Can I Still Have Pain After a Root Canal?

Most of the time, a root canal is a relatively simple procedure that results in a mild to moderate amount of discomfort after treatment. The most common symptom is tenderness around the tooth for a few days after treatment.  You can minimize your tenderness after treatment by not chewing on the tooth and taking anti-inflammatory medications as prescribed.

A common complication after treatment is a “flare-up”.  If your symptoms increases 48-72 hours after treatment or you experience swelling your dentist may prescribe antibiotics in addition to pain medication.

If you are still experiencing tooth pain weeks after a root canal, contact your dentist right away. You may need follow-up treatment to alleviate your pain. Having a root canal should remove the pain resulting from an infected tooth. Root canals eliminate the infection and the nerve tissue inside the tooth.

What can cause pain after a root canal?          

The two main causes of pain after a root canal are infection and inflammation.  Infection is the presence of bacteria around or inside your tooth where it is not normally found.  Inflammation is the body’s way of signaling the immune system to initiate repair after injury.  To cause pain, both infection and inflammation require a living nerve to send a painful signal to the brain that something is wrong.  Painful symptoms after a root canal can be sent from:  unremoved nerves inside the tooth, nerves in the surrounding bone and ligament and nerves in affected muscles.

Unremoved nerved inside the tooth

During root canal treatment, the nerves inside the tooth are removed.  Many teeth, including molars, can contain multiple roots with multiple nerves in each root.  If you dentist fails to remove all of the nerve tissue from the tooth, you may experience persistent pain.  The use of a dental microscope during treatment has shown to help dentists visualize hard to reach anatomy.  Additionally, a 3D x-ray of your tooth can reveal the presence of difficult anatomy.

Nerves in the surrounding bone and ligament

Root canal treatment removes the nerve tissue from inside the tooth, however, the bone and ligaments around teeth remain highly innervated.  The mechanical instrumentation during a root canal and the presence of bacteria can irritate these nerves and cause pain. A fracture in your tooth may be a persistent source of bacteria that causes irritation in the surrounding bone.  Antibiotics and steroids may help to relieve your pain.

Nerves in affected muscles

If your facial muscles become inflamed, you may experience prolonged pain after root canal treatment, especially if you clench or grind your teeth.  One likely culprit of facial pain is the masseter muscle.  The masseter muscle attaches from your cheek bone to your jaw and is one of the main muscles to help you chew.  Anesthetic injections and staying open for extended periods of time can irritate the masseter muscle. Pain from an irritated masseter muscle can often be difficult to differentiate from a painful tooth.  Warm compresses, facial massages and prescribed muscle relaxers can be helpful in resolving muscle pain.

Find an Endodontist in Lone Tree, CO

If you are experiencing pain weeks after your root canal treatment, it is important for you to have a follow up visit with your dentist to determine the cause of your pain so that the proper solution can be found.  You may need to see an endodontist to search for missed canals with a microscope or to take a 3D x-ray.  If you searched for an endodontist near me, here we are! Contact our office at (303) 524-9343 to schedule an appointment.