No, this is not a sweeping statement that artificial crowns or what we call Caps on the damaged teeth can cause pain. Actually, I could not find a better caption.
But I must make it clear that these artificial crowns are not the cause of pain by themselves. I have seen persons in whom caps were fitted decades ago and they are functioning without any problem. This must satisfy doubts nurtured by many about the durability of such artificial crowns (caps).
Now, coming to the point. This patient around 40 came to me with the complaint of pain in the capped tooth on her right side. You can view the picture of this cap in this oral photograph which has been indicated with an arrow.
She tells me that she had got this crown fitted about two years ago. There was not any trouble earlier but this has started to hurt for the last couple of days. First of all, I must tell you that this artificial cap that you are viewing in this photograph is a Ceramic cap, also known as Porcelain Crown.
Just a look at this cap tells a lot of things about it —first of all it is poorly contoured. A qualified dental surgeon would never do such a job. My doubt was well placed. She had got this crown fixed by a quack. After a couple of months or even years patients don’t feel any pain but later on it starts aching. Why is it so afterall?
There are a number of reasons for this pain – because of poor contouring it is in traumatic relationship with the lower tooth or the tooth on which this cap has been fitted has not been properly treated —either there has been some problem with the root canal treatment or it was never done. Yes, I have seen many cases treated by dental quacks in which RCT was not done before fitting a cap on the decayed tooth. Now, the tooth would be obviously painless for sometime before it starts causing pain.
Please don’t be under the impression that the tooth on which cap is to be fitted has to undergo Root canal treatment (RCT), nonetheless, in majority of cases it is required because the patient goes to a dentist quite late –when the dental pulp (nerve of the tooth) is exposed or the infection has already spread to root of the tooth leading to Dental Abscess.
She has been asked to get a Dental X-ray done which would confirm the diagnosis and accordingly required treatment would be provided.
Let’s have a look at her artificial cap on her left upper side –indicated in this picture with the help of an arrow. On this side , her problem is less severe – she says that she only feels pain when something gets stuck in between the capped tooth and the adjacent teeth. Again, this cap has also been fixed by a quack only.
If a patient start experiencing this problem of food impaction or something fibrous getting stuck inbetween the capped tooth and the adjoining tooth, it is almost sure that there is something wrong with the cap itself. And this problem generally starts immediately after the cap is fixed. A badly made or we can say a poorly contoured cap would encourage food impaction –and there is hardly anything which can be done in such cases except to replace the cap itself.
But that is not easy – quacks are master in playing with words —they just convince the patients in believing that there is nothing wrong with the caps. Even otherwise many a times patients also don’t bother and for impacted food stuff, they start using a match-stick which is known to injure gums and hence a chronic problem sets in. This lady has also been using a match stick for keeping the area clean.
She has been advised to use an interdental brush for this job. She would come back to me with dental radiograph (X-ray) which would throw light about the health of the tooth which has been capped and also if there is any problem in the adjacent teeth, it would be revealed. Accordingly , treatment would be planned.
This post just to remind my readers that our dental quacks are quite daring!