Crown, than Root Canal and the pain still persist...

[Allie101]

I had a large filling and my dentist said it was cracked, so my dentist suggested a crown.
He did the prep, and set a temporary crown until the permanent was being made.  While with the temporary crown I complained about pain on the tooth when biting down..The dentist response, the temporary crown is just too high! He went on with the positioning the permanent crown on, adjust the bite and send me home…
I came back complaining that I still have the pain on the same tooth. OH! Then you need a root canal!! He said.
My question is: Shouldn’t he figure that out before putting the permanent crown in?
Is this lack of experience on his part? After that I found out that he graduate in 2005...
So now he went on and performed the root canal over the crown, leaving the filling seeing on the crown… I did not know that was the way to do things and when I asked on my next visit if the dark spot on the crown would even out, since I thought the purpose of the crown is to cover the filling…his response was, the purpose of the crown is because you had a very large filling!!!

Ok, now more than a month past and I started having pain on the same crown, and the crown have a very tiny wiggle if I try to move it... Went back to him and he said that this tiny movement is normal with the ligament, his proposition to my problem is take the RX antibiotic for 7 days and wait a month to see if, the antibiotic take care of the infection that he sees on the x-ray, “small gray area" if stop the pain we are done; but if the pain continues, he will go back in and thru the same hole and re-do the root canal. Wouldn’t that week the crown and give me less life on the crown and making it prone to crack?
Can I request that he do-over of the crown? Do I have the right giving the whole scenario? And what is the standard of care?
Please advice, this doctor did one previous root canal and then a crown on another teeth and I did not had a problem with it.
Ok, I got some impute from you guys, and one of the suggestion was the it was reasonable on my part to ask for another crown, since it was done recently, this Dentist didn’t take it very well, and now he changed his approach and instead of go back and re-do the root canal he said that I have high expectations and sincerely he doesn’t want to treat me anymore and he wants to send me to  root canal specialist. And the costs are mine to incur since nobody can guarantee a root canal…
I appreciate your thoughts on this scenario.
Allie101

[lynn117]

just so you know that removing the crown can sometimes seriously damage the fragile tooth underneath. drilling through the tooth top will not weaken the crown. my dentist routinely  sends all root canals to a specialist since they have more experience and better equipment for doing the procedure. yes root canals are not guaranteed but its difficult to promise any dental procedure will not have a complication.

[StratRebel]

"Shouldn’t he figure that out before putting the permanent crown in?"  
Absolutely!

"Is this lack of experience on his part?"  
Thats got nothing to do with experience.  I have known that since second year dental school.

A filling or root canal separates the center of the tooth, making it very prone to splitting in two, or fracturing off a cusp.  A crown's main purpose is to hold the tooth together.  Making a hole in the center will not weaken the crown, as metal is very good against sheer (splitting) forces, while a tooth is not.

If you have pain on biting, this may just be the bone under the tooth healing from the infection.  However, its also possible the crown is too high and hits too hard when you bite or slide.  A perceptable wiggle in the tooth is NOT normal (if it was not there before).  This wiggle should lead you (and the dentist) to believe your crown hits too hard when your jaw slides....this puts added force on the tooth that its not meant to handle (a tooth can withstand huge compression forces, it does not do well at all to torquing forces).

"Can I request that he do-over of the crown?"  
Sure.  Doubt he will accept though, as the crown is still fully functional, just not as esthetic.  This is not a violation of standard of care to do a root canal through a crown, just poor planning.  You can log a complaint with the state dental board.  They won't do much with a single case, but if he has other complaints of the same nature they will investigate.

If your pain is upon biting, you will either heal on your own, or its the crown that needs to be adjusted.  If you have sharp pain to cold, or spontaneous pain, thats what necessitates a new root canal.  I would suggest getting a second opinion, especially from someone who has experience with occlusion problems (there is no good way of finding them other than off referrals from other patients).

I hope things turn out well, good luck!