chewing pain with temporary crown

[brk10]

Mid July 09, I had my second to last upper right molar prepped for a crown.  There had been a deep amalgam filling in that tooth that had started to deteriorate and my dentist suggested a crown to preserve the structure of the tooth.  For several weeks after the procedure, I had NO pain upon chewing.  Then I noticed pain upon chewing -- like a jolt-ish feeling, but only when chewing something harder.  There was the initial twinge-jolt and then the tooth eased into the chewing.  I noticed when I had been flossing (I pulled the floss from between the teeth, rather than straight down) one night that the temp may have shifted.  I also noticed that there was a pungent old food smell on the floss.   I don't have pain in the tooth when I'm not chewing and I have no hot/cold sensitivity.  I went back to my dentist and he pulled the temp off, cleaned it and re-cemented it.  He also took an x-ray to look at the roots and he said it looked fine. The next day the chewing pain was still there, however there was no more bad smell on the floss.  I went back to my dentist the following week and he checked to see if the temp had shifted and he determined it had not.  He decided I should go to the endontist, which I did that day.  The endontist only did the bite test and determined I needed a root canal in that tooth.  He didn't do the hot, cold, pulp test and they took a digital x-ray that the endontist said seemed "fine".  I clearly don't want to get a root canal if not necessary and am wondering if the the temp is compressing my tooth when I chew.  I also am a clencher and wonder if that is also causing stress to my already 'stressed out' tooth.  It has been 2 months since I first had the crown prep on this tooth.  Why was I pain free when chewing for the first several weeks?  Is it possible to have my dentist put the PERMANENT crown on with TEMPORARY MEDICATED CEMENT, to see if that stops the chewing pain?  Any thoughts would be greatly appreciated.  Thanks.

[Jerome Tsang, DDS]

You can place a permanent crown on the tooth with temporary cement.  You can also make a new temporary to see if that'll fix the problem as well.  I normally would defer to a specialist if they feel there is a need for a root canal since they have more advanced training but its interesting to note that he didn't check the pulp vitality to see the pulpal status.  I would recommend seeking another opinion before committing to a root canal.