pain biting on top molar

I recently received a composit  filling in my top first molar about two weeks ago.  It was a replacement for an old amalgam filling.  I did not have problems or complaints with the old  filling. My dentist said  It was old and starting to wear and my dentist was afraid of leakage.   So I had it replaced.  The filling is only an occlusial filling.   Five days after the filling was replaced I started having pain any time I would chew or bite on the tooth.  My dentist had me come back and replace the filling .   I am still experiencing pain while biting on the tooth.  He sugessted to give it a few weeks.  I have never had a problem with pain and biting after afilling in the past.  Even with teeth that are 2 and 3 surface fillings.   He said there may be a fracture and possibly a root canal or crown.  If he just does a crown I know my tooth is still under the crown.  Would I still not feel pain while biting down on the tooth?    What would you suggest if you where my dentist?   thanks  rabbit22

[chance's mom]

I am not an advocate for replacing amalgam fillings just because they are amalgams.I personnally believe they are still good restorations.In this day and age and a new placement,absolutely I recommend a composite filling.An amalgam is different than a composite in the respect that an amalgam fills the hole.A composite has primer and bond  and is bonded into the area.Metal does have a tendency for expansion and contraction,hence...cracks.Replacements may be indicated with cracks,lifted margin edges,or missing pieces.A filling with only one surface such as an occl.is much less invasive than say a two ot three surface as you has mentioned.An occlusal can be invasive if it was deep.If it was my tooth I would give it some time as suggested by your dentist.Time does indeed sometimes settle these stirred up teeth.One reason to put a crown on would be alot of missing enamel.Structurally it is then comprimised.This does not sound like the case.Another reason would be it has a crack,a crown would help to displace forces.But if a crack had been present he would most likely have seen it at first treatment and mentioned it.Did he look at it with an inneroral camera?By placing a crown we have to cut more enamel.The goal is to preserve as much as possible.Teeth are living things.Two teeth adjacent to one another,may present one as  highly sensitive while the other responds only mildly.Some teeth therefor are just sensitive.Why cut into a tooth, possibly unnessarily?Sometimes it just takes time to settle.Monitoring should be done.This is done with exrays,a bite stick,precussion,hot and cold.or a vitality meter.Sometimes it is very evident just by exray diagnosis.
.Another idea is just asking your doctor to check your bite if things have not settled in.That is not alway's something one might notice immediatly.If it is still sore, ask him to recheck your bite.It is easy,painless( typically )to make an adjustment. Advil sometimes helps with inflammation,in moderation.If however you have something waking you in the middle of the night,develop a pimple on the gum tissue.Call your Dr. immediatly.