Crown prep on a tooth with irreversible pulpitis?

As I have written, I have a molar with a large temporary filling that has been showing signs of irriversible pulpitis.  I went to a 2d dentist to get an opinion on treatment v. extraction & implant.

He said it will need crown lengthening but he still thinks it's better to try to save the tooth (he thinks in this case CL won't interfere with future placement of implant if/when needed).  BUT he said it's possible there's more decay he can't see under the temporary filling that would cause him to recommend extraction instead.

He wants to remove the sedative filling and see.  If no additional decay, he'll prep the tooth for the crown and I'll get endo 1-3 days later.  Otherwise extract.  He said he doesn't do any endo including emergency pulpotomy.

My concern is, won't the prep on an already sensitive tooth (I'm on regular advil and tylenol to keep the pain at bay) be almost certain to give me horrific pains until I can get endo done?  If I need to get an emergency pulpotomy to manage the pain until I can get to an endodontist, how much can I expect that to cost?

[mcclos10]

I think you will definatly have pain until the root canal is done.  I am in the same boat right now.  I had the crown prep done on Weds.  My dentist put me on antibiotics and vicodin for the pain.  The anitbiotics usually calm things down in a couple days.  My endo/root canal is being done next friday.  It is my molar furthest back on the right bottom.  My whole face and jaw is still very swollen and it is definately painful.  I have a ton of work in my mouth but am not familiar with the term you use "pulpotomy" do you mean root canal?

[elspouse]

Thanks for the input.  My situation is slightly different because the pulp is inflamed but not the rest of my face etc. (and no absess (abscess) was showing on the x-rays a few days ago).

Can the dentist inject some sort of long lasting anasthesic that would block the pain for a day or two?

Also, if I am able to have the crown and root canal done the same day or a day apart, is it safe to take a 5 hour flight a couple hours or a day after RCT?

[mcclos10]

I have never had a dentist willing to do root canal and crown prep the same day.  they usually like to wait a week or so in between to assure there are no problems or complications.  I have never heard of being able to inject numbing medication that will last for a couple of days.  It would be a dream medication if it existed.  The numbing just wears off in a few hours.  My face is just swollen due to all the injections and it just got inflammed.  The infection is only in my tooth not in my jaw or face.  There is no technical reason why you can't fly. Often people just would choose not to so that they could remain close to their dentist in case of complications.  Once the root is removed from your tooth you shouldn't have anymore pain anyway.