Wednesday, October 1, 2014

Why Does My Tooth Hurt After A Root Canal?

In many cases, root canals are performed on teeth that are either dying or are already dead. Many of these teeth are incredibly painful. Root canals are performed to eliminate pain and infected tissue within the tooth. Fortunately, pain after having a root canal is uncommon. The literature shows that approximately 95% of the time there is little to no discomfort.

If you are one of the unfortunate few that does experience discomfort, there are several potential reasons why this could occur. The tooth is not the source of the discomfort after a root canal. It is the surrounding structures of the tooth that is the source of the pain. The tooth itself does not hurt because there are no longer any nerves within the tooth.

Here are some potential reasons why:

1. Inflammation

Inflammation may be present at the tip of the root. This may occur for a number of reasons. Once the inflammation is resolved, the discomfort will dissipate. NSAIDS such as Ibuprofen will usually resolve the inflammation.

Infected tooth. A root canal is indicated
2. Infection

When a root canal is performed, the inside of the tooth is completely cleaned out of any bacteria and diseased tissue. However, a root canal does not clean past the tip of the root. In order to remove any infection past the root tip, we rely on the immune system and antibiotics.

While the infection is still present, it is not uncommon for the bone surrounding the tooth to be tender. This is exacerbated whenever the tooth is pushed on or bitten into. A round of antibiotics will most often resolve the infection.

3. High bite

After a root canal is done, a temporary filling or temporary crown is placed. If too much material is placed, then a high bite can result. This will cause the opposing tooth to hit the treated tooth prematurely. The result is excessive force and pain on the tooth every time the teeth come together.

When a patient is numb, sometimes it is difficult to assess the bite. After the numbness wears off, it is much easier to assess the bite. If the bite feels funny after the numbness wears off, do not assume that you will get used to the bite. You won't. It will start to hurt and cause bigger issues. Fortunately, a high filling is easy to correct. All that is necessary is to grind the filling down slightly.

4. A fractured tooth

Sometimes a fracture can be incrediblydifficult to see even with high magnification. An x-ray most often will not reveal a fracture either.

When a tooth has a fracture that extends into the nerve or all the way through into the root, it will die. The treatment for a dead tooth is to remove the dead tissue within the tooth. The problem with a fractured tooth however is that no matter what is done, the tooth will eventually fail and the only thing we can do to correct the problem is to extract it.

5. Persistent infection

The goal of a root canal is simple…..remove all dead and infected tissue within the tooth and seal it so that it doesn't get recontaminated.

If the canal(s) is not cleaned thoroughly, then the root canal will eventually fail. Bacteria will remain within the tooth. Antibiotics will not be able to reach the site because there will no longer be a blood supply to the tooth to carry the antibiotic to the infected site.

Accessory canals can be difficult and sometimes impossible to clean and seal.

If you experience pain after a root canal is performed, call your dentist to determine why.

Dr. Cisneros maintains a practice in Freeburg and Columbia, IL. Both are in the Greater St Louis, MO area. For more information on a wide variety of subjects, please visit

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