Advice On Pain After Root Canal and Other Possible Complications

So, you’ve just had root canal and the tooth is still causing pain?! What’s going on???

In the first few days after root canal treatment (also termed RCT or endodontics), it is quite normal to experience some pain. Any pain should be mild, and the tooth may be tender to touch or bite down on. Likewise the gum around the tooth may feel tender. This is a normal response and can be helped by taking pain-killers and avoiding the area when eating.

Your dentist will advise you on what analgesic is best for you; typically ibuprofen and aspirin are advised to for pain management during recovery here (but as always only take any medication if you know it is safe for you to do so). See more in our article on dealing toothache remedies.

If the symptoms do not begin to ease after a few days or you get severe pain, you should contact your dentist. Symptoms that do not settle after a few weeks may be a sign of root canal complications…

 

Pain After Root Canal: A Sign of Complications?

RCT is usually very successful, in that the outcome is a pain-free mouth. However as with any medical treatment, complications can occur with RCT. If symptoms fail to settle down after the procedure, this could indicate a complication with the treatment.

Root canal complications could include:

• Post root canal pain and/or swelling. This may last a few days or may not resolve. If the throbbing pain does not eventually resolve this may indicate a failure of the procedure…
• Failed root canal. This is more likely with difficult teeth and your dentist may warn you of such possibilities before treatment. Difficulties will include tight, curved root canals and teeth that are difficult to access.
• Fracture – Teeth are inherently weak after this work, due to the original damage (usually decay) and the access needed in this treatment. As they are weak, they are more likely to crack. Depending on the extent of the crack, it may be one that is easily dealt with or one that can necessitate an extraction.
• Failure of and/or pain after root canal can also occur if the dentist is unable to find and clean out all the canals inside your tooth. Likewise if those that are found aren’t filled adequately, a failed root canal can be the result. Sometimes endodontics are so complicated that, despite all the expertise and modern equipment the dentist or endodontist has, the treatment will ultimately not settle the tooth.
• The dentist uses files to clean out the insides of the tooth, ie the pulp. These files need to be very small and sometimes they can break. Again, this is more likely with tighter root canals. A broken file may not adversely affect the tooth, but sometimes can result in a failed root canal.

 

Failed Root Canal Management Options

A root canal is said to have failed if the tooth does not settle (i.e. is still painful or causing other problems- e.g. symptoms of infection such as swelling). This can be for one of any of the complications outlines above.

If an RCT has failed, the options will include:

• Root canal re-treatment.  This involves removing the previous endodontic filling and repeating the process. This is often best carried out by a specialist endodontist.
• Apicoectomy. The tip of the root is accessed through a small incision in the gum and then cleaned from there. This surgical approach allows for better access to the tooth tip, to help ensure thorough cleaning of the area. Read more on this in our guide here.
• Extraction. Sometimes, despite the best efforts of all concerned, this is the only option to relieve symptoms from an infected tooth.