New crown feels clunky and uncomfortable, day three post fitting. Is this normal and will it improve?

[ToothPatient]

Prosthodontist placed the crown, made some adjustments, placed it again, checked with occlusive paper, more adjustments and polished it.

Then he said there was contact on all other teeth so he was going to cement it, which he did.

It's full gold, upper 2nd molar.

When I bite down now, it's actually noisy, like clunking sound.

I was hoping he would take it out of occlusion but he refused, stating it was over erupt if he did so.

I'm currently at the end of day 2 post fitting.

Will the bite naturally begin to feel more comfortable after another week or two?

It almost feels a little high at the moment or something.

 

[ToothPatient]

I bite and there's a rubbing between the crown and opposing tooth, and I have to bite harder to close the bite entirely.

But again it's just over 48 hours since the crown was fitted.

 

[Dr M]

The crown should settle. It is something new after all. If the crown is still high, you might start getting a headache on the associated side. If this is the case, go back to the prosthodontist, explain your symptoms and let him adjust it a tiny bit more.

 

[ToothPatient]

The crown should settle. It is something new after all. If the crown is still high, you might start getting a headache on the associated side. If this is the case, go back to the prosthodontist, explain your symptoms and let him adjust it a tiny bit more.

How long should I wait for it to settle?

I had read if there's knocking or catching, it can cause other issues so get it seen to sooner rather than later.

But at the same time I don't want to rush back and have him take more than necessary off the crown when I should have just waited for it to settle instead (made this mistake with a composite filling before and made a total mess of it).

It was done last Thursday so this will be nearing four days since its completion.

Also Dr, have you ever heard or experienced of tinnitus worsening as a result of having a gold crown fitted?
I have mild tinnitus in my right ear (opposite side to crown). It feels like it's got slightly worse the last couple nights, but that also be just my nervous systems response to having the crown placed (a little stressed), rather than a direct effect of the crown itself. Either way I guess I should give it more time before anything dramatic gets done.

 

[Dr M]

I would wait a week. But the worsening tinnitus sounds like there might still be a small adjustment needed. I often adjust the opposing tooth a little bit, and not only the crown, in order to prevent it from becoming weakened.
Wait a few more days, and then go back for another adjustment if there is no reduction in signs/symptoms.

 

[ToothPatient]

Might I ask also, when flossing between the crowned tooth (2nd molar, upper left) and the tooth in front of it (first molar), the floss is now like, really tight, and it stays tight along the length of the tooth.

As in normally when flossing there's a "click" to get passed the contact point of where the two teeth meet, and then it loosens up.

Here it stays tight along the entire length of the tooth, right up to the gum line.

I know the crown was fabricated to "ideal" dimensions based on the scans taken, but there was no adjustments made on the mesial surface prior to cementation.

He only checked using floss after it was cemented in.

Would the floss staying super tight between the mesial surface of the crown and the 1st molar, be cause of concern of any kind?

I'd worry it might push that first molar out of its original place and mess up my bite a little?

 

[ToothPatient]

In terms of "height" on the occlusal surface, when he was checking the crown using occlusal paper, I was laid on the dentist chair and my head was back.

When I find it, in this posture, there's less of a height issue.

However if I keep the bite closed, sit up, and lean my head forward, I can actually feel the crown between to push my bite apart.

So obviously the contact between the crowned tooth and its opposing tooth differs depending on the posture of my head, maybe how far forward the jaw is projected?

I'm guessing I'd need to go back to him and explain this, and repeat the occlusal paper test again in different postures and jaw positions so he'll know exactly where to reduce?

 

[Dr M]

Might I ask also, when flossing between the crowned tooth (2nd molar, upper left) and the tooth in front of it (first molar), the floss is now like, really tight, and it stays tight along the length of the tooth.

As in normally when flossing there's a "click" to get passed the contact point of where the two teeth meet, and then it loosens up.

Here it stays tight along the entire length of the tooth, right up to the gum line.

I know the crown was fabricated to "ideal" dimensions based on the scans taken, but there was no adjustments made on the mesial surface prior to cementation.

He only checked using floss after it was cemented in.

Would the floss staying super tight between the mesial surface of the crown and the 1st molar, be cause of concern of any kind?

I'd worry it might push that first molar out of its original place and mess up my bite a little?

There usually should be a click when pulling the floss through. This indicates a nice and tight contact. If the floss did not pass through at all, then it would be an issue.

 

[Dr M]

In terms of "height" on the occlusal surface, when he was checking the crown using occlusal paper, I was laid on the dentist chair and my head was back.

When I find it, in this posture, there's less of a height issue.

However if I keep the bite closed, sit up, and lean my head forward, I can actually feel the crown between to push my bite apart.

So obviously the contact between the crowned tooth and its opposing tooth differs depending on the posture of my head, maybe how far forward the jaw is projected?

I'm guessing I'd need to go back to him and explain this, and repeat the occlusal paper test again in different postures and jaw positions so he'll know exactly where to reduce?

Try and do it in a semi-sitting position yes and see if it makes a difference.

 

[ToothPatient]

Cheers!

One more thing on this.

Before he placed the permanent crown, he took off the temporary, checked the permanent a few times whilst making adjustments by placing an removing it (reminding me not to swallow it as it fell off once), gave the tooth stump a quick once over with an air blower, then cemented in the permanent crown.

Is that protocol typical?

I would have thought the area would have been cleansed thoroughly to ensure no debris or particles were left stuck underneath the permanent crown, perhaps leading to decay later?

 

[Dr M]

It depends on what cement he used. A lot of times a tooth can be sand-blasted ( type or 'airblower'), in order to clean the tooth and roughen the tooth surface in order to ensure an adequate bond. The type of cement then influences if the tooth needs to be bonded/etched, prior to cementation.
So all in all, would require more information regarding materials/equipment, in order to comment.