Toothache in an existing crown - what can be done?

[Flightty]

I don't know if anyone can advise at all, I'd appreciate it if so.

I have an emergency appt tonight because one of my teeth is really, really sore. It's been hurting since Thursday/Friday, and it's played up briefly before and I was given antibiotics (didn't take them the first time) so I asked for some this time, and was given a script.

I started them on Friday and it's got so much worse since last night, now if anything touches it, including my lip, or any food or drink it is agony.

I am pretty sure it's an infected nerve as it still has one apparently, and my own dentist took an x ray and said he might drill through the crown and take out the nerve, so I'm hoping that's what they will do tonight. But I'm not sure if they will be prepared to do that on an emergency basis.

Also, if this is done, will the crown be likely to fail or should it be ok?

And if they can't/won't do that tonight, is there anything they CAN do to get me out of extreme pain? I've been counting the minutes since this morning and don't know how much more I can handle.

btw I'm on Nurofen and just bought some naproxen but can't take it till 8pm, 4-6hrs since last dose of nurofen apparently.

Thankyou.

If it is an infectd nerve then the only thing that will fix it is drilling & removing the nerve. It will go away on its own given time which is why many people think antibiotics work. They don't.

About 20% of teeth which still contain a nerve will die when they are crowned. The process of dying involves the nerve becoming necrotic (like gangrenous). Think of tying a piece of string around your finger, it starts to throb but the nerve cannot swell because it's inside the rigid tooth. The very disturbed blood supply means antibiotics/painkillers can't get there and all in all it's pretty shit.

I very much hope you find a dentist who will remove the nerve but I would understand it if they were reluctant to drill through another dentist's crown (you have paid for it & presumably don't want a hole in it forever!). It can alos be very hard work drillingthrough them, depending on what they are made from & the quality of the metal (more expensive=higher gold content=sofer & easier).

sofer=softer

I had root canal through a crown. Not ideal but it worked.

OP fingers crossed it's sorted by now .

Grumpy Is it normal practice to leave a nerve in a tooth when it's crowned ? ( so 20% of people may end up like Flighty ? ?

Or is not always possible to tell if there's a nerve there ?

Not criticising dentists ( more I read more in awe of them I am ) just trying to understand . ( and frighten myself ! )

Yes it is normal. Root canal treatment is last ditch stuff so only when necessary. Some things make a tooth more likely to die. Decay, large fillings prior to crowning. Gold crowns are better than porcelain at keeping the tooth healthy.

Lots of different scenarios!!

Oh thankyou very very much, I didn't manage to read your replies as I was pacing the house waiting for my folks to turn up and babysit my contagious child so I could go and have it done!

I started to get a bit feverish and that freaked me out, so I'm glad I got the appt when I did - but anyway, the dentist was brilliant and gave me the option to try stronger antibiotics or try and begin the RCT. So I bit his hand off to take out the nerve, as I thought leaving it in there was no use to anyone. (I didn't know it would go away by itself...wow...but perhaps not worth the risk of systemic infection?)

So big injection into top lip (Angelina eat your heart out) and he seemed to drill through it no problem, very quick, scraped away at it and got the nerve out plus a load of stuff I shan't go into detail about...one of our chickens had an abscess a while ago, it smelled the same < that's not envy, that's my face.

It did really hurt still while he did it but that's because it was so bad I think, the anaesthetic didn't work completely. But it was better than before.

Then he pretty much chucked me out and told me to double up on the amoxy for the rest of the course (only 3 days worth) and see my own dentist again.

I have an appt in 3 weeks, is that soon enough do you think? It was horrid last night but when I went to sleep, I slept pretty well and it only hurts to bite on this morning so am trying to eat softish stuff,

Thankyou very much again for your advice. It all makes sense. I feel vERY lucky that he was prepared to drill it - I've had this crown must be about 7 or 8 years now, so it's done well. I'm not fussed about the hole in it. Gotta do what you gotta do

Don't want to steal your thread but I have a 10 yr old crown thT I had root canal for and it's started hurting now in and off. What could this be?

Darling, you can have my thread

I am just so bloody relieved this morning. Yesterday was awful.

I'm not sure why your crown is hurting. It might be worth getting the bite adjusted on it, that means they just take off a little bit...you could have bashed it and upset the hammock nerve that is like a sort of cradle at the base of it, other than that I don't know. It's possible to get infection in a root filled tooth, sometimes if persistent they will do an apicectomy which means they go in through the gum to take off the tip of it and that has a fairly good success rate I am told.

Ask your dentist next time you're there and see what they reckon.

I've just had a retreatment of root canal through a crown. Was 4 1/2 hours of work. Fortunately my dentist said they would be unable to carry out the work and referred me to the Dental hospital who carried it out for free, so bonus :) IMO it was the only option as I did not want an extraction and to be left with a gap, even if it is at the back of my mouth.

There ate two parts of a tooth that can cause pain. The infected smelly nerve that OP had removed, and the ligament that holds the tooth in. In OPs problem the first infection causes the ligament to be sore, hence pain on biting. It's likely that if the tooth has been root filled already then there is some residual infection around the root. There are lots of ways up treat/manage this depending on lots of factors so you need to see your dentist really.

OP , where there is lots of infection, the area becomes acidic & anaesthetic works best at neutral. This is why it can be sore. Three weeks will give the infection time to settle & so should be painless next time

I think mines was that the treatment had not originally gone to the end of the root iyswim. But it was fine for about 10 years and then started seriously hurting whilst i was preggers. Has taken about 1.5 years to get through my own dentist then waiting list at dental surgery for treatment though!

Grumpy, you're a star, thankyou SO much. I am a bit worried these antibiotics wont be enough, maybe I should ask for some more 500s? I don't know. Only got a day and a half of 500 dose left.

Will see how it goes.

Thanks again