Pain after temporary crown - root canal needed???

Help!!!
Your responses are so thoughtful and helpful I am hoping you can help me!!! I had a bottom molar with a large filling that evidently cracked at one point and decay seeped underneath cavity. No pain previous to crown preparation.  Dentist said that he needed to do a build up due to the amount of deep decay and then applied temp crown . LOTS of discomfort following procedure as gum was also purple and swlen (doc saus it happens with some sensitive to ligamentus novacaine (sp?) adminstration. Kept taking m
Motrin.  Gum healed and local pain stopped but this incredible aching pain never subsided.  Another visit to the dentist 4 days later, he said the bite was fine, xrayed the tooth and said that nerve intact, no apparent injury or abcess (abscess), and said he did not breech the nerve/root cavity when he was drilling he was just very close to it. He said sometimes nerves just get inflamed from major work/drilling close to them and then they need to a root canal as the oy option to get rid of the pain.  I told him I would wait it put for a bit to see if it settled. It seemed to improve a little, went from 2 Motrin every 7-8 hrs to one every 12-15 hrs.  It has now been 11/2 weeks but as soon as the Motrin wears off the aching/throbbing pain returns with a vengeance.  Slightly cold sensitive , but all my teeth are.  Oddly warm/hot makes mine feel better most times, never worse.  Could the temp be too tight and putting pressure on the nerve or air under the temporary crown? Should i have him remove the temporary crown?Or anything else you could suggest.  I just don't love the guesswork given there is no definitive evidence that it needs a root canal?? I'm so upset and frustrated not knowing what the best choice is?  I ofcourse don't want to put the permanent crown on until I figure it out and don't want to have this pain continue either. I'm happy to get a root canal if that is what's needed? Any advice would be eternally grateful!!!!!!!

[Jerome Tsang, DDS]

Ok.  After reading this post with more information, I would say you can wait up to 6 weeks from the day of the drilling to see if the nerve will settle down.  If the pain subsides, then go ahead and try to permanently cement the crown.  If it doesn't settle down in 6 weeks, it'll need a root canal cause the symptoms won't improve at all.

[RaeSuba]

Thank you so muchfor your timely and informative response!  I will wait a bit then to see if it settles further . My only remaining question is wether the temporary crown could be mis-seated continuing to compliment any discomfort or irritation due to pressure or misalignment with other teeth?  When not in pain the temporary feels quite snug between it's surrounding teeth. And I continue to wonder wether removing it or replacing it would help some of the discomfort as the nerve possibly heals.

[RaeSuba]

And oddly given I also have Lupus and i am no stranger to ibuprofen I find it almost strange how quickly the pain seems to resolve within 15 -20 minutes of taking it and then can be completely gone for well after the longevity of the dosage indications. During which time biting and everything else cause no discomfort?   I would think root inflammation would require much more anti-inflammatory to relieve it?  Fascinating

[Jerome Tsang, DDS]

Motrin's a pretty good pain killer.  If you have concerns about the temporary, you can always ask your dentist to make a new temporary to see if that'll resolve the issue.  There's no other way to really know if its the temporary's fault.  Maybe they can adjust it.