Root Canal Pain: Dealing With Pain After Root Canal

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Dentists perform root canal treatment on a tooth to remove the nerves that cause you pain.

Root Canal Pain

Ideally, a root canal treatment should result in a symptomless tooth as it completely removes the nerves that cause pain, leaving it as a structure in your mouth without any sensation.

As nerves are the roads that carry signals to the brain, removing these structures must guarantee pain removal. However, sometimes, you may still experience pain after having a root canal treatment done.

Although root canal therapy has had a bad rap for years, advanced dental technology has made it less scary and painful. Usually, patients step out of the dental office pain-free and symptomless.

Let’s uncover the reasons behind root canal pain before, during, and after the treatment and how to overcome it if you face it. 

What is a Root Canal Procedure, and Why Is It Needed? 

A root canal is a procedure carried out on your tooth, especially the back tooth, where the caries have managed to reach the tooth pulp. The tooth’s pulp is highly vital and has many nerves and vessels. It gives painful signals to the brain of a persistent nature. 

The bacteria colonize the rich blood supply of the pulp, making it infected or inflamed. The dentist performs the procedure under local anesthesia, removing the infected pulp and sealing the tooth to prevent further infection and pain.

The procedure may take place on several appointments, each appointment an hour long or so. 

What is Root Canal pain?

People widely fear root canal pain. A systematic review conducted in 2011 found that pre-treatment pain was high but dropped to minimal levels post-treatment.  Root canal  pain can be divided into three parts: 

#1 – Pre-Root Canal Pain

If the dental pain makes you jump on your couch and increases with lying down, this is probably root canal pain. Pre-root canal pain is persistent, and it doesn’t go away with over-the-counter painkillers.

Tooth Decay Pain

It is felt throughout the jaw; sometimes, pain is even felt in the head and shoulders. Apart from painful signals directed to the brain, patients also experience sensitivity to heat and cold. Pain is experienced due to the infection within the tooth.

The pressure and the volume inside the inner portion of the tooth increase with the inflammation. Since the nerve chamber cannot expand, the throbbing nature of pain is experienced.

The pain is usually pulsating in nature, and you would feel like pulling a tooth out of your jaw yourself. The infected nerves will be so infected with a lot of bacteria that it may create a draining abscess (gumboil)

#2 – During the Root Canal Pain

You will not experience any pain during the treatment if your tooth has been properly numbed before instrumentation. However, you may experience pain sometimes.

Your dentist or endodontist will numb the tooth area with the help of local anesthesia and will also offer dental sedation to put you at ease during the treatment. You may feel pressure at some intervals while the instruments are moved within the tooth. 

The procedure involves tooth access through a small opening made with a dental motor and the bur. The drilling sound and vibration might make you feel uncomfortable but will not cause you pain.

Then, your dentist will clean, shape, and sterilize the area with dental files and seal it with a material known as gutta-percha.

#3- Post-Root Canal Pain

Once the nerve factory is removed from your tooth,  your tooth shouldn’t be painful. There are a few causes of pain after a root canal treatment. 

1) Infection In the Bone: 

Our mouth is a combination of good and bad bacteria. If the bad bacteria that causes tooth inflammation has managed to invade the bone, it will stay there until the cause is removed.

Sometimes, bone recovery takes about 3 to 6 months, even after completely removing the pulp. Your tooth feels painful when chewing, and you’ll have odd sensations.

2) Infected Root Canal:

Sometimes, even after the pulp tissue is removed, the bacteria can enter the body of the tooth through a leaked filling.

Root Canal Treatment

There’s a risk of post-root canal infection if you have delayed getting a crown on your root canal-treated tooth.

3) Missed Canal

Your teeth are supplied with nutrition through narrow canals. Multiple canals are found in the posterior teeth and sometimes in the anterior teeth.

Dentists usually carry out a diagnostic X-ray to identify the number of canals in the tooth before the treatment. However, sometimes canals are missed, harboring harmful bacteria.

The bit of nerve tissue in the tooth leads to pain and sensitivity to hot and cold. 

4) Overfilled Canals and Underfilled Canals

Your dentist needs to negotiate the tooth canals to their full length. Failure to do it will lead to post-operative pain. For, say, a canal is 23mm in length. Your dentist missed the length and cleaned it to 21mm. The leftover dental tissue on the root tips with nerves can cause pain, leading to the underfilling of the canals. In contrast, if a 23mm long canal is prepared to a length of 25mm beyond its actual length, this over-instrumentation will also cause pain.

Painless Root Canal Treatment

if you fear tooth pain during the treatment, this newer technique is for you. With the evolving technology and AI, endodontic treatment or root canal therapy is now performed with the latest laser technology. This new technology employed a laser beam to clear the root canals.

The debris and bacteria will melt down with the laser heat, providing prompt treatment and healing. It comes with fewer downsides and fewer failures. People have reported lesser discomfort during the treatment and the painless therapy overall. See your dentist and explore laser dentistry more. 

Causes of Root Canal Pain

Here are a few reasons why your tooth must be saved with root canal therapy only: 

1) Deep Dental Decay:

Tooth decay is a process where bacteria eat up tooth enamel and dentine in the presence of mouth sugar and acids. If the decay is not treated at early stages, it will advance to the pulp, resulting in pulpal inflammation in the form of reversible and irreversible pulpitis. Irreversible pulpitis can’t be reversed, and root canal therapy is the only option to save the tooth. 

2) Fractured or Traumatized Tooth

Whenever a tooth is fractured at the pulp level, restorability is only possible after a root canal treatment. Usually, the pulp gets necrosed, leading to pulp death. 

3) Tooth Abscess:

The bad bacteria in the root sometimes extend beyond the premises of the tooth and reach the bone and the soft tissues.


This is called an abscess and will present you with symptoms like localized swelling and a metallic taste in the mouth. 

4) Multiple Fillings:

Every time a tooth is filled, it causes trauma to the tooth and the pulp. Over time, the filling material may leach into the pulp, causing pulpitis and death. Old fillings let bacteria and debris reach the pulp, warranting a root canal treatment.

Symptoms of root canal pain

If you want to differentiate precisely between a filling pain and a root canal pain, here’s precisely how you can do it:

1) Severe throbbing pain on chewing and lying down

One of the significant identification factors for root canal pain is that the pain threshold varies with the change in position. The pain reaches its maximum when lying down as the pressure increases within the tooth. You may experience severe pain for the first few days, which may turn mild once your tooth pulp is dead entirely. 

2) Extreme and prolonged sensitivity to hot and cold foods

Massive expression of sensitivity is experienced with hot and cold foods in a localized area. This is especially felt in an affected tooth. 

3) Tooth discoloration 

Sometimes, your tooth may necrose and appear different from the neighboring tooth. You’d better be able to appreciate it if the tooth involved is the front tooth visible with the naked eye. 

4) Pimple-like sores on gums

Gum boils, parulis, or abscesses are common findings associated with the affected tooth. These depict the ongoing internal inflammation

Preparing for Root Canal Treatment

A root canal treatment may need more than one office visit. Your favorite dentist or specialist orthodontist can perform it with an extra degree. 

Usually, your dentist will ask you for your symptoms and medical history before your intra-oral examination and investigations. He will take an X-ray to determine the severity of the tooth damage, the formation of tooth abscess, and the number of canals present. 

The process will start on the day of your appointment, and he’ll numb the area where he’ll do the procedure. He may offer you sedatives to help you stay calm during the treatment.

Later, he’ll place a rubber dam sheet on the tooth to free the saliva during treatment. Next, he’ll drill your tooth with a small round bur to get access to the root canals. He’ll then debride the canals with special instruments called root canal files.

He’ll place multiple files in increasing diameters to shape the canal to its length. He’ll even wash your canals with sodium hypochlorite to eliminate all the debris and harmful bacteria.

Once the canals are cleaned, your dentist will seal them with gutta-percha. He’ll remove the extra gutta percha from the coronal portion of the tooth to fill it with a tooth-filling material.

Root Canal Treatment

If the permanent filling is not placed at the same appointment, your dentist will send you back with a temporary filling

The final step involves getting a cap or a crown for the tooth to make the tooth functional in the long run.

Managing Root Canal Pain Before the Procedure

We have already understood the science behind tooth pain. The tooth becomes painful when it gets inflamed. This causes discomfort, and a solution is sought to eliminate the pain. Here are a few pain management options before you see a dentist: 

1) Over-the-counter pain relief medications:

NSAIDs like ibuprofen and Synflex manage pain well. However, patients prefer taking basic acetaminophen for the pain relief. A total of 4g of acetaminophen is okay to be taken daily to get rid of the pain. 

2) Topical anesthesia:

If applied, over-the-counter numbing gels are the anesthetic agents that will numb the area. This can provide instant, short-term relief from pain. 

3) Home remedies:

  • Apply cold compresses to the affected side. 
  • Do warm salt water rinses to soothe the area
  • Use clove oil or cloves for analgesic and antiseptic effect

Managing Root Canal Pain During the Procedure

1) Anesthesia and sedation options:

Injecting local anesthesia on the affected site during the treatment numbs the area and lets the patient cooperate massively. The administration of anesthetic agents with epinephrin maximizes the dose of the numbing agent in that area, keeping the patient pain-free for the next few hours.

However, patients who are highly anxious and don’t cooperate during the treatment are provided with 50% nitrous oxidation to keep the patient realized. Oral and IV sedations are also given in some patients.

2) Communication with the dentist during the procedure:

Talk to your dentist about your fears and concerns before starting the treatment. Agree on hand signals if you need a break from the treatment or are uncomfortable. Communicate well with your dentist and let him give you the best outcome.

3) Relaxation techniques for managing pain and anxiety: 

Adopt relaxation techniques like deep breathing, mind diverting, and muscle relaxation. You may also watch procedural videos on YouTube before appearing to your dentist for the treatment

Post-Root Canal Pain Relief

1) Medication options for posttreatment pain

Initially, post-root canal pain and discomfort can be managed with over-the-counter painkillers.


Sometimes, prescription medication like opioids for pain relief and antibiotics for infection relief is also given.

2) Home remedies for managing discomfort::

Adopting a few home remedies like salt water rinses and cold compresses helps relieve pain.

3) Followup care and pain management guidance from the dentist:

Ideally, your root canal-treated tooth shouldn’t be painful. You must check with your dentist if it’s hurting and causing discomfort.


1) How do you know if you need a root canal treatment? 

A tooth generally needs a root canal treatment when it’s excruciating and sensitive to hot or cold food. This might happen due to a deep previous filling, a deep cavity, or a trauma. There are a few symptoms that will tell you that you must see your dentist:

  1. Severe pain on biting and chewing
  2. Pain increases when lying down
  3. Pimples on the gum
  4. Chipped or cracked tooth
  5. Tooth trauma 
  6. Localized sensitivity to hot or cold 
  7. Swollen or tender gums

2) How long does it take to recover from a root canal? 

The localized treated area will stay numb for a few hours. Most people are able to get back to work directly after the treatment.

3) What is the cost of a root canal treatment? 

The cost of the treatment varies on the size of the tooth, the complexity of the procedure, the expertise, and the location of the dentist. Many dental insurance companies cover the costs, but you must know the amount if you don’t have an insurance plan yet. 

1) Front tooth: $700 – $1200
2) Posterior most tooth: $900 – $1500

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