Pain after Root Canal

Especially since the movie Marathon Man, where a man was tortured by doing a root canal treatment (endodontic treatment) without anesthetic, this treatment has been feared tremendously. However, these appointments themselves are generally not painful. And they are generally not traumatic—there isn't a lot of grinding as there is with a filling or a crown. Most of the work is done with hand instruments. Sometimes the tooth itself is dead and there isn't even any novocain required. Root canal treatment is performed in order to solve toothache pain. Extraction—taking a tooth out—is much more traumatic, from my experience as a dentist. Read our page about what to expect when you need a root canal procedure.

But many times there can be some toothache pain after a root canal treatment. Here's an explanation of that.

There are two types of toothaches:

One source of toothache pain can be the inside of the tooth. Toothaches usually start as this type.

Another source of toothache pain can be the ligament that attaches the tooth to the bone. When the infection inside your tooth spreads through the tooth apex to the bone around the tooth, your toothache may become this type. Pain after a root canal treatment is almost always this second type--it arises from the ligament surrounding the tooth because the tissue inside the tooth has all been removed.

The more promptly you seek attention for your toothache, the less likely you are to have pain after the treatment. When your tooth is infected, the longer you allow the infection to become entrenched, the more likely you are to have that infection try to spread when it's treated.

When a dentist performs a root canal treatment, he or she cleans out the infected tissue inside the tooth. It is very easy for some of this infected tissue to be pushed out the end of the tooth, through the apex into the bone. Or, the instruments used by the dentist can penetrate through the apex and irritate this tissue.

If this happens, the tooth will hurt afterward. This is not an indication that the dentist did anything wrong. In fact, there are some prominent experts who insist that if endodontic treatment is done properly, there will always be some pain afterwards.

There are ways that the dentist can minimize this post-operative pain. One way is to reduce the tooth so that you don't touch it when you clench your teeth together. A second aid is to take an anti-inflammatory medication, such as ibuprofen, either at the beginning or the end of the endodontic treatment.

What to do for pain after root canal:

If you are unable to clench your teeth together after a endodontic treatment because it hurts too much, you should visit your dentist as soon as possible. Simply reducing the tooth so that you don't hit it can produce immediate, seemingly miraculous results.

Taking antibiotics after a root canal treatment may be necessary. If the infection that was inside the tooth has spread to the bone surrounding the apex of the tooth, then antibiotics will help you heal.

If a tooth that has had endodontic treatment has pain that is aggravated by cold temperatures, it could be that there is an extra canal in the tooth that wasn't visible to the dentist. A return visit to try to determine the source of the pain would be wise, in this situation.

If the pain begins a long time after the completion of treatment, it may indicate a failed root canal, and re-treatment or root canal surgery may be required, or extraction of the tooth.