After your root canal procedure.
In between appointments, or once your dentist has completely finished your tooth's root canal therapy, you'll no doubt want to know what to expect during the hours and days that follow.
We've divided this topic up into the following categories:
- Post-operative Pain - Most people will experience little or no discomfort after any of their scheduled root canal appointments. But for those who do, here's information about possible causes and solutions.
- Aftercare - As a general precaution, you should take things easy with your tooth for a while.
- What type of final restoration will your tooth need? - After its root canal therapy has been completely finished, your tooth will need some type of permanent dental restoration. Having the proper kind placed (such as a post and core / crown), in a timely fashion, helps to insure your treatment's long-term success.
A) Will you have any pain or discomfort after your appointment?
In most cases, a person will notice very little, if any, discomfort following any of their planned root canal appointments. If something does hurt, however, here's what may be going on.
1) The gums around your tooth may seem tender.
During each visit, your dentist will isolate your tooth using a rubber dam.
The prongs of the metal clamp that's used to hold this rubber sheet in place can traumatize (pinch, bruise, cut) the tooth's surrounding gum tissue.
Any tenderness you experience should be just minor and should disappear in just a day or so.
2) Your tooth may seem a little tender too.
It's not uncommon that for the first day or so following a root canal appointment your tooth might be a little sensitive.
Any discomfort that's noticed can usually be controlled by way of taking an over-the-counter analgesic, especially one that has anti-inflammatory properties such as ibuprofen (Advil, Motrin) or aspirin. (Check the label of any product you are considering, so to make sure it's use is OK for you.)
a) The discomfort you notice is probably inflammation.
The most common source of pain after root canal treatment is inflammation of the tissues that surround the tooth's root. (This can make the ibuprofen remedy mentioned above a very effective one).
This tissue may have been irritated by the dentist's root canal files if they poked beyond the end of the root's tip, or debris that has escaped into this area. And although a dentist will do their best to minimize the chance of these events occurring, they are not necessarily preventable.
b) Infection may play a role.
It's possible that performing a tooth's root canal therapy will trigger the activation of bacteria harbored within it. If so, the net result can be an acute infection.
This is a less likely event than simple inflammation but it is possible. With this scenario, a dentist will typically prescribe an antibiotic. They may also prescribe a narcotic analgesic (pain reliever) that can help to keep their patient comfortable until the infection process has subsided.
3) How likely is it that you will experience a problem?
Here's information from two studies that evaluated the topic of root canal post-treatment complications.
Tsesis (2008) reviewed published research and concluded that the incidence rate for endodontic post-treatment flare-up lay on the order of about 8%. (Flare-up was defined as the development of pain or swelling after a scheduled root canal appointment that necessitated an unscheduled dental visit for attention.)
As further example of what to expect, another study, Al-Negrish (2006), followed a group of 112 patients for a period of one week after the completion of their root canal therapy. (We chose to cite this study because, to some degree, it quantified the level of pain the patients were experiencing.)
This study found that at two days 90 patients had no pain, 9 had slight pain, and 13 had moderate to severe pain. At day 7, 104 patients had no pain, 4 had slight pain, 3 had moderate pain and one was experiencing severe pain.
a) Keep in touch with your dentist.
Of course, it should go without saying that in all cases where you are experiencing any type of problem, you should always feel free to contact your dentist. Most situations will require little or no direct assistance from them. But they are the ones who have the knowledge and experience to know what treatment is indicated, and when.
b) Scheduled visits vs. emergency visits.
The information found on this page primarily just applies to those types of appointments scheduled after a tooth's need for root canal treatment has already been diagnosed and the tooth, if previously painful, has since settled down. That's different than an emergency visit where a dentist must take steps to get a painful tooth under control.
Emergency visits typically involve a situation where the dentist must deal with acutely inflamed tissues, and they are more unpredictable. However, in most cases, your dentist's emergency services will effectively settle your tooth down and the post-operative conditions we describe above will apply.
B) Aftercare: What precautions should you take?
After an appointment, don't look for trouble. It's usually best to exercise caution with a tooth that's either having endodontic therapy or has just had it completed. Until your dentist tells you otherwise, you should favor the tooth. Here are some reasons why:
- The filling may break. - In those cases where a tooth's treatment requires more than one appointment, the temporary filling that's used to create a seal to protect your dentist's work might break or come out.
If it does, saliva (and the bacteria and debris it contains) will recontaminate the interior of your tooth and your dentist will have to spend your next appointment cleaning out your tooth a second time.
Even in the case where a tooth's treatment has been completed, if the temporary filling that's been placed looses its seal, coronal leakage may occur. (A situation where bacteria are able to recontaminate the treated tooth's interior.)
- The tooth may break. - Since the way their tooth feels is now back to normal, a person is often eager to make use of it again. Until your dentist has had a chance to finish rebuilding your tooth, it should be considered fragile. What a disappointment it would be to spend the time, effort, and money to have root canal treatment performed, only to have the tooth irreparably break or crack before it was fully restored.
- Foods to watch out for. - In light of the above, avoid using a root canal tooth to bite into or chew hard or crunchy foods. Notably, this might include items like raw vegetables (carrots, celery) and hard candies. But really, due to a tooth's potentially fragile state, any number of other kinds of foods might be able to cause damage too.
- Tooth brushing. - All teeth require regular brushing and a tooth that is receiving, or has received, root canal treatment is no exception. In the case where your gums or tooth are sensitive, simply do the best that you can.
- Flossing. - A dentist will need to place some type of temporary filling in a tooth that's receiving root canal therapy. And this type of restoration typically isn't as finely crafted and durable as a "permanent" one is.
That means, when you floss your teeth don't look for trouble. If your floss feels like it's starting to wedge or snag, back off. Report the difficulties you've had to your dentist so they can make the needed adjustments to your filling.
C) Rebuilding your tooth after its work has been completed.
All teeth that have received root canal therapy will need some type of final ("permanent") restoration. The kind that's chosen, and the time frame in which it's placed, can greatly influence the long-term success of a tooth's treatment. (We discuss this topic in much greater detail here.)