What to do if You’re Experiencing Pain After a Root Canal: Go Back to the Dentist

You finally decided to go and get that one painful tooth fixed and receive a root canal. You were explained that a root canal is basically the process of removing the nerve tissues from the tooth and replacing it with a rubber like material. This gets rid of the pain and the infection will eventually go away so you get to keep the tooth at the same time. But somehow your tooth is still hurting even though there is supposedly no more nerves in it. How could this be? Should you wait to see if the pain subsides on its own? Or could something have gone wrong and it’s best to go back to the dentist right away?

Pros of Going to the Dentist

1. There may be an unsuspected nerve left behind. This usually happens with the back teeth, particularly the molar teeth which have multiple nerves.

  • All front teeth as well as lower bicuspids usually have one nerve and area easy root canals to perform.
  • Upper bicuspids usually have two nerves and are so-so difficult. Sometimes the dentist misses the lingual canal.
  • Lower molars are hard since they usually have 3 or 4 nerves and your dentist may miss one
  • Upper molars are the hardest. They may have as many as 5 different nerves in one tooth. Most dentists will refer these to an endodontist, although some very skilled ones can fix these as well.

Your dentist may have inadvertently left a nerve behind without even knowing it existed. If this is the case and there was a nerve unnoticed then you shall continue experiencing sensitivity to hot and especially cold even after the root canal is done. This can be a big problem. Your dentist may need to either go back in and find the nerve or you will have to be offered a refund and an immediate referral to the root canal specialist, an endodontist, who can find and fill this evasive nerve.

2. Your tooth nerves may have been improperly filled. Now this is not supposed to happen but unfortunately it does sometimes. To complete a root canal the tooth nerves must be properly removed and filled with a sterile material. The filling material, known as the gutta percha, needs to pretty much fill the entire nerve. If this filling material does not fit well to the nerve, such as if it is short of the end of the nerve or if it sticks out too far past the nerve, then this is a problem which needs to be addressed. You may have to be refunded for the root canal fee and referred to the endodontist to have the work redone properly.

helpful hint – It is a good idea to ask your dentist to show and discuss the final root canal X-ray as a verification of the success of the treatment whenever possible. Also, if you have dental insurance, the insurance will only pay your dentist if they submit an X-ray showing an acceptable root canal which is a nice safety net to have!

3. The bite may be left too high. This is one of the most common problems that gets overlooked all too often. When your root canal has been completed the tooth is filled with a temporary filling material until the time to do the crown. Because the tooth is now traumatized and a lot of the tooth structure has been removed to do the root canal it becomes very weak and tender. If the tooth or the temporary filling is left where you are biting on it then the pressure applied can cause severe pressure pain. So it is very important to make sure the tooth has been taken out of bite after the root canal is completed for the pain to dissipate. This literally takes a minute but many times dentists or endodontists fail to do so.

helpful hint – If you feel that you are applying too much pressure to the root canal treated tooth then you need to go back to your dentist to have the bite adjusted. But the better solution is to always test your bite right after the root canal treatment has been completed to verify a correct bite and avoid this unnecessary additional visit.

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What to do if You’re Experiencing Pain After a Root Canal: How to Decide