Pain After Root Canal: What You Should Know

If you have ever visited your dentist on account of a toothache, you may be familiar with the term root canal. It’s normal to experience mild to moderate pain for a few days after a root canal. Any pain beyond a few days is not normal and this may warrant additional treatment or procedures from your dentist.

The aim of this article is to explain all you need to know about pain following a root canal treatment procedure.

Painful tooth

What Is A Root Canal Treatment?

A root canal is a very common procedure that dentists use to try to save a dying tooth. During the procedure, your dentist will carefully remove infected and damaged pulp from the inside of the affected tooth thereby eliminating the source of the pain.

Most people associate having a root canal with a lot of pain and discomfort but this is not necessarily the case. Modern technology and the use of local anesthetics have made this procedure quick, safe, pain-free, and an excellent way to help save the natural tooth.

Reasons for Pain After A Root Canal

The most likely reasons for pain after a root canal are –


1. Post-Procedure Inflammation

One of the most common causes of pain after root canal is inflammation, which can be caused by the procedure itself or because the infection caused the tissues surrounding the tooth to become swollen.

2. Infection


It’s possible that after a root canal, there’s still some bacteria present in the canal. This usually occurs if the canal is not properly cleaned and disinfected during the procedure leading to re-infection of the tissue and more pain.

This can also occur when the filling that was put after the procedure leaks, allowing bacteria from your saliva to work their way in around the filling. Once inside, the bacteria can cause an infection within just a few days.

3. Too Large Fillings or Crowns

Tooth filling

After your dentist removes the pulp from inside your tooth, the empty pulp space is filled with root filling material. If the filling material used is too much or too high, it will cause the tooth to sit higher than the other teeth in the mouth causing pain anytime you bite down on food.

4. Missed Root Canal

Hot drink

Some teeth, especially the molars, can have multiple canals. This makes it possible for your dentist to miss one or more of these during the procedure leaving a bit of pulp tissue inside the tooth or a small pocket for bacteria which can form an infection.

If pulp tissue is left behind, your tooth will remain sensitive to hot and cold food and drinks, and if the bacteria cause an infection, the tooth will be sensitive to pressure. In either case, you’ll experience pain.

5. Damage to the Surrounding Tissue

During the root canal, tissue damage can occur if bacteria is accidentally injected into the surrounding tissue during instrumentation, if too much filling material is used and flows past the tip of the root, or if the instrument used to clean the inside of the tooth slips beyond the root tip and pokes into the tissue below.

6. Infection in the Bone

If after a root canal procedure there is still bacteria in the bone around the root, there would be continuous pain.

Management of Pain After Root Canal

Pain after a root canal is normal but bear in mind that it should improve a little bit each day. However, when it persists it becomes a cause for concern. The management of pain is dependent on the cause
• If the pain is as a result of inflammation after the procedure, no need to worry as the pain would resolve after some days. Your dentist will prescribe analgesics to take care of the pain.

• If the pain is a result of infection due to bacteria still present in the canal, the problem should resolve itself once your immune system attacks and kills the bacteria. If the problem persists, your doctor or dentist may recommend antibiotics and analgesics.
• If the pain is due to a high or large filling, this problem won’t resolve on its own. The issue can be fixed easily by your dentist adjusting the filling. If as a result of a defective filling, the filling has to be replaced.
• In cases of pain due to damage to surrounding tissues, the pain would resolve as soon as the damaged tissue heals.
• If the pain is due to infection of the surrounding bone, antibiotics and analgesics will help relieve the pain and heal the infection.


Home Remedies for Pain Management

Aside from taking medications, there are other things you can do to manage pain after a root canal.
• Taking care of your teeth by brushing twice daily.

Tooth brush
• Avoid eating hard and crunchy foods until your pain improves.
• Quitting smoking.

• Rinsing with warm salt water solution.
• Placing an ice pack on the affected area.
• Stress relieving activities like yoga.


When Should I Be Worried?

Pain after a root canal should decrease over time. If you still experience pain or swelling even after taking analgesics, you should see your dentist. Most people need more than one session for a root canal to be successful. In severe cases, you may need more than two sessions.

Recurrent pain could also be an indicator of treatment failure and in this case, the procedure needs to be repeated.


Root canals are an effective method for treating tooth problems caused by damaged or infected pulp. However, if your tooth pain persists after the root canal, these are the common reasons that might explain the problem.

In most cases, the tooth pain is mild and will resolve on its own, but if the pain is excessive or continues for more than five days, consult your dentist as soon as possible.

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Onyeka Mgbemere, BDS

Dr. Onyeka Mgbemere is a graduate of Dentistry and a licensed dentist who is passionate about the promotion of oral health education and prevention of oral diseases. She is currently undergoing her residency program in Oral medicine after spending years working at a Naval hospital. Her hobbies are watching movies and reading.