Root Canal FAQs

[Kings20]

Pain after root canal with temporary crown

So I had a root canal last Tuesday and they put a temporary crown on it. The temp crown was made from plastic I think it feels weird but otherwise ok. They told me not to eat on that side so I haven't but I notice every once in a while when I bite down I get pain in that tooth. Is this normal and will it go away once the permanent crown goes on?

Also since I'm kind of nervous about the crown coming off I haven't been brushing extremely well on that tooth and I am nervous it's gonna mess up my root canal.

 

[Gordon]

I hate lazy endodontists who don't tell patients this kind of stuff

Basically with all the guddling about in the canals there is always a little bit of inflammation at the top of the root after a root canal. It's inevitably going to be tender to bite on for a few days and is perfectly normal.

Brushing your teeth or not won't make any difference to the success or failure of the root canal, but poor brushing will make it really difficult to get a nice new permanent crown on there, so get in there with the brush!

 

[Kings20]

Ongoing pain/sensitivity after permanent crown

Hi So I just got the permanent crown put on the tooth, I was wondering if it's normal to feel some pain/sensitivity and for how long? They were digging pretty good with floss to remove extra cement so that could be why. I feel a tiny bit of pain if I bite down on the tooth so I'm not gonna eat on that side for at least a day.

 

[Gordon]

Yes, that would be fairly normal. Try not to keep "testing" it, otherwise it'll take longer to get better. (This is far easier said than done though!!!).

 

[carole]

WHAT ARE THE CHANCES OF RCT being a success

I have had a RCT done on a back tooth on the bottom, in one treatment before it had thawed out properly it hurt, which I expected, later that night after thaw, still painful still expected.
The day after it got worse and swelling appeared, as I got to the evening it was really painful, throbbing and warm salt water rinses made it worse and my mouth was on fire.
I got antibiotics the next day, I have been on these for 3 nearly 4 days now (5 day course) and all my other teeth are sensitive and hurting now. The swelling has gone down a lot and a lot of the pain has gone. My cheeks feel swollen and my gums on the side of the infection both top and bottom are very sore. I have a very painful bridge at the moment, an old one, on the same side as the infection but on the top. My teeth feel tight as if they are pushed together. My tongue is also very sore down one side.

What are the chances that this RCT will be successful, I am an NHS patient so is it likely I will lose the RCT tooth, and could it be possible that my bridge needs looking at.
I had an untreated abscess for 20 months before having treatment in Sept last year, a removed tooth and a RCT on the abscessed tooth cleared that up. The problem is at the opposite side of my mouth.
Could the fact that I had the other abscess for so long be causing the problems I have now. I read somewhere that if a dental abscess is left untreated, you can get an abscess appear somewhere else in the body.

 

[drhirst]

Hi Carole,

One does occasionally read suggestions that abscesses in the mouth can eventually cause abscesses in the brain which would have serious consequences. However, the chances of this happening are extremely remote... So relax this isn't happening to you.

We will have to keep our fingers crossed that the root canal settles down.

It is depressing when one dental problem follows on from another but hopefully, this bad period will pass.

Best wishes

Lincoln

 

[carole]

I just thought I would update this, so anybody that hasn't had a root canal need not worry, I feel very good no pain all the swelling has gone and my teeth have stopped aching now. Whewwwwwwwwww!! what a difference a day makes, thank goodness.

So I am giving myself some of these

 

[Anxioustom]

Had a root canal done, in pain

Hi guys,

Certainly getting over the fear of the dentist now having had another root canal done on Thursday. Now it's 2 days after the root canal and I'm getting a throbbing pain above the tooth I had the root canal done on...

Is this normal for after a root canal? The pain is persistant.

Cheers

 

[drhirst]

Hi,

It is not uncommon. It should subside over the next couple of days. Keep taking the pain killers. If you feel it is not improving get it checked out. Occasionally these situations need antibiotics to resolve them.

Hope things improve fast for you.

Lincoln

 

[AnotherUser3737]

Pain and discomfort two weeks after root canal was finished​

After dithering about whether to have a root canal on a dead tooth which looked as though it was beginning to cause problems. I went ahead and had the treatment done.

It is one of my top front teeth and was done over three visits.

After each of the first two visits, it was a bit painful for the first couple of days after but fine after that, and for the six weeks between the second and third visits it was no problem at all, apart from a few days before the final visit when I felt a few twinges (which I put down to nerves!).

Now though it is two weeks later and I still have what I would call varying mild to moderate pain and discomfort. I'm constantly aware of what could best be described as a dull ache, or maybe pressure, that varies in intensity. It's made me take painkillers a couple of times, but mostly it's just there making me worry.

It's difficult to say if it is getting worse as the pain comes and goes, but it is certainly not getting any better. The sensation makes the tooth feel as though it should be painful to eat with, but it isn't.

Can anyone advise as to whether this suggests that something has gone wrong? Is there maybe an infection now at the tip of the root that has been sealed in and will continue to get worse. Have the files pushed it into the soft tissue when the dentist went too far? Should I go back and ask for some antibiotics just in case? I know some people experience pain for quite a while after root canal, but isn't that usually when there was a lot of pain beforehand and the tooth was alive before the treatment?

Any advice, especially from the dentists here, would be very much appreciated.

 

[rob wain]

Hi,
I would have expected your tooth to have settled by now but the fact that it is still giving discomfort doesn't mean that the treatment has failed.

I would suggest you return and explain your symptoms. They may give you some antibiotics.

 

[AnotherUser3737]

Thanks for replying. I'll give it until it is exactly two weeks (in a couple of days) and then speak to my dentist like you suggest.

It just seems very frustrating that it was fine right up until the moment it was filled during the last treatment. Could it be something to do with the filling instead, or the fact that, as it has been dead for several years up until the root canal, that suddenly having something in it has upset things somehow?

Or was six weeks too long to leave it between the cleaning and the filling and allowed the possible infection to re-assert itself?

 

[rob wain]

It may have been fine in that it wasn't hurting but the abscess may have been growing slowly all that time.

One of the problems that can arise when you do a root filling is that you stir up a hornet's nest for a while but if the filling is well done then it should settle with time.

6 weeks is perhaps a little longer than is ideal but if all was well at visit three then it should have been fine to proceed to fill the root.

 

[AnotherUser3737]

Thanks very much Rob. I'm not sure my anxiety (or occasional wobbling/prodding) is doing it much good either but I'll try to be positive about it and hope it eventually settles down.

 

[Ellie721]

Root canal fail?!! Please help!!!

Hello,

I had a really nasty irreversible pulpitis/possible infection for 6 weeks in tooth #31 due to a deep gumline filling. My dentist did part of a root canal to stabilize the tooth 5 days ago, he drilled it, removed nerve/infection, and filled it with medicine and put in a temp filling and told me to come back in a couple of months for him to finish it and hopefully this calms the pain down in the meantime. I will say that the terrible pain I was in before this that I was having that radiated through my jaw and into my neck/ear is gone.

Well, I have a lot of tenderness and pain when I chew on that tooth (yes he told me not to chew on it for at least a week) but sometimes that is hard and food gets back to that area of my mouth, but I am also having some sensitivity to cold or hot fluids (not anything like I was prior). Did it fail? It is normal to still have minor/slight sensitivity to temperatures AND tenderness/pain when chewing this soon after a partial root canal?

I have gone back to the dentist so much due to my anxiety issues and bite issues (my TMJ is horrible on the other side with all the stress I'm going through) so I am really embarrassed to call my dentist and ask-- I am sure he is sick of me.

Please help, I am panicking that it failed.

 

[drhirst]

Hi Ellie721
It can take a while for these things to settle so I would not worry too much. The treatment has not failed because it has not been completed yet. If things are getting more tender rather than less, then I would let your dentist know, as he or she may want to bring forward your appointment to finish the treatment.
Best of luck

Lincoln

 

[Acheygirl]

At a total loss 2 root canals and still in pain 2 yrs

I am at such a loss and not sure what to do.

Mid 2019 I developed a tooth ache in my premolar. I had a root canal by an endodontist. The pain continued so he retreated the tooth twice. He also did a cone beam scan all looked good with some curved roots but he or his radiologist did not see that to be an issue. No cracks visible inside the canal or on scans. Crown was adjusted many times but still almost 2 years later sometimes the tooth feels off alignment and hits the bottom strange like it's moved and out of bite. Not only does it feel out of bite or "fat" at times but touching it with my tongue the tooth feels strange mildly painful and like it's not anchored in there good?

My pain continued and we moved to the neighboring tooth and did a root canal. That tooth was partly dead. We felt that would fix it but the pain continued.

After numerous visits to the dentist and endo with no clear answers I visited an orofacial pain dentist who did a set of cone beam scans and also found no issues and diagnosed atypical odontalgia and ordered an MRI. With Covid and some uncertainty I did not get the MRI yet. My dental pain had started to improve but the beginning of this year something new happened. When I eat hot foods and it hits #12 I get an intense pain jolt in it. I can drink cold no issues. I have always had discomfort biting on this and the neighboring tooth after the root canals but dentists could not explain why. I accepted this would be a new normal but the pain with hot is not only incredibly painful but alarming how bad it hurts.

I have developed severe dental anxiety from all of this. With your years of experience in the field does this sound like trigeminal type pain? Would a cracked root canal tooth do this if it had a hairline fracture? Recent dental x-ray was normal. My dental ache is constant and the extreme pain is only with hot foods touching that tooth. I can eat hot foods on the other side no issue. The pain is only in the teeth/tooth and does not spread in my cheek etc. I feel the pain at the very tip of the tooth root area or that's how it feels. I am embarrassed and ashamed to further bother my dentist or endo as I think I have exhausted any further options they can offer and I know they are frustrated which makes me feel even more hopeless of the problem. My biggest fear is extracting teeth or doing more root canals that would only make it worse if neuralgia. Thanks for listening.

 

[Gordon]

Pain on hot is almost always a sign for periapical infection. It doesn't sound like a crack but they're sneaky wee beggars and can give all sorts of weird symptoms.

Sometimes even fantastic looking root canals can "fail".

It's complicated... basically, with the very best technique and materials there is no way to TOTALLY clean out and seal up every single root canal. There are occasionally a number of tiny little "accessory" canals that radiate out from the canal at the apex, think of a river delta and you'll get the idea. We can't sterilise all of them and seal them up, so we do the best we can. There is then a sort of balancing act between the bacteria and the body's own defences. By cleaning out most of the canals we can tip things in favour of the body, the more we clean out the more we help. Sometimes if the patient's own defences are a bit lowered, just by being physically a bit out of sorts, then the balance tips a bit more towards the bacteria. We can't really see all these accessory canals on x-rays, the resolution isn't fine enough.

There's no need to be embarrassed or ashamed, it's not your fault and your dentists know that sometimes these things can happen. If it's as clearly associated with that single tooth, then it's not likely to be neuralgia or whatever, so the tooth needs further investigation.

 

[Pearly77]

Root canals just don't work on me

Is this possible? Dentists, have you ever had a patient that they didn’t work on?

I have had two root canals in the past — both on teeth that were never infected but had old fillings too close to the nerve. Upper left—premolar and canine. Both root canals never settled and ended up needing apico s.

Last week I had a new crown placed on my #30. It doesn’t seem to be settling and Im worried it’s heading into that root canal territory. But I’m also terrified that it’ll be another situation when the root canal just won’t work.

Am i crazy? Or is this a real possibility?

 

[Gordon]

This is going to be a long answer, just what I need on a Saturday morning

A root canal is always a slight compromise, it's completely impossible to remove all of any infected material from every single root canal, some canals have little accessory branches from them and others have tight kinks and curves in them which our files and chemicals simply can't access.

Other canals have a sort of delta at the apex rather than a single large (relatively!) opening where the pulp enters.
Even with the best technique there are always going to be a few small amounts of bacteria able to colonise these areas.
There is also the question of the seal at the mouth end of the canal, a slightly compromised final restoration of the tooth can allow new bacteria into the canals and away it all goes again

HOWEVER, the idea behind root treatment is to reduce the bacterial load to such an extent that the host's own defences can mop up any bacteria which get out into the space between the tooth and the bone.
There are 2 things which can mess this up, 1; if the bacteria are particularly aggressive and reproduce quickly enough to overcome the host response and 2; if the host response is a bit compromised so the bacteria don't get killed off quickly enough. Or more likely a mixture of the two.

So that's a long way of saying that you're not crazy, but you also can't assume that every single root canal on all your teeth will be the same