Following completion of your root canal some pain and discomfort is to be expected despite the most careful and thorough of procedures. Since the dentist is working very near the apex (end) of the root some inflammation and soreness may arise or persist for a few days, sometimes weeks.
It can often be confusing to the patient to feel pain since the nerve has been removed but it is the many nerves in the ligaments surrounding the roots of the tooth that are sending the pain messages. All this being said, a good proportion of patients do not report any problems following their finished root canal treatment, but expect some temporary discomfort and if it doesn't happen- great!
Pain after a root canal could be due to the following reasons:
- Files through the tip. Files extending slightly beyond the root during the preparation aggravating the tissues around the end of your tooth. This is common and will settle in a few days.
- Pre-existing inflammation. Inflammation around the apex from the toxins released by the bacteria hasn't yet settled down.
- Sealant through the apex. A small amount of the sealant used to bind the root filling material together has been pushed through the end. This will resorb over time but may be sore for a while.
- Missed canals. Sometimes extra canals are very hard to see and can go undetected. The dentist might find three when actually four exist and the one that wasn't found and disinfected can cause problems.
- Perforation. A post or file that has perforated the sides of the root will give any bacteria the chance of remaining in the root canal system ;a potential source of food that will allow bacteria to grow causing persistant infection.
- The root canal has been slightly over filled. Often this will only cause a mild discomfort. Painkillers as advised above may be necessary.
- The root canal has been under filled. The important thing here is- has the canal been sufficiently disinfected? If the canal is cleaned properly and the filling is just short, then it is unlikely to be an issue. However, if some bacteria remain in the canal system because the dentist has incorrectly calculated the length of the canal, then a re-root treatment or extraction may be needed.
- High filling. The filling or restoration in the tooth maybe slightly too high.
- Undiagnosed root fracture. This may lead to the tooth being lost. This is most often found with lateral incisors, first premolars and molars. Your molar teeth should be protected against this occurring by having a crown placed. Root fracture is more likely if this is not done and if you grind your teeth at night.
If there is no sign of improvement after a few days or if things appear to be getting worse, it is advisable to see your dentist again for a review. The dentist will assess the options above and talk to you about your situation.