Why does my tooth still hurt after a root canal?

Dear Dr. Diesburg:

I had a root canal on one of my back molars and it hurt for a while even after the procedure. What gives?

Best regards,

Jim in Amity


Dear Jim,

This is an important question. I can understand why this would be confusing because a root canal removes the nerve from the tooth, so you would think that by removing the nerve completely you would remove the pain. The bones that hold the tooth and the gums around the teeth also have a lot of nerves in them.

When a tooth needs a root canal, there is usually an infection there that causes inflammation in the area; you can think about inflammation as excess liquid that has gathered around the tooth. That liquid has volume. That extra volume creates pressure that pushes the tooth up and can cause pain. After root canal therapy, it takes your body some time to allow the inflammation to leave the area. Also, sometimes, when root canals are cleaned out, the files can go out the end of the root and can poke the inflamed tissue. It can take time for that soreness to go away. It’s not the tooth that’s hurting anymore, it’s the tissue around it. Lightly touch your teeth together, if that tooth you just had worked on is touching first you should call the endodontist or dentist and have us adjust the height.

If you were given antibiotics, keep taking them. If the pain is unbearable, try an over-the-counter pain medicine or talk to your dentist or endodontist about other options for pain.

Happy brushing,

Dr. Adam Diesburg

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