Ongoing pain after root canal treatment

[Firin]

About six weeks ago, I had root canal treatment for an upper molar that did not appear to be infected, but where a deep filling was judged to be too close to the root canal.  After the treatment, the tooth was severely painful for two weeks, during which time I could not bite down even slightly.  Even when I chewed food on the other side of my mouth, my bite would occasionally connect on the wrong side and have me yelping in pain.

After the tooth calmed down, my regular dentist fitted me with a temporary crown - three weeks ago now.  Since this fitting, I have had a resurgence in pain in the tooth, especially with sideways pressure.  It is not hot/cold sensitive.  Due to this, my regular dentist re-referred me to the endodontist and has elected to defer fitting the permanant crown.

The endodontist re-examined my post-treatment x-ray a week ago and said that it looked like a good job and that my tooth might just be taking longer to calm down.  He also said that sometimes 'endo teeth' were just like this.   The pain is still sufficient to affect every meal I eat and even hurts sometimes when I haven't been eating for ages.  It's really starting to wear me down.

I'm 24 weeks pregnant and I imagine that this will be why antibiotics seem not to have been considered - that or there were no signs of any infection at the time of the actual treatment.  Could this pain be a symptom of an infection developing since the treatment and therefore not caught on the x-rays?  Should I really be getting this much pain 6 weeks after treatment?  It doesn't seem to have diminished at all during the last 3 weeks when I have been wearing the temporary crown.

Any advice gratefully received, thanks.

[Firin]

Many thanks, that makes a lot of sense.

[scottma]

If there is no evidence of infection, administration of antibiotics is contraindicated. The source of pain upon chewing may originate from preiapical imflammation after root canal obturation or occlusal interfernce of temporary crown. Molar crown is particularly vulnerable to occlusal interference. If there is no pain upon chewing or no discomfort provoked by digital pressure or cotton roll clenching after removal of temporary crown, the culprit is probably occlusal interfernce of temporary crown. On the contrary, if digital pressure or cotton roll clenching on uncrowned tooth provokes discomfort, the culprit is probably periapical imflammation. Going back to your restorative dentist to have a follow-up exam is advised.