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Root Canal Pain: Secrets Dentists Don't Want You to Know!

Aug 11, 2023

If left untreated, tooth decay can progress into the center of the tooth where the nerves and blood vessels are located, leading to intense root canal pain. When this happens, the pain can be excruciating. Many patients believe that the only way to eliminate the infection and the associated root canal pain is to have the tooth extracted. However, extraction brings additional oral health concerns related to missing teeth.

Dr. Afroz Burges recommends root canal treatment instead. This procedure involves drilling a small hole in the tooth to remove the infected pulp. The structure of the natural tooth is preserved, which means there is no need for tooth replacement options.

Root canal treatment has been an option for many years- but most people avoided it in the past because it could be a painful procedure. However, thanks to advancements in dental technology and anesthesia, it is not nearly as painful as you might expect.

Here’s what you need to know about pain following root canal treatment.

How Does Root Canal Treatment Work?


Failed Root Canal?


Root canal treatment is typically done by an endodontist, which is a dentist that is trained in caring for the inside of the teeth. Here are the steps for root canal treatment:

Step 1: Consultation 

The first step is the examination and x-rays. This will determine the severity of the infection and whether or not you will benefit from root canal treatment.

Step 2: Prep

If root canal treatment is the best option, the dentist will administer local anesthesia. Then, a dental dam, or rubber sheet, will be placed around the affected tooth to isolate it and protect the rest of the mouth.

Step 3: Procedure

A small hole will be drilled in the tooth. This will give the dentist access to the pulp so that it can be removed. After removing the infected pulp, the chamber will be cleaned and disinfected to eliminate any remaining bacteria so that the infection does not return. A bio-compatible, rubber-like substance will be used to fill in the empty chamber to support the tooth from the inside. Then, the hole will be filled with a temporary filling while it heals.

Once the tooth has healed, you will return to the clinic to have the temporary filling removed and a permanent restoration put in place.

Step 4: Crown

The best way to ensure that the tooth remains protected is to cover it with a dental crown after it heals. A dental crown is a cap that fits over the tooth and may be made of composite resin, porcelain, metal, or porcelain-fused-to-metal. On average, a crown lasts about 20 years or more with proper care and maintenance.

Once the final restoration is put in place, the tooth should be back to full functionality, and you should not experience any additional pain. If you do, it’s important to contact the dentist right away to determine the issue.

How Much Root Canal Pain is Normal?

Since root canal therapy is a somewhat invasive procedure, some minor discomfort and tenderness for a few days is perfectly normal. However, excessive pain is not. There are several reasons you may experience discomfort and tenderness:

Surrounding tissue remains swollen or inflamed

While the nerves and blood vessels are removed from the tooth itself, the surrounding tissue still contains nerves. Therefore, when the area is inflamed, some tenderness is expected.

Damage from the procedure

In some cases, the dentist may inadvertently cause damage to the surrounding tissue, which can cause some discomfort.

Temporary filling isn’t smoothed down enough

After the dentist finishes removing the infected pulp and disinfecting the tooth, a temporary filling will be used to seal the hole. In some cases, the filling is too high, which can cause the mouth to bite down harder on that spot. This can cause some discomfort and tenderness.

Most of the time, the discomfort following root canal treatment should resolve on its own within a few days. However, if the pain is severe or worsens, it’s critical to seek professional treatment.

Can Root Canal Treatment Fail?

According to the experts, root canal treatment has a 98% success rate. However, this means that there is a 2% chance of root canal failure. In some cases, failure occurs within a few days- but it may not happen until several years later. Some of the most common reasons for root canal failure include:

Breakdown of coronal seal

When the procedure is complete, the dentist will place a temporary filling to seal the hole in the crown. If the seal becomes compromised for any reason, the tooth may become reinfected when bacteria and other contaminants re-enter the tooth.

Breakdown of crown

Typically, dentists recommend that a dental crown be placed on the affected tooth to protect it from further damage. In some cases, the crown will break down, allowing bacteria to get into the tooth, reinfecting it. There are two primary reasons for this:

  • Extended delay between the procedure and crown placement
  • Damage to the crown

Failure to effectively disinfect the canal

The root canal system within the tooth where the pulp is located can be complicated, curved, and narrow. This makes it difficult to get accurate images, as well as to thoroughly clean the canal. If a small amount of infection/decay is left behind following the procedure, it will continue to spread and cause damage to the tooth and the area around the tooth.

New decay/trauma

If new trauma causes damage to the tooth, new bacteria can enter. This results in additional decay and infection.

Most root canal treatment procedures start out as successful. Most of the time, failure is the result of damage after the procedure allowing bacteria to re-enter the tooth.

Root Canal Pain FAQs

If you have any questions or concerns about root canal treatment or other oral health issues, Dr. Afroz Burges can help. Here are a few of the most common questions that we’ve gotten about root canal pain:

What Is Root Canal Treatment?

Root canal treatment is the process of removing infected dental pulp from the center of the tooth. This procedure is used to salvage the structure of the natural tooth, preventing the need for tooth replacement options.

Can You Avoid Root Canal Treatment?

The best way to avoid dental problems that result in the need for root canal treatment is to practice proper oral hygiene habits. This includes:

  • Brushing at least twice daily
  • Flossing at least once daily
  • Using an alcohol-free, antibacterial mouthwash
  • Visiting the dentist at least twice yearly, and any time you have an oral health concern

While these habits won’t necessarily 100% prevent the need for root canal treatment, they will help in reducing your risk of oral health concerns.

Is Root Canal Treatment Painful?

In the past, root canal treatment could be a painful procedure. However, thanks to advancements in dental technology and anesthesia options, this procedure is no more painful than any other procedure. Plus, recovery time is much quicker than in the past- most people can go right back to their normal routine within 24 hours.

What Can I Eat After Root Canal Treatment?

You should not eat anything at all until the anesthesia wears off. If you try to eat while your mouth is still numb, you risk biting your tongue, lips, or cheeks and causing mouth sores. However, once the anesthesia wears off, you can eat anything you like, though you may want to stick with soft foods if you do have some discomfort. Also, avoid chewing directly on the affected tooth for a few days.

How Can I Treat Root Canal Pain?

Most of the time, pain following root canal treatment is mild, which means an OTC pain reliever such as ibuprofen, aspirin, or acetaminophen can be used to treat it. You may also want to use an ice pack to help with pain and/or swelling. If you do have significant pain, you can speak with your dentist about prescription pain relievers.

How Long Will Root Canal Procedure Pain Last?

Most of the time, pain following a root canal procedure will resolve within a few days. If it does not or if it gets worse, it’s important to contact the dentist right away.

What Is The Success Rate Of Root Canal Treatment?

Root canal treatment has a 98% success rate, which means that there is a 2% chance of failure. This failure could occur within the first few days or it may occur years later.



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