Temporary crowns pain etc!!?

I finally saved some money and got much needed dental work done. The total plan was done at a very large dentistry network with ortho, dentist, cosmetics, full mouth reconstructions etc are done, so I felt I was in great hands.





After the first appt., free evaluation, and about 30 X-rays later I was shown the game plan. I may be saying this wrong, but I had 4 extractions in the past, so 4 crowns with bridges were needed, 2 root canals, ZOOM II whitening, full cleaning, then Invisalign braces. Total bill 16k. I didn't save that much, but the dentist insisted to save the teeth around the extractions a bridge was necessary. Let me add I have NO MOUTH PAIN WHATSOEVER!! I'll fast forward to now on one side lower 1 root canal and temp crown/bridge. Same side upper he grinded a filled tooth down and put crown/bridge. This was 4 days ago!! I can't eat at all on that side, if I push on the upper or lower temp. crown/bridges it hurts this can't be normal can it? I'm starting to regret this 16K

Temporary crowns pain etc!!?
The grinding down has caused a misalignment in your bite which will be corrected when the crown is placed. In the meantime, some tylenol or ibuprofen would be appropriate. Since this is being done in stages, you can stop at any time, allow your mouth to heal, save some more money and then proceed with the rest of your plan.
Reply:This pain is in normal range if it was only 4 days ago, your gums and teeth had major surgery and needs time to heal and the temp does not help it at all but it will get better and once you have you crowns and bridge on, this will be a distant memory.
Reply:First let me emphasize that this process isn't going to be pleasant. Sure you are paying a lot of money to get a service, but such service comes with the understanding that mild pain and discomfort will be part of the process of replacing lost teeth. Temporary crowns and bridges are temporary for a reason. The dentist and his assistants do their best to make a custom temporaries in a relatively short period of time. These temporaries are inherently porous and do not insulate the underlying tooth as well as the final product. The dental lab ceramists have many, many hours to fabricate ideal contours and margins with the help of computers and various devices. Once the final product is cemented, discomfort and pain should be a thing fo the past. With that said, the number one problem with dental temporaries is the bite not being just right. Even a slight high spot, especially on a multi-unit bridge, will be noticably painful and sensitive to cold. Also, as I mentioned, temporaries are prone to shrinkage and flexure with oral temperature. Cold fluids and foods will shock these areas and you should chew on the opposite side or avoid these foods until the final crowns and bridges are placed.





Take ibuprofen for mild pain, but see your dentist to make sure that the bite is correct. If your temporaries fail long before the final products are fabricated, the dentist will have a hell of a time making adjustments on the day of cementation.





Good luck.
Reply:A small differnce in the correct fit can cause inflammation and swelling. This will subside once the problem is fixed.
Reply:1. Any crown or bridge preparation damages teeth, just as does any filling. Thankfully teeth are fairly resilient and can recover from the insult in most cases after a couple of days.


Whereas most cavities go into the depth of the tooth and therefore the deeper the more likely you will have post-op pain, with crown preps it is usually shallower but over a much wider area, so same post-op pain can occur. There is a 5-10% chance of irreversible nerve damage which leads to a Root Canal Therapy - this should've been explained to you for your informed consent.


2. Depending upon the angulation of the teeth supporting the bridge, sometimes the preparation can be deeper than usual. The final preparation on the supporting teeth (abutments) must ideally be parallel to each other. If the teeth are tilted, then the preparation might go deeper than usual, and therefore more post-op pain is likely. For some tilted teeth, where parallelism would cause too much deepening, then the bridge should be made in 2 separate parts with a semi-fixed connector (male/female) slots.


3. The temporary crowns are cemented on with a temporary and soft cement. Usually this is a zinc oxide/eugenol cement that has some painkilling properties. However, it does start to leak after a few days, and it is important to get the real bridges back ASAP.


So, either you are having standard post-op pain which you should control with ibuprofen; or the prep was deeper than normal; or they didn't use a eugenol temp cement; or the temp cement is leaking. Ring the dentist.