Pain 3 Months After Root Canal

[Squashface]

Around 3 months ago I had a root canal on my upper front tooth. Ever since then I’ve had on and off low level pain in that tooth. The pain never gets past a 2/3 out of 10, and I don’t get pain biting into food. Pressing on the tooth only hurts if I put quite a bit of pressure on it.

The main thing I’m finding painful is exercise. The tooth can be completely pain free all day, then I’ll go for a run, to the gym or even a brisk walk and it’ll start hurting (still only 3/10 pain level max). Sometimes the pain will go away straight after exercising, but other times it’ll linger for the rest of the day and I’ll take painkillers to make it go away.

Also about once or twice a week, the tooth will hurt for no obvious reason. The pain will build through the day, but be gone by the next morning.

I’ve contacted my endodontist and initially was prescribed antibiotics in case there was a low level infection. These didn’t make any difference. Since then the endodontist has reassured me that this sometimes happens and root canals can take a year on occasion to heal! The pain has changed over the last few months. In the first 6 weeks it throbbed a lot, I had pain under my nose and the gum above the tooth hurt, this has all gone away. It also hurt running my tongue on the back of the tooth, this also no longer hurts. But the pain while exercising hasn’t changed much.

The problem is I’m really fed up. I now associate exercise with tooth pain. I don’t enjoy going for walks as it often leads to pain, even if it’s only mild. I’m beginning to wonder if it could be a crack in the tooth? But I can’t find any reference to my symptoms anywhere. Has anyone had anything similar? What was the outcome?

 

[Gordon]

Sounds like it would be worth getting the bite checked, when you're exercising you'll be clenching your teeth a bit, as well as banging up and down when you run. Would fit in with your symptoms.

 

[Squashface]

Thanks for replying Gordon. I've got a bit of an overbite, so my front two teeth don't meet with the bottom teeth. I have to push my jaw forward to touch my bottom teeth to my top front teeth. Also the crown hasn't been replaced since the treatment. Could it still be the bite even if it doesn't hit any other teeth?

I do think I might be clenching down on neighbouring teeth though. I have noticed that the pain seems to spread to the teeth next to it sometimes. If the area was sensitive after the root canal could the pressure from clenching other teeth be delaying full healing/causing intermittent pain?

 

[MountainMama]

Not a dentist, but as Gordon said, it could be the bite, even if your teeth don’t touch. I have an overbite as well, and my front top teeth are not touching the bottom ones at all. I had an implant put in for my top front tooth. It was still having pain for months after the crown was put on (with very little pain before). The pain was up under my nose and behind the tooth, like you said. Plus in the gums around it. I had the implant and tooth checked multiple times and they found nothing wrong. It would get very painful after exercising, or anytime my blood was pumping hard.
I finally mentioned it at my cleaning last month, and the dentist checked my bite. He said it looked good but took some off the back of the crown anyway. The pain has gone down considerably!

 

[Squashface]

Thanks MountainMama- that’s really interesting. Sounds very similar. I’ll ask my dentist about it. I thought it couldn’t be the bite being off as the crown wasn’t changed after the root canal. But I really hope that is what it is!!

 

[Gordon]

They had to go through the crown to do the RCT, then they filled up the access cavity, the filling could be slightly too high...

 

[Squashface]

Update: I was finally able to see the endodontist. He says it’s not the bite, and he also confirmed that I don’t have any signs of infection. He said the most likely case is that the bone is still healing which will take a long time. He showed me the X-rays of today and before he started the root canal and showed me how it had improved. I couldn’t see any sign of bone loss on the original X-ray, it looked the same as all the others. But then I’m not a dentist!

He then pointed out that the root of the tooth wasn’t very long (probably due to the original trauma or my braces from 20 years ago). I could clearly see the gutta percha went beyond the end of the tooth into the tissue above. I asked whether that could cause the issue, but he said it couldn’t. I had previously read that this can cause quite long term pain and discomfort. Does anyone know whether this could be an issue?

Interestingly the other front tooth which had a root canal 15 years ago also has a short root and the gutta percha goes beyond the root end and I had no problems after that root canal.

He went on to say the current tooth in pain had a large infection prior to treatment so the bone has to grow back and it’ll be tender for months maybe up to a year! Can this happen?

I just find it strange because the other front tooth which had a root canal 15 years ago had the worst infection the dentist had ever seen! My entire face had swelled up and I had blood poisoning. But that one had no problems after the root canal. I would’ve thought I’d lost far more bone with that tooth.

I don’t like to second guess my dentist as he’s one of the most well trained in my area, but it doesn’t quite add up.

 

[Gordon]

Being a bit through the apex shouldn't cause a lot of issues, it can promote some activity by white cells etc to munch away the extra bits, so I suppose that could cause some discomfort.
Other than that and without examining you or seeing x-rays it's hard to suggest anything else.

 

[Squashface]

Thanks for the reply. The endodontist has asked me to give it 6 months to see if it improves (but go back if it gets worse before then). So I guess I should trust that he wouldn’t send me away for that long if he thought there could be a problem. He seemed very convinced it was fine, just taking a long time to heal fully. Shame it’s painful in the meantime!

 

[loopylass]

I had root canal 3 months ago and it was very tender for a few weeks, which worried me as I was reading how fast everyone else seems to recover from rct. Each week it has gradually improved and I have accepted that I am just a slow healer. My dentist also made me a mouth guard as I was having jaw pain, and thought I might be clenching/grinding my teeth and that has helped too. Hope yours feels more comfortable soon

 

[Squashface]

Thanks Loopylass. I really hope it feels better soon too. I’m so fed up! It’s weird how some days it doesn’t really hurt at all, whereas others I end up needing to take painkillers! Every time I have a pain free day I pray it’s finally healed, but then it always starts hurting again