I saw my dentist for sensitivity to heat, cold, and pressure in an upper left molar tooth in late December. My dentist placed a crown over the tooth. But a few days later, the symptoms increased. I returned to my dentist, who said she would adjust the crown. I even asked her if I needed a root canal, but she said it was unnecessary. She told me that the tooth should settle down within three weeks. The tooth did not settle down, so I took Advil. Now the tooth is still slightly sensitive. I have not decided if I will return to my dentist or switch dentists because I was supposed to start Invisalign last month but cannot because my dentist has not resolved the issue with my crown. I am concerned that I might lose the tooth and need a dental implant. How can I tell if the problem is with the crown or my tooth? – Nate from San Diego
Thank you for your question
We recommend that you ask another dentist to x-ray your tooth. It is unusual for a dentist to use a dental crown to resolve tooth sensitivity without checking for infection.
What Causes Tooth Sensitivity?
A tooth is sensitive to heat, cold, or pressure due to irritation. Irritation may increase when a dentist prepares a tooth for a crown, reducing tooth structure on all sides. If you have tooth decay or an old filling, removing it first and applying bonding or a glass ionomer might relieve the irritation and allow for a dental crown. But if the irritation persists or increases, you need root canal treatment and a dental crown.
When Sensitivity Decreases without Intervention
The pulp (living tissue and nerves) likely died if tooth sensitivity decreases without your dentist’s intervention. And if that is the case, you still need root canal treatment.
The only way to confirm the status of your tooth is with an x-ray. If you are not confident that your dentist can resolve the issue, please get a second opinion. Although tooth infection can spread and result in tooth loss, prompt care can prevent the need for tooth extraction and a dental implant. Although it is disappointing to delay Invisalign treatment, it is best to resolve your concerns now rather than interrupt it due to a flare-up later.
Dr. Brian LeSage, a Beverly Hills accredited Fellow of cosmetic dentistry, sponsors this post.