There are a number of possible causes of pain after the completion of a root canal. After a root canal is completed no living pulp tissue remains inside the tooth, but nerve endings remain in the ligaments that attach the tooth to the surrounding bone. These ligaments have nerve fiber associated with them that can feel pain. They are the source of any post root canal pain.
One possible cause of pain are numerous and include inflammation of the periapical tissues post root canal. This inflammation may be due to extruded sealer or 'over instrumentation during the endodontic procedure. Sometimes the root canal files go past the apical terminus and can either inject some debris periapically or just damage the ligaments. This inflammation usually resolves by itself given enough time.
Another source of post root canal discomfort is a high bite and this can easily be corrected by a dentist. If a patient bites down, with no food in their mouth and their root canaled tooth hurts, then the bite should be adjusted. Teeth undergoing root canals should be not be in a heavy occlusion.
Other possible causes of pain are a persistent infection or a root fracture. If a root canal is completed, but an infection still is present around the periapical area then a retreatment may be indicated especially if significant time has gone by without a resolution of the infection. Sometimes an infection can be caused by a fracture of the tooth in question and in that case the tooth usually has a hopeless prognosis and requires extraction.
It is also possible, but not as common that persistent pain exists due to a sensitization of a nerve ganglion We have all heard of 'phantom limb pain'. This a similar phenomenon. Some of these patients can have pain even after the offending tooth is removed.
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That is a very good post. you told nicely about pain after the completion of a root canal. You did a good job man. keep it up.
NEVER NEVER NEVER let a dentist use formaldehyde, lead or mercury in a root canal. don”t assume they won”t…ASK ASK ASK. Its called Sargenti Paste/N2/RC2B/RC2W. The dentists who use it conceal it from the patient (even after harming them) because they know it is malpractice. The FDA rejected it based upon safety concerns, every state dental school teaches NOT to use it because it is below the standard of care. Injuries can be life altering and life threatening. We are two patients who will suffer life long problems because we didn”t know to ask. The ADA does not recommend it, their endodontic board (AAE) is strongly against it…
http://www.aae.org/NR/rdonlyres/14F3726F-DA2D-4155-97E9-D0201E690B17/0/paraformaldehydefillingmaterials.pdf
Don”t take the chance….injuries are random and can show up months or years after a seemingly properly done root canal. ASK, SAY NO. Don”t walk in our shoes. http://www.worstrootcanalever.com
My friend had her root canal done five weeks ago, she had been feeling acute pain for a few weeks, and the pain has only gotten better until a few days ago when she started taking Ibuprofen. Is this normal? How do we know if she needs re-treatment?
Sometimes soreness can last for several months or more. If there is no swelling or obvious reoccurrence of an infection, it can be hard to tell whether the root canal is failing. If possible your friend should wait. She should call the dentist who did her root canal and ask if he has any advice. If after about 6 months if there is not noticeable improvement it is certainly time to go for a consult with an endodontist to see if a retreatment might help.
I had a filling in Dec 2007 on tooth #4, not working out, so we had to do a RC in Feb 2008. It was infected so after the root canal i was in extreme pain and on antibiotics. I went thru about 5 bottles of antibiotics b4 the tooth was healed enough to cap it, months later. I thought after the root canal i would have some relief, on no it was much worse after. 1-1/2 year later my same tooth is sensitive to pressure and aching (not hot or cold). I saw the Endo specialist and he said there are a few possibilities, re-treatment of possible missed canal or apico surgery to see if infection is present, or a possible fracture that will not show on Xray. Last Friday 8-14 i had the re-treatment RC done and again on SAT i was in agony. Again, it hurts much worse than B4 i went in there. When I even touch my tongue to the tooth, it is very sensitive and shoots pain up in my cheek. If I press on my right cheek it is painful. I am on antibiotics already since Friday to make sure an infection didnt start. HELP? In lots of Pain!!!
Hi
Your posts always prove to be of a high value and quality for readers.
keep it up
Hi.
I had RCT treatment done on a back top molar 6 months ago.
I had it done by an endondontist.
It has never settled down to "painfree" situation and now is very sensitive to hot liquids and I certainly cannot bite on it.
Is it possible to feel discomfort on hot stimulus?
I know it cannot be another tooth because it is the only tooth left in that area.
Thanks.
To the best of my knowledge it is very unusual to feel sensitivity to hot on a tooth that has a completed root canal. I would advise you to contact your endodontist about your symptoms at this point.
I was amazed at the quality of root canal. It makes my life alot easier. This is the most reliable thing of thing we've ever used.
How long is too long to be hurting, my dentist said i was severely infected. How long before something should be "done"?
I am mostly concerned because i'm wondering if this tooth and infection has been a trigger or cause of my migraines, which is WAY worse than the pain of the tooth. I have to go and get shots.
I had a root canal commence before Christmas 2009 and the tooth is sore my dentist has not completed the final fillings due to the pain. I have been sent an Endodontist 2 weeks ago he tested the tooth and thinks that it may be a muscluar problem. I have seen a chiropractor who massage the face and now I have tried an Cranial Osteopath hoping that she can help. I have been on pain killers,soft food and used heat packs over the past two weeks with out any difference. I saw the endodontist again yesterday and I am to keep seeing the Osteopath over the next 6 weeks before going back to the Endodontist. He doesn't see anything wrong with the xrays that have been taken but still thinks it pain is muscular. Why is this the only tooth that hurts if it is muscular?????
hey that's a god blog.if u don't maintain your root canal you will have a lot of problem.Dr. Kumar Subramanian,provides you root canal therapy in completely painless manner. Thank you
I had a root canal done on upper molar a year ago. Was very traumatic. Was told that one root had deviated becuase of a filling, and she could not find this root. Was told that it would be ok, she found the infected root and sealed the tooth. This tooth is not crowned, but I could still feel slight sensitivity when biting. I have been back to the dentist twice to ask about this in the last year, was even told that I am only feeling the sensitivity because I know there is still one root in there!! IN other words, all in my mind !! This is very patronising!
I now feel a lot of sensitivity when biting, but no hot/cold sensitivity, but it's getting to the point that I can't eat on it. This is exactly what happened just before it became acutely infected the first time. I am fearful that i'll have to pay a lot more money to finish the job which should have been completed properly the first time.
I have had xrays from this dentist that turned out to be useless (£40 per xray), as she told me that you can't see everything on xrays.
Do I need to change dentist? I'm fed up with being treated like I have disposable income to keep throwing at this tooth.
ps - was even told each time I have gone back the last year that I cannot be feeling anything in the tooth as it's dead, and that it's the tooth behind that's the issue, but it's definitely not. I'm fed up with being treated like an idiot. I definitely know which tooth hurts and which doesn't. I think she is hoping that if I go over one year without the tooth having to be re-treated, (there is a one-year guarantee on work), she can charge me again. Fuming!!
I'm on my third retreatment on tooth #13. I have this wierd feeling in my cheek like someone is pressing on it and pain in the tooth. I don't know if an apico is worth it or if I should just have it pulled at this point. My endontist said it might have to be pulled. Any thoughts?
I had a root canal on a top back molar just a little over a month ago. If I touch the tooth with my tongue I feel pressure pain. My dentist has put in a post to stabilize the tooth and filled in. In a few months they are going to crown the tooth. I don't have alot of pain, but I do have pain. Should I hold off on the crown until this goes away, if it does, and is it normal to feel this pressure pain??
It is really difficult to give advice without an examination or seeing a radiograph. Often if one of my patients does have a tooth that is symptomatic after root canal treatment, I do choose to delay completing the final permanent crown restoration, for six months or more. I like to see if the symptoms improve or worsen. Also after a sufficient length of time I might take an additional X-ray to check on the periapical area of the tooth.
I have had a tooth bothering me for a few years. Had a root canal and it did not fix the pain. I was up the other night all night and almost cried the pain was so bad. Got referred to another dentist, she said the tooth looks healthy and put me on some anti depressants for pain saying the pain might be phantom. I doubt that. anyway, it is very sensitive to cold, not so much hot. almost ready to part ways with this bothersome tooth. i fear eating as i dont want to trigger pain and cant eat on that side. Should I have it pulled? Cleaning the drug store out of pain medication trying to keep down the pain. Long list to see a specialist.
Mark-if your tooth is feeling sensitivity to cold it is extremely unlikely to be originating from the tooth that had a root canal. Most likely your cold sensitivity comes from an adjacent tooth. Consider having a dentist check for cold sensitivity with an ice probe. This ice challenge will most likely pinpoint the source of the cold sensitivity.
I told them to just yank the tooth, I'm "that" patient that stuff happens to, but they kept saying "save the tooth" so I had a root canal done. It's been years and it still kind of hurts. They finally did an xray and noticed a massive infection (keep in mind I have MVP, I don't need infections!) and wondered that I wasn't howling I'm pain...
So they want to "retreat it".
Seriously? Don't they ever listen to patients? I warned them I was that .0001 % of the population that stuff happens to, if the first RC which has a success rate of around 90% didn't work, do they actually believe the 2nd at a lower % success rate will work? Sigh
Anyways, I'm going to get it pulled (lower jaw) is it easier to pull a tooth that had a root canal?
Extracting a tooth that has had a root canal can be slightly more difficult, since teeth that have had endodontics are often more brittle. Sometimes in the course of an extraction these teeth can split and the pieces have to be removed individually.
That being said, most times the teeth come out without complications and the patient is fine.
I had a root canal done 2 months ago, and my mouth is still numb, what causes this, and will it ever go away?
Some endodontic infections of lower teeth can cause a paresthesia, since they can affect the mandibular nerve. If the numbness is caused by an infection, usually "feeling" will slowly return over time butit can take up to a year for it to return to normal.
Yay, great blog. I bookmarked this post. (I'm not even sure how old it is). I got 2 root canals done three months ago and they both still hurt. My endo tested them for cold/hot, and got no pain response. They hurt when touched or when I chew food. My dentist said this is normal and healing takes time. Do you feel that pregnancy delays healing of root canal teeth? Susan
I had a root canal done four months ago that had been capped many years ago. The pain still persisted and they "retreated" it with another root canal yesterday and my tooth still hurts in exactly the same spot it did before. Should I have my dentist cut the cap off to see what is going on or have it pulled and replaced. I'm tired of throwing money at "a dead horse".
It is not at all unusual to have pain the day after a root canal is completed. This is true with retreated root canals as well. Sounds like waiting is a good idea to see if your symptoms subside. Why not call your dentist to let him know what is going on?
I have a question. I had a root canal done on #13 about 4 months ago and I have pain every so often on that tooth when pressure is put on it. There was a crown put on it days after the root canal was done. Is this pain common?
In July 2010 I had an old silver filling removed to have a crown put on instead (was my dentist's suggestion, I had NO PAIN)....and I then had excruciating pain in the temporary crown, she ignored this and then put on a permanent crown. I still had the pain in the permanent crown, so she did a root canal through the crown. I still had pain so she had me do 3 rounds of antibiotics, still had pain. In October I went to an Endodontist, he found a "secret" root so he re-treated one side of my tooth. I was still in pain a month later so he just opened up the other side of the tooth last week and re-did the original root canal and put some antibiotics down inside the tooth to sit for a week. I am still in pain but am horrified and terrified to have my tooth extracted, my endo seems to think that there must be a crack inside the tooth that he cannot see. I don't understand why it hurts so much when all of my roots are dead. I am only 35 and am exhausted from the pain of 6 months of this, but want to still try to save my tooth. It is #30 and an important molar. Any advice? I am supposed to call my endo today to tell him if I am pain-free, I'm putting it off because I don't want to hear the answer- that I have to have it pulled. I am so MAD at my original dentist for putting me through this for no reason at all. Why would she want me to get rid of a filling when I had no pain?? I appreciate your help.
I had root canal work done about 3 months ago but in the last few days it has become sensitive to bite pressure and the filling (which is silver) seems to have moved and now has a hole on one side I really don't want to go back to the dentist as she scares me but I need some advice on what to do
It sounds like either your tooth or the filling has fractured. I believe a visit to your dentist is in order. He will be able to diagnose what has happened and will offer appropriate treatment.
I had a root canal done almost a month ago. It still pains, not much as before though and the pain doesn't last long.I called my dentist searching for advice. I had the tooth X-Ray. He toll me that the tooth is in good shape and gave me a prescription. He also talked about the possibility that the tooth cracked or infectious. I'm taking Teva-amoxicilin in one week and it does get better, still pain though,not very much but one time it gave me a short headache.I went to sleep and when I woke up the pain went away. I'm so afraid that the pain will come back if I stop taking that medication. Please give me an advice.
Your anxiety is understandable but sometimes successfully completed root canal can still cause some pain. It sounds like in your situation the amount of pain you are experiencing is diminishing. Since your dentist has already evaluated your tooth and found no obvious problem, waiting is the best option. Sometimes patients notice discomfort for 6 months or more, but often it eventually resolves. Try and be patient for now.
Hello Dr. Spindel, I have hope that you can clarify my situation. I had RCT done a little more than a month ago in one sitting due to tooth fracture and pain. The tooth was fine until today when it pains with pressure and looks like I might have a vertical fracture. The endodontist created more visible fractures while working on RCT. What do I do now? Can the tooth be saved with crown?
I had a root canal done about 6months ago and a few days ago it started to hurt a little bit when I bit down on it. The endodontist said that I had a cavity on the adjacent tooth and that it could be causing the pain, I had that filled in but my tooth still hurts. Could this be due to an infection?
My dentist did a root canal 3 days ago, on a tooth that is infected, before putting me on antibiotics. I'm in quite a bit of pain now, and had none before the root canal. It especially hurts to bite, so eating anything I have to chew is out.
Would it have been better to do a course of antibiotics first? My gums are badly swollen, and weren't until the root canal either.
Vicodin isn't even touching the pain. I'm also taking 2 ibuprofen every 6 hours. Would it be a good idea to brush the tooth and gums a several times a day, until the gums stop swelling? I have been doing ice pack, 20 min. on, and 20 min. off. Any other ideas on the pain?
Usually patients are not premedicated prior to initiating a root canal for a tooth with a non symptomatic infection. Instead, commonly antibiotics are prescribed after an endodontic treatment of a non vital tooth (with or without an infection). The thinking is that the contents of the pulp chamber and the root canal system are contaminated with bacteria. Sometimes instrumentation of on non vital tooth can cause a flare up of an infection. If you have swelling after your treatment you should contact your dentist and discuss it with him. He may want to see you.
Help!! I was told that I needed a root canal before my vacation in Jan. I thought I'd wait till I got back. Big mistake. I got a sinus infection in SF and the tooth exploded. My cheek swelled up and the worse nerve pain ever. The dentist put me on anibiotic then worked on the tooth a couple of weeks later. What I noticed was a sensitivity from just under my nose all the way down the cheek to the tooth. Yet another round of antibiotics and more drilling. Nothing changed even when I wiggled the tooth it was sensitive and the whole cheek thing. He then said I needed to see a specialist. But soon found I couldn't afford him so I went to another dentist that said he could retreat it. That was today. Now that the numbing is gone guess what?? The same sensitivity is still there, very upset, I'm too young to loose a tooth. Could this infection win?? If I just left the tooth alone could the infection resolve itself? How dangerous is it to just do nothing and see what happens? Would a "specialist" be worth it?? Could it just be an irritated nerve? Oh and the process of drilling and redrilling has been a 5 month process since the first dentist scheduals at least a month to and a half in advance--and no sooner.
Not all root canals are successful and if they fail and retreatment has not been a resolved the problem, then usually extraction is an option to consider. Although I haven't viewed a radiograph of your tooth, I think you should take the advice of the first dentist you mentioned and see an endodontist for a consult. He or she will advise you of what your best options are.
Dr. Spindel,
I had a root canal done about 3 years ago. It didn't hurt, aside from it's regular numbness. However, in the past 3 years, my root canal has been hurting for a week or so every so often. Currently it's hurting so much, but I have no idea why and am in pain killers. What do you think this reoccurring issue may caused from?
Three years is a long time for you to be feeling pain from a root canal. If you haven't already done so it is time to have a consult with an endodontist to see if they can explain the source of your discomfort.
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