New crown has been hurting for a month now

[tooleey]

My Dentist told me to first brush with sensitivity toothpaste then flouride rinse, then pusn extra toothpaste around the tooth at the gumline. I have been doing it for about 3 weeks, and all this did not help. I still get frequent pain, not only with cold, but sometimes out of the clear blue sky when I am sitting at my desk. I had absolutely zero pain during the 2 weeks that I wore the temporary. This is really frustrating and stresses me out. I like my Dentist and feel that he is competent but I think maybe I should just get a root canal and be done with it all. But wow! the extra expense! The permanent crown would have to be be cut off, right? Then the root canal charge, then the new crown charge! And guess what? I had zero pain before I even had the crown started. I only gave him the go ahead because he said that "eventually" that tooth will need a crown. I figured he must know what he is talking about so I said lets get it over with. Now look at all the grief and expense I am in the midst of now! Any help truly appreciated.

[scottma]

Sensitivity to cold stimulus is the sign of pulpitis, which may be classified as reversible or irreversible. Pain lasting more than 10 seconds after cold stimulus suggests irreversible pulpitis, in which condition root canal treatment is indicated. However, in the condition as reversible pulpitis, occlusal interference is the most common culprit. Subtle occlusal interference introduced by molar crwon is difficult to detect. The common mistake is that articulating paper placed between teeth  and ask the patient to close his or her jaw. This method generally fails to mark occlusal interference. If you close your jaw and clench teeth hard, if the crowned tooth feel pressure or pain, there is generally occlusal interference present. Additionally, if you place a cotton roll between crowned tooth and opposing tooth, if you feel pressure or pain, occlusal interference is generally present. You can compare the crowned tooth and other natural teeth. Other natural teeth generally do'nt give you similar results.

[tooleey]

Ruling out occlusal interference, and I feel we can, as does my Dentist, what would be your next most likely scenario? Thanks!

[scottma]

Based on the information provided, it appears that you develop thermal sensitivity after a new restoration, which is a temporary or final crown. In dentistry, we tend to use the term " final", instead of permanent, because nothing is permanent other than tax and death. The most common culprit of thermal sensitivity after new restoration is occlusal interference, if there is no carious lesion or periodontal pathology present. Other than thermal sensitivity, occlusal interference may induce a variety of other symptoms,such as, hurt when chewing, gum pain or discomfort, jaw bone aching, sensitivity to touch, masticatory muscle pain which may manifest as headache, tmj tightness or pain, and stuffy ear or pressure. Going back to your restorative dentist to have more meticulous occlusal adjustment is advised. Root canal treatment does eliminate the problem of thermal sensitivity, however, other problems associated with occlusal interference may persist after rct.