Dr. Noah's Dentistry Blog

Questions About Dentistry Answered

Root Canal Caused Days of Pain

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I had a root canal treatment done five months ago, and it was very traumatic for me. My dentist wanted to put a crown on the tooth, but decided that it would be best to wait, since the tooth was still painful. When it never got better, my dentist referred me to an endodontist. He thought maybe he had missed a canal, and the root canal specialist would be able to find it.

Well, the endodontist re-did the root canal. He told me there were no missed canals and advised me that there would be some discomfort for a few days. However, it’s been four days and I still have pain in the tooth. I don’t want to lose this tooth.

How long do you think I should wait to see if it gets better before I assume something is wrong? It’s been five months since we started this and I’m not sure what to do. I do know that I don’t want anyone else to mess with my tooth.

Your advice would be greatly appreciated.

Regards,

Kari from Colorado

 

Kari,

The key to knowing if the root canal was successful is not so much the discomfort itself, but if it’s improving at all. If it is improving, even just in the slightest, I would be optimistic. Your endodontist said that you would be in discomfort for a few days. I don’t think four days is too long, provided that it isn’t getting worse. Especially if you’re biting on the tooth, it can take it a while to get better. If the pain is coming from biting on the tooth, one remedy could be to grind the tooth down so that you don’t hit it at all when you bite. Since you’re planning on getting a crown on it, taking it out of occlusion shouldn’t hurt anything.

You didn’t say anything about swelling, so hopefully there isn’t any. Increased swelling would be a problem—a sign that the tooth isn’t going to get better.

For our readers, I’d like to add that this kind of trouble with a root canal treatment isn’t typical. Most of them these days are fairly uneventful. But a certain number of root canal treatments will fail, and to be fair, we can’t rule out that possibility with your tooth. But you need to give it more time to know that.

The root canal failure that happened with your general dentist may have been an inadequate seal at the end of the root since it wasn’t the result of a missed canal.

This blog is brought to you by Tulsa Dentist Dr. Ryan Noah.

Why do I feel pain after a root canal?

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Around three and half years ago, I had a tooth that needed to have a root canal and crown. Now, I’m experiencing pain with this tooth but my dentist says the root canal looks good. The dentist did not inform me of any cracks in the tooth so I’m not sure if that’s the problem or if I will lose my tooth. Also, the dentist said my tooth might need a new crown. I think the crown looks good and I don’t see any problems. What do you think?
– Brenda from Oklahoma 

Hi Brenda,
There may be many reasons why you’re experiencing discomfort with your tooth that has had a root canal and crown. One possibility for the pain you’re feeling is that the crown may be placed too high and it may need to be adjusted. If you’re biting hard on a crown tooth and it’s seated too high it can cause the tooth to ache even with a root canal. It’s important your bite be checked.

Did your dentist study your bite to see if the tooth needed adjustments? If not, have them check to see if it needs to be adjusted. If this isn’t the problem, it may be that you may grind or clench your teeth at night when you sleep and may not be aware of the issue.

Clenching and grinding can also cause teeth to hurt. Get your dentist to check and see if there are signs of grinding or clenching. If you have this issue, the dentist should create a night guard for you to protect your teeth and gums. There is a possibility the tooth has a crack within the root, however it is difficult to diagnosis. To confirm this, you will want to have a consultation with an endodontist who specializes in root canal treatments and would give you a better indication if the tooth actually has a crack or not. If your tooth has a crack, it would need to be extracted because there is no way to fix the tooth. If your tooth has to be removed, you have the option of getting a dental implant or dental bridge to replace your missing tooth.

Reasons why a root canal procedure may fail and cause discomfort:
■Sealers used to coat the filling material may wash out, creating a gap within the root canal, therefore causing infection
■If gaps are left at the base of the root and not filled properly, the tooth gets contaminated with bacteria which infects the tooth again
■If the tooth had multiple canals and exit points a spot may be missed and infection can set in
■If the root has small fractures the tooth may get contaminated with bacteria, causing infection which will lead to extraction
■If the tooth is not restored with a properly fitted dental crown then contamination may occur
■Inadequate cleaning, reshaping, or a lack of aseptic techniques of the root may cause root canal failure

As was mentioned before, there are multiple reasons why you’re having pain in your tooth. You should consult your dentist to determine if the bite is too high or to see if you have issues with grinding or clenching. These are two very common reasons for root canal pain. If your issue isn’t resolved, we advise you to see an endodentist who will inform you whether  the tooth is re-infected and needs to be retreated or if the root is cracked and the tooth needs extraction.

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