While most root canal procedures result in minimal to no discomfort, it is quite normal for some teeth to be a bit problematic after treatment. Most of the time, the pain is mild, but there are cases where the pain can be acute for a short period of time after the initial treatment. Usually these symptoms are normal, not serious and resolve quickly. This is why you have to be consistent with taking your medications as directed by your doctor. There are a number of possible causes of pain after the completion of a root canal. Even though the living pulp tissues are removed after your root canal, nerve endings remain in the ligaments that attach the tooth to the surrounding bone. These ligaments have nerve fibers associated with them that can feel pain. These fibers (not the pulp tissue or the tooth) are the source of post root canal pain.
Causes of post- operative pain are numerous. If the tooth was painful prior to your procedure, there is a good chance that it may be more irritated and painful after the procedure. You can even get a slight to moderate amount of swelling around the tooth or the gum. The reason for this is that the tooth was further irritated due to the root canal procedure itself and enhanced by the already inflamed periapical tissues that surround the tooth. Additionally, inflammation may also be caused by the irritation of the physical instrumentation that is required during the endodontic procedure to clean the canals. Sometimes the root canal files can either push some debris past the end of the root or just injure the fine ligaments around the roots. The inflammation and swelling (if present) usually resolves by itself given enough time. Your doctor is aware of what post operative complications may occur on a case to case basis. If necessary, You will be prescribed specific medications that will help you during this phase.
Another source of post root canal discomfort is a high bite. A high bite occurs when your teeth are not coming together properly and hurts every time you bite down with nothing your mouth. Unfortunately, the inflammation that occurs around the tissues of the tooth after the root canal can be significant and can actually push the tooth up and out of the socket slightly into a different position. Subsequently, you will feel pain because you're biting on this tooth first. This can be easily and quickly corrected by a bite adjustment. If chewing is uncomfortable or if you bite down with no food in your mouth and the treated tooth still hurts - the bite should be adjusted immediately. You will need to give us a call so we can get you right in. Teeth undergoing root canal should not be in a heavy occlusion or in other words, a heavy bite.
Other possible causes of pain may be due to persistent infection. If a root canal is completed, but the infection is still present and persists without resolution, there are other procedures that may help resolve the problem. Other times, an infection may not be resolved, especially when it is related to a root fracture. In these cases the tooth usually has a poor to hopeless prognosis and may require extraction.
Every case and every tooth is unique and responds differently after treatment. We ask that if you are not feeling any better after your appointment, to please let us know so we can address your issues promptly!