Dr. Baruch Tetri

Tooth pain after root canal treatment

Board-certified periodontist
September 05, 2023

After undergoing root canal treatment, discomfort may occur. You may wonder – Is this normal? Should I urgently see a dentist? How many days does the pain last after the procedure? When is it necessary to see the dentist again?

In this article, we will discuss the symptoms to pay attention to first, and what to do if the pain occurs some time after the treatment.

What should I expect after root canal treatment?

Inflammation and tissue sensitivity can cause pain. These symptoms are normal after the removal of the nerve or root canal treatment. The intensity and duration vary individually. However, the discomfort should gradually subside within a few days.
After root canal treatment, patients may experience the following sensations:
  • Pain or sensitivity when biting or chewing. The dentist may prescribe pain medication during the recovery period.
  • Sensitivity to cold or hot temperatures.
  • Gum pain. The tissues may be irritated due to the dental procedures.
  • Discomfort from a temporary filling. It may affect the bite. It will be replaced with a permanent filling in a few days.

Successful root canal treatment

Successful root canal treatment involves the following: During the canal treatment, the dentist administers anesthesia. Pain may arise only after the procedure, but it is a natural tissue recovery process. Discomfort should subside within 5 days. The treatment will progress well if the pain does not intensify during the recovery period.
It is important to monitor for the absence of new painful symptoms after the procedure. The pain should not worsen. Gradually, inflammation and sensitivity should diminish.
Successful root canal treatment includes the following:
Examination of the canal using computer tomography. The tooth structure and nerve health are assessed, checking for the presence of cysts or root fractures.
Effective anesthesia. The dentist ensures complete numbing of the tooth and isolates it to prevent infection from saliva.
Removal of infected tissues. All procedures are performed under a dental microscope.
Cleaning of the root canals. They are treated with an antiseptic and filled with a sealing material, tightly sealing the cavity.
Restoration of the tooth with a permanent filling or crown.

Experiencing root canal tooth pain months or years after treatment?

These are dangerous symptoms of a hidden problem:
Throbbing pain

Occurs when an infection sets in, causing inflammation at the root of the tooth. It may intensify or lead to other complications such as fever, swelling, sensitivity, or an abscess.

Pain when biting down

This symptom indicates tooth or restoration damage. It can be caused by a crack or fracture in the root, as well as damage to a filling or crown. It may be intermittent or persistent.

Pus discharge
Indicates inflammation due to infection in the root. It can also occur as a result of gum abscess caused by dental calculus.
Dull, persistent pain

May arise following inflammation or improper nerve removal.

Example of a canal treatment

We received a patient who had already undergone root canal treatments for several teeth. However, the canal treatments were not done properly. Some of the dental canals were missed or not completely sealed.

Dr. Sain re-treated almost all of the canals – 20 in one day.

A year has passed, and the patient comes for preventive check-ups. Tooth pain no longer bothers her.

Before After case-1-after

Experiencing tooth pain after root canal treatment? Here’s what to do

Have you noticed an increase in root canal pain or has it been bothering you for a long time? Make an appointment with a dentist immediately to avoid complications. Our endodontist will provide recommendations on how to reduce the pain and give you a plan of action before your visit to the clinic.

Endodontist at Tetri's Smile Clinic

We often see patients from other clinics who are experiencing dull pain. We check for infections and any fragments from instruments. Sometimes the cause of the pain is deep-rooted and requires careful treatment.

During the treatment, we use a microscope to locate any branching or difficult areas in the canal. This helps us perform precise and painless treatment.

Tooth with root canal hurts with pressure or when biting

Infection remains
Even after cleaning and disinfection, infection or saliva can still enter the canal. The dentist may not completely remove infected tissues. That’s why we use a dental microscope to prevent reinfection.
Nerve damage
Pain occurs immediately after the anesthesia wears off. The cause is a small portion of the nerve remaining inside the tooth. It leads to persistent sensitivity when pressure is applied.
Foreign object lodged
A small piece of an instrument can break off during canal cleaning. During filling, tissues can become inflamed and cause pain.
Damaged filling
Over time, the filling may stretch, leading to barely noticeable cracks. Pain occurs when air or infection enters.
Allergic reaction
Allergy to filling materials can cause throbbing pain.
Bite disturbance
It’s uncomfortable to close the teeth if the filling or crown protrudes significantly. Restoration adjustment or bite correction is required.
Cyst or granuloma formation
Occurs during root inflammation. Pus and infected tissues accumulate at the tip of the tooth, seeking a way out into the oral cavity, thus causing pain.

Treatment options for a tooth

If a filling was placed

Preservation of the filling
If pain occurs due to a bite disturbance and the filling protrudes significantly, the dentist will adjust its position. Excess material will be removed, and the surface will be polished.
Filling replacement may be necessary
In some cases, a new restoration is required when the old filling is worn, loose, or damaged, causing pain. The dentist will place a new filling of proper anatomical shape.
Root canal retreatment is needed
If the pain persists, infection needs to be removed. The dentist will remove the old filling, clean the root canal, eliminate missed canals, and place a new filling.

If a crown was placed

Crown adjustment
This is necessary when the crown significantly affects the bite. Overhanging margins can irritate the gum and cause severe pain. The dentist will adjust the position and shape of the prosthesis, perform antiseptic treatment of tissues, and polish the crown.
Treatment and placement of a new crown on the same day
In some cases, canal treatment can be performed without removing the crown. The dentist will make a small hole, treat the canal, and seal it with composite material. However, if the crown is damaged or extensive treatment is needed, it will be replaced. The dentist will scan the tooth, treat and reseal the canal, and immediately place a new crown.

Seek immediate retreatment at the clinic. The dentist will provide instructions to alleviate pain before the appointment:

  • Advise on suitable pain medication.
  • Prescribe antibiotics if signs of infection are present.
  • Prescribe anti-inflammatory drugs in case of swelling.

Delaying the visit to the dentist will allow the infection in the root to progress, potentially leading to tooth fracture or gum inflammation. In severe cases, the dentist may recommend tooth extraction and implant placement. Therefore, do not postpone your dental appointment!

Prevention of issues with a treated tooth

Attend regular preventive visits to an endodontist or dentist
The doctor will conduct an examination, assess the condition of the root canals, and perform preventive teeth cleaning.
Follow all the dentist's recommendations after treatment
The dentist may prescribe medications. Adhere strictly to the prescribed regimen and do not self-medicate.
Maintain oral hygiene
Brush your teeth in the morning and evening. Use dental floss and mouthwash.
Adhere to a healthy diet
Limit the consumption of sugary products or beverages to prevent secondary decay. Drink plenty of water throughout the day. Consume fruits, vegetables, and protein-rich foods.
Avoid harmful habits
Refrain from smoking and alcohol consumption, at least during tissue recovery.