of it the prosthodontist told me he was going to give me a "new bite" but I don't notice a difference.

 

[Why Me]

2 hours ago, lopburi3 said:

The most expensive crown, high grade gold, is not more than about 25k in my experience.

Mine were 18k a piece, zirconium.

[clivebaxter]

I pay 8k these days, no point wasting money at my age, did have with gold a few years back