Root Canal Pain Management

by Dr. Fatahi, DDS

Here are 5 simple steps to follow before you have a root canal or during your root canal recovery and a few root canal symptoms or situations that can cause you to need a root canal.

1. Take your antibiotics as prescribed by your dentist.

Most teeth that require a root canal were painful to begin with. It is perfectly normal for a tooth that has had endodontic therapy to be tender for a short time after the treatment has begun throughout the root canal recovery process. If the tooth was infected and antibiotics were prescribed by your dentist, the medication takes at least 24 to 48 hours after the medication regimen has begun.

2. Relieve pain with anti-inflammatory medication that allows for reduction of inflamed periodontal fibers during your root canal recovery as tooth heals.

When a tooth is infected and requires a root canal, the periodontal fibers that anchor the tooth to the bone are also irritated and stretched from infection around the roots of the tooth. The trauma of the fibers/ligaments being stretched can also be very painful and will need some time to heal during your root canal recovery. Ibuprofen, either over the counter or a stronger dosage prescribed by your dentist, has an anti-inflammatory action that will provide relief during the healing period. Gentle but thorough cleaning of the tooth and gums around a recently root canal treated area will create an environment for quickest healing and relief of discomfort and pain after root canal treatment from irritated gums.

3. Give the tooth that has had a root canal started or completed some time to settle down and become more comfortable.

Often, patients ask "does a root canal hurt"? "Ghost pain" after a tooth has had a root canal can be explained by the fact that nerves in the root of the tooth have been amputated from the major nerve that supplies all of the teeth along its pathway. In much the same way people who have had a limb removed report pain in the missing limb. The "ghost pain" diminishes over time and usually goes away completely. But, remember each situation is unique.
Often an infected tooth has been pushed slightly out of the socket by the infection accumulating at the root tips. The infected tooth is bearing more biting pressure than it can comfortably stand. Even if the tooth has had some reduction of its height taken off by the dentist, it may still be tender for a few days. Grinding your teeth or clenching your jaw muscles (bruxing) contributes to pain after root canal treatment. A night guard or relaxation techniques to keep your teeth slightly apart, can contribute to a more comfortable dental state.

4. Avoid crunchy, hard or tough foods on a recently treated root canal tooth for several days afterward.

Staying with softer foods and chewing on the opposite side are helpful suggestions to reduce pain after root canal treatment. If the tooth does not become less sensitive after a few days, additional adjustment of the traumatic biting pressure may be needed by your dentist.
A tooth that has had a root canal is more brittle. Most of the time a tooth that needs a root canal had a large area of decay or a large old filling, so little of the original healthy tooth structure remains. A full crown to reinforce a more fragile endodontically-treated tooth is recommended as soon as possible after a root canal has been completed. If the tooth develops a crack or fractures, there can be pain associated with that unwanted occurrence.

5. Having a crown made for a root canal treated tooth helps to maintain it, keep it intact, functional, and less likely to develop pain from fracturing.

The final step of a root canal is often placing a crown. Often times when a tooth needs a root canal, there is extensive decay or a large filling that was placed a long time ago. In order to restore the tooth to full function and also lessen further complications such as fracturing, a crown is placed.

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