One of My Crowns Suddenly Started Hurting, Then Felt Fine Again—They Say I Need an Implant. Is It Really Necessary? They Said It’s Inflammation

I understand why most people would naturally feel reluctant at first if a dentist tells them that they need an implant.

Since natural teeth cannot regenerate once they are lost, this can understandably be an especially worrying matter.

It is only natural to feel a mental burden when a tooth that you had used well for several years or even decades suddenly starts hurting, and you are told that it needs to be extracted and replaced with an implant.

However, every treatment has its appropriate timing.

This was a previously treated tooth that had been functioning well.

If a tooth develops an unexpected problem after being used for a long time without any issues following dental treatment, I understand that it can be unsettling.

Today’s case involved someone who had used a tooth successfully for as long as 20 years after receiving a crown.

The person had been using the tooth normally, but suddenly developed pain after eating hard nuts two weeks ago.

A CT scan showed inflammation, and I explained that the tooth was in a condition that could not be treated, but the patient did not want to accept it.

An implant was necessary, but this was a case that did not require bone grafting.

After taking commonly available medication and feeling that the pain had improved, the patient contacted us again to ask whether an implant was really necessary.

I do not consider this overtreatment, but this was a case in which the patient thought, “The pain has subsided, so maybe it has gotten better.”

“It doesn’t hurt now. Couldn’t it have gotten better?”

With pain anywhere in the body, it is difficult to say that the problem has disappeared simply because you take medication right away or because time passes and the pain goes away.

In similar cases, the tooth root may already be fractured, or inflammation near the tooth root may have progressed considerably.

If a CT scan, rather than just an X-ray, has been taken and the tooth has been judged difficult to save, the cause may be a root fracture, loss of the alveolar bone, or inflammation around the root rather than a cavity.

Medication cannot solve everything

There are various medications sold at pharmacies, but medication cannot resolve this type of problem.

Medication may temporarily calm the inflammatory response and reduce the pain, but it cannot be said to eliminate the problem.

Medication cannot readily treat a cracked tooth or a fractured tooth root.

If you endure it and miss the appropriate timing, the tooth may seem fine for a while, then hurt when you chew, and develop and lose pus repeatedly, eventually leading to extraction.

I cannot say that waiting is always wrong simply because it does not hurt at present, but extraction is also a possibility that cannot be overlooked.

That is because it is quite common for people to endure the symptoms and miss the appropriate timing for treatment altogether.

If the inflammation continues to progress, the surrounding alveolar bone may deteriorate further, making extraction more difficult and potentially resulting in a need for bone grafting before an implant later on.

Even if you were told that an implant is currently possible without bone grafting, the condition may progress over time to the point where bone grafting becomes essential.

Personally, rather than simply deciding to endure it because it does not hurt, I believe it is more important to determine clearly whether the tooth can or cannot be preserved.

If you are uncertain, I recommend visiting another dentist for an additional evaluation.

If extraction is definitely necessary, I do not recommend delaying it any further, so please make sure to receive treatment at the appropriate time.

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