Why is the enamel grinding procedure carried out?
Grinding of teeth involves removing a layer of hard tissue (enamel and dentin), so that the orthopedic structure subsequently installed on the “support” looks natural and beautiful, fits tightly, is securely fixed, has stability and strength. This is also done to ensure that microbes do not get under the prosthesis or food debris gets clogged, which together can provoke the development of an inflammatory process.
On a note! Typically, the doctor removes a layer equal to the thickness of the chosen prosthesis. If a crown or bridge is installed, the tooth is ground down to a cone shape. When turning for microprostheses, for example, for veneers, the specialist “cuts down” the enamel in the frontal, lateral and cervical areas.
Often after the procedure, the patient’s gums around the ground tooth hurt, or the prepared element itself ache. Naturally, discomfort does not arise immediately, but after the anesthesia wears off. For some people, discomfort does not appear until several days, weeks or even months later. What is this connected with? We'll figure it out together.
Causes of pain
Unpleasant sensations can arise for various reasons. Sometimes this is a common reaction after the procedure, because the tissues need time to heal and adapt to the new structure.
Usually the pain is aching in nature and lasts no more than 3 days. If the pain is acute, does not go away and even intensifies, or at first it was not there, but some time after installing the crown it appeared, you should consult a doctor. Perhaps inflammatory processes have begun, and it is no longer possible to do without medical help. Causes of toothache under a crown.
The process of installing a crown on a tooth is a team effort of three specialists: a dentist-therapist, an orthopedic dentist, and a dental technician. A mistake in one of them can lead to unpleasant sensations.
Causes of painful sensations in teeth
1. Physiological response to intervention
This is the most common reason why teeth and gums hurt after grinding for crowns and other orthopedic structures. After all, during the procedure, the specialist acts on the tissue instrumentally and medicinally, touching the nerve endings. This reaction is considered normal.
On a note! If, after grinding teeth, hyperesthesia (increased sensitivity) and aching pain appear, especially during the consumption of cold, hot, sour and spicy foods, and hygienic cleaning, then this often simply indicates a thinning of the tissue area of the prepared unit.
Most often, hyperesthesia after turning occurs on vital, that is, living units where the pulp is preserved. Sensitivity is enhanced even despite the presence of temporary crowns, which, it would seem, serve as reliable protection from external irritants. Temporary structures are fixed immediately after preparation and worn until permanent dentures are created.
Medical errors
If a tooth or gum hurts after grinding, then unqualified actions by the doctor cannot be ruled out. Most often, inexperienced specialists make the following mistakes:
- overheating of the pulp: occurs when preparing tissue with a bur,
- removing too much tissue,
- nerve injury: to avoid complications associated with damage, overheating or inflammation of the nerve under the prosthesis, experienced specialists advise depulping the tooth, that is, first removing the pulp from it.
If the doctor made the mistakes listed above, then the pain makes itself felt almost immediately after the procedure and can persist for several weeks or even months.
3. Development of a pathological inflammatory process
If a lot of time has passed after medical manipulations, and you have severe discomfort and your teeth hurt after grinding for crowns and bridges, then this signals the development of various dental diseases: caries, pulpitis, periodontitis, cyst, granuloma, fistula, abscess, gumboil. In this case, the pain does not go away for a long time, intensifies with each subsequent day, and is poorly relieved by analgesics. Along the way, other alarming symptoms arise: purulent bumps appear on the gums, the gums and cheek swell, the body temperature rises, it becomes painful to chew and press on the causative element.
More often, the problem arises again due to the fault of a clinic specialist who, during the preparation and preparation of tissues before prosthetics, violated the rules of asepsis, did not fully treat (after all, dentures are often placed on teeth destroyed by deep caries and other dental diseases), poorly cleaned and poorly sealed the roots channels. Pulpitis can occur if, in the process of preparing the “support,” the doctor caused irreversible damage to the nerve.
Expert opinion
Andrey Rastislavovich Chernov
Specializations: Orthopedic dentist
Experience: 11+
“Treatment, grinding and prosthetics of a tooth with an orthopedic design is a complex and multi-stage process, in which at least several experienced specialists must take part - a therapist, a dental technician (creates a prosthesis using casts of the jaws), an orthopedic doctor. If everyone has done their job efficiently, then pain after completing all the manipulations should not arise either in the short or long term.”
Sometimes a pathological inflammatory process occurs due to the fault of a patient who systematically violates oral hygiene, does not monitor the condition of installed dentures and surrounding tissues, and receives various injuries.
Treatment options for a tooth under a crown
When contacting the clinic, the dentist determines how great the changes are in the dental tissues, and based on the results of the examination, prescribes treatment.
- If the tooth stump has not undergone any changes and rot has not affected it, the doctor cleans out the accumulated food debris from under the crown. Then a new prosthesis or an old one, but corrected, is installed.
- If healthy roots remain, the crown is placed on the stump tab. This device is made in a dental laboratory from an impression and is a structure with peculiar “legs” that are designed to fix the inlay in the tooth canals. And a crown is attached on top.
- If both the upper and root parts of the tooth have rotted, the remains are removed from the mouth and periodontitis is treated. The patient then has to decide on how to restore the tooth. There are two options: implantation or installation of a bridge.
When contacting a clinic for initial prosthetics, it is important to find out at the stage of monitoring institutions whether the clinic provides a guarantee for the treatment provided. If there is a guarantee, then in case of medical errors, treatment and re-restoration are carried out free of charge for the patient.
Why does my gum hurt?
Sometimes the teeth do not react at all, but the gums hurt after grinding. Let's list the reasons for this:
- physiological reaction to an anesthetic injection,
- gum retraction: in order to qualitatively fit the prosthesis to the soft tissues and eliminate discomfort during operation, as well as to create a highly accurate design that fully corresponds to all the anatomical features of the patient, before taking impressions, specialists widen the periodontal sulcus. For the procedure, special threads are most often used, which are inserted under the gum and lift it. Such manipulations lead to the fact that the gums then become slightly inflamed and swollen, and also hurt for several days,
- individual reaction of the patient and allergies to the medications used during the grinding process: in this case, the gums may itch and itch, a rash appears on them,
- traumatic gingivitis and periodontitis: if in the process the specialist damaged the gums, then the patient experiences persistent aching pain, swelling and bleeding of the mucous membrane. As a rule, it all starts with gingivitis, but if the disease is neglected, it is complicated by periodontitis.
How is the treatment carried out?
Of course, the simplest option is this: the doctor removes the crown, treats the tooth, and then installs the crown again. But the disadvantage of this method is that the patient will have to pay again for all orthopedic work, including the crown.
However, today you can go a different route, which is offered by some dentists. In this case, the tooth is treated without removing the structure. The doctor makes a hole through which he performs the necessary manipulations, and then seals it.
Before treating a tooth, a photograph is always taken under the crown. If the problem is not detected on the diagnostic image, then the crown will need to be removed to determine the cause of the pain.
Treatment of a living tooth
If the cause is caries, then treatment; most often performed through the crown. Main signs: pain is sharp and severe, the tooth reacts to hot and cold.
If the reason is a violation of the fixation of the crown, then the crown is removed, medicine is applied to the ground tooth, and then the crown is put back.
Treatment of a pulpless tooth
Signs: aching pain, accompanied by pulsation in the temple and ear. Treatment is carried out both with and without crown removal - it depends on the presence of a pin and the cause of pain (periodontitis, a fragment of an instrument in the root, etc.).
Methods of tissue trimming: after which procedures pain occurs more often
There are different ways to prepare tissue. According to experts, after grinding the teeth, some of them may actually experience aching pain. But other methods, on the contrary, are considered gentle, and therefore do not cause discomfort at any stage of treatment and prosthetics.
Using a diamond-tipped bur
The drill, despite the loud, annoying sound, is still popular among dentists, because with its help you can quickly and efficiently carry out work of any level of complexity and scale, and grind off any amount of tissue.
It is boron that is most often used for preparing tissue for crowns and bridges, and for turning teeth for veneers. During the process, the doctor uses the device at different speeds so that it does not cause overheating of the tissues and pulp; at the same time, a cooling liquid is supplied to the oral cavity. Despite all the safety measures, many patients note that it was after using boron that they experienced pain.
Via ultrasound
Situations where a tooth hurts after grinding performed using ultrasound are quite rare. The method is characterized by a more gentle effect, compared to boron[1], allows you to process fabrics carefully and without contact, and does not cause overheating. However, ultrasound can still cause discomfort and short-term increased sensitivity of hard tissues and gums in people with a low pain threshold and weakened enamel.
The method is used if you need to remove a small amount of tissue.
Laser method
Here, a laser is used for preparation, which, like ultrasound, acts in a targeted and non-contact manner. The method is considered one of the safest and most painless[2], suitable for people with sensitive gums and mucous membranes, and does not cause pain or discomfort. The laser not only carefully grinds the tissues, but also disinfects them, promotes rapid healing, and prevents bleeding.
Water-abrasive treatment
Suitable only in cases where a minimum amount of tissue needs to be removed. During the process, a specialist treats the enamel with a stream of water containing abrasive particles. After such grinding of teeth, aching pain and any discomfort are completely excluded.
On a note! Until recently, dentistry also used a chemical method, where tissues were first softened using chemicals and then removed with an instrument. However, today this method is recognized as traumatic and very dangerous for the nerve of the tooth.
How long does the discomfort last?
Many patients are interested in how long their teeth can hurt after grinding. Normally, the unpleasant sensations disappear after 3-7 days. This is the case if the preparation was carried out without removing the nerve, or immediately after depulpation.
According to many experts, long-depulped teeth that have been ground should not hurt at all. If discomfort occurs, it goes away after 1-2 days.
When tissues and nerves are overheated with boron, increased sensitivity can persist for several months. But in any case, pain that intensifies and does not go away for more than one week should be a reason for a visit to the dentist.
What measures to take at home
When your teeth and gums hurt after grinding, it is important to know what to do in this situation. Usually, to quickly eliminate the physiological reaction of tissues to intervention, doctors advise performing the following procedures:
- mouth rinse: you can use chlorhexidine solution, Rokotan. Decoctions of chamomile and sage, which have a calming, antiseptic and anti-inflammatory effect, are also suitable. Rinsing is carried out 2-3 times a day,
- applications: if the gums hurt, it is recommended to apply Solcoseryl ointment to it up to 3-5 times a day,
- taking painkillers from a home medicine cabinet,
- following a gentle diet: in order not to further irritate sensitive tissues, it is necessary to exclude solid, cold and hot foods from the diet. It is better to also give up sour, salty, spicy and sweet foods for a while,
- Carrying out oral hygiene as carefully as possible: if your gums and sharpened teeth hurt, then under no circumstances should you stop performing hygiene procedures. However, to minimize discomfort, you can temporarily switch to a brush with soft bristles and a paste with anti-inflammatory components (chamomile, propolis).
