Unfortunately, the symptoms you describe are non-specific, and it is not possible to reliably infer what is going on in your tooth. While I would like to take your dentist at his word that "decay wasn't to the root", I have personally witnessed quite a few teeth go on to show definite signs of pulp infection
which required root canal therapy DESPITE only modest amounts of tooth decay
. So, although there may be no discernible reason why the pulp in your tooth may be infected, one cannot yet rule out that possibility.
Regardless of the status of your dental
pulp, there are quite a few other things that could be to blame for your symptoms. For example, if the temporary crown was too high as your dentist asserted, this could definitely contribute to your pain-- and even if your dentist sufficiently reduced the bite to eliminate this factor, it may take several days for your tooth to accrue the benefit of this adjustment. Also, if your dentist "prepared" (i.e., drilled) the tooth to a level below the gum line (as is customary), this can unavoidably inflict injury on the gum tissues and cause pain. Additional contributory factors that may be playing a role in your pain include a sensitivity
reaction to either the acrylic composition of the temporary crown or the temporary cement
In any case, the diagnostic process often cannot distinguish reliably between the many factors that may be contributing to your symptoms. Your dentist has addressed one of those factors by adjusting the temporary crown contours, and you may need to wait a few days to get a sense of whether any inroads have been made against your pain. If not, your dentist may need to address the other possibilities, one by one, until he hits on the root of the problem. In the meantime, you should prevail upon your dentist for assistance in controlling your pain. Even if the cause for the pain is eluding him, he should be able to provide you with some manner of pain relief, whether that consists of local measures or prescription-strength pain medication-- especially going into the weekend when he will probably not want to obligate either you or himself to make an unscheduled emergency
visit to his office.
If all else fails, you may ultimately need to have a root canal
in that tooth. I would discourage you from doing so unless or until there is good evidence that a root canal is an appropriate treatment. If you need additional corroboration, you may wish to request a referral to an endodontist (root canal specialist) for a more aggressive assessment of your tooth.
I caution you to wait until this pain issue is resolved before you move forward with your crown. If root canal is ultimately determined to be necessary, it will be easier to do if your crown has not yet been permanently cemented on the tooth.
Hope this helps...