Dentistry and Root Canal

Root Canal Complications - Pain After Root Canal

What are the complications of having root canal?

In only about 1% of the cases, there will be a ‘flare-up’ of the tooth with pain after root canal and sometimes swelling. This usually happens within the first three days following treatment and is caused by dying bacteria inside the tooth that put off toxins into your jaw. If this happens, you will need to be on an antibiotic. Call your dentist and let them advise you what to do.

Most of the time, however, there is little or no pain after root canal, if performed when first indicated. Many patients report immediate relief of their symptoms. If there was a lot of infection in the tooth before the root canal, there will be healing time required after the procedure and you may experience some pain. This pain can be moderate to severe and last several days, getting a little better each day.

If your tooth hurts when you chew on it, it is still healing and you need to chew on the other side of your mouth until the pain is gone.

Some teeth swell in the socket and feel ‘higher’ than the other teeth, disrupting the healing process. If this happens, call your dentist or Endodontist and get an appointment. They can adjust your bite to prevent this tooth from hitting so hard when you bite.

Occasionally, a endodontic file will break inside the tooth during the procedure. Most of the time, this is not a problem and the file is cemented into and becomes part of the tooth. There are reports of both complications and no problems at all with a broken file in a tooth.

Some people are surprised when they experience pain after root canal thinking the nerves are gone. The nerve inside your tooth is gone, but there are still nerves surrounding the outside of your tooth where in enters the gum. These nerves can be irritated by the procedure or by infection and can take time to heal.

You can have pain afterward if your tooth has a fracture. A fracture in your tooth can be diagnosed using a microscope, or dye tests. Teeth with a fracture should be crowned as soon after your root canal as possible. Avoid chewing on the fractured tooth until your dentist has crowned it.

Even after crowning, some teeth that have fracture will be sensitive on occasion, much like a healed broken bone is sometimes sensitive. This is normal and nothing to worry about unless the pain or sensitivity gets severe which could indicate the fracture has worsened and the tooth needs to be removed.

Sometimes, in spite of best efforts, the body does not heal the infection that was inside the tooth. It is a biologic procedure and is not guaranteed because everyone has differing immune systems and healing capacities. If your tooth does not heal, a re-treatment of the root canal can be performed, where the root canal is tried again.

If a pocket of infection is left in the bone that does not heal, an apicoectomy might be indicated.This is where a surgical procedure is performed and a small incision is made in the gum above the tooth and the infection is removed, the area sterilized and cleaned. This procedure is almost always performed by an Endodontist or Oral Surgeon and is rare, but the sucess rate is high.

A root canal removes the nerve inside your tooth. This nerve controls sensitivity to hot or cold. If you experience pain with hot or cold after your root canal, it is impossible for it to involve the root canal tooth. Unfortunately, it will be another tooth that may need root canal.

Root Canal

Dental Fear

It starts with a minor pain when you chew and grows to an excruciating toothache. Or you bite down and get a sharp pain that feels like it is stabbing the whole side of your face into your eye. “Oh, no”, you think. “Now I’ll have to go to a dentist.” Your dental fear sets in.

We need our teeth to eat, to enhance our smile. But we fear dentists more than any other doctor.

Why is that?

To overcome your dental fear, we should look into your level of fear. Rate yourself, on a scale of 1-10 for your level of agreement for the following:

The night before your dental appointment, you feel uneasy and anxious thinking about your appointment and want to cancel the appointment.

You enter the dental office one limb at a time, dreading each step that brings you closer.

Your blood pressure goes sky high the minute the dental chair is reclined.

You feel helpless, anxious, and/or out of control in the dental situation.

The sight or thought of a dental injection brings up fight or flight reactions.

You feel you can’t breathe when dental instruments are put in your mouth.

You wish you could just pass out and wake up after it’s all over.
If you scored yourself a 5 or more for any of the above, you have dental fear and anxiety.
Discuss the points you scored highest on with your dentist and his assistants. It is important that the whole dental staff takes your dental fear seriously and listens to you with compassion.

Now, where does dental fear come from? See is any of these sound familiar:

I had a terrible experience in the past with a dentist. Past careless comments have made me feel uncomfortable.

My teeth embarrass me. I am afraid that my dentist will think my problems are from dental neglect and I fear ridicule and/or belittlement.

“I’d rather have a root canal than…” and other dental analogies instill dental fear in me, as does scary portrayals of dentists and dental procedures in movies, magazines and other media.

When I tell someone I’m going to the dentist, they share their ‘horror’ stories with me.

My parents were afraid of the dentist and passed dental fear on to me.

I can’t relax in the dental chair. It’s uncomfortable, lays down too far. I fear loss of control. I panic. I feel strapped down.

I hate shots! The dental needle looks a foot long to me.
Yes, there are some dentists that are not compassionate, gentle and caring and a few bad apples can spoil the whole barrel if you’re already anxious.

There are many more dentists today than there have been in the past. If your dentist makes you uncomfortable in any way, feel perfectly justified in finding another. If his staff is not compassionate, handles you roughly, or belittles your dental fear, tell your dentist. If it is not handled to your satisfaction, find another dentist.

So now that you know what causes your dental fear, what can you do about it?

Express your fear to your dentist and staff and expect their help in overcoming your fear. Remember you are not their only patient with fear and they will admire your resolve. If they laugh you off, they’re not compassionate. Find another dentist.

Not all dentists and/or staff are rough handling their patients. Dental procedures are not supposed to hurt. If your dentist hurts you, jerks your head into position, seems impatient or unprofessional in any way find another dentist. (And report this one to your State Dental Board).

Make a conscious effort to overcome your dental fear. Set your mind to it. Talk it out to yourself and realize that it can be overcome.

During your appointment, take deep breaths and let them out slowly.

Remember, the needle itself is not the major cause of shot discomfort, but it is the pressure and volume of the numbing agent being injected. Try to see it as a help to you instead of a pain to be endured.

Stop the cycle. Dental fear is learned and can be un-learned. You can pass on these fear-reducing techniques when your friends or family develop a toothache and express their fears to you. You CAN overcome your dental fear with the right resolve, dentist, and staff helping you.

Root Canal