Temporary crown and dull ache

[elizabeth c.]

I had my rear molar prepped for a crown 9 days ago. The tooth had a fracture on the cusp and I had the crown done as a preventative measure. A few days after the prep I noticed a dull ache that seemed to flare up after eating or in the night when I would grind my teeth on my night guard. I stopped using the night guard and now I have no pain at night only in the morning after breakfast but the pain is not severe-just mild and nagging-one 200mg. advil lasts me the whole day. I have no sensitivity to hot, cold or biting...and it seems to throb a bit when I am active-walking or working in the garden.
I'm kind of upset because the dentist did not keep the tools cool while she worked (I smelled fire!) and I have read that this is critical to avoid nerve irritation during the procedure. My question is threefold. One is: What is your best guess as to what is wrong with my tooth? Two is: What is the likelihood that this tooth is going to heal on it's own? Three is: Is it not the current standard of care to keep the instruments and the tooth cool during such intense drilling? My dentist attended NYU and I hate to think she would not be up to snuff on the latest techniques- Did she she make a mistake? I hope you can set my mind at east..I really appreciate your time..
Thank you
elizabeth

[Jerome Bogin, D.D.S.]

I am on the faculty at NYUCD so hope your dentist is up on her techniques.I will try to answer your questions the best I can with out seeing you. It sounds like the nerve might be inflammed and that can go either of two ways-it is reversible and no root canal therapy is necessary or irreversible and the rct is needed. I would suggest that the temp be removed to test the vitality of the nerve.I am assuming that you mean that there was no water when she was preping the tooth. I would not be happy if the entire tooth was preped without water. You can do some touching up of the prep dry and I do not think that would cause a problem. When the temp is removed without anesthesia the tooth should be sensitive to temperature changes. I hope I have helped you somewhat.

[elizabeth c.]

Thank you Dr. Thanks for your reply. I will see my dentist on Friday and hopefully the tooth will heal.  Yes, I think she did use water so I guess it's just my tooth..she is a fantastic dentist by the way (kudos to NYU)...I just panicked a little...thanks again.
elizabeth