Root canal treatments (RCT), like extractions, are what most people dread about the dentist. Oftentimes, it’s associated with intense pain. But it doesn’t have to be that way. In fact, it usually isn’t.
A Quick Recap
Root canal treatment is needed when tooth decay goes too far and infection spreads too deep, affecting the nerve. It’s a procedure that aims to remove the infected/dead nerve (pulp) inside the tooth. Once removed, the next stage is to disinfect and clean the inside of the tooth (rendering it bacteria-free). The final stage is sealing the root canals with root filling material.
Endodontists specialise in RCTs but some general dentists can also perform the treatment. For any general dentist who can’t, they’ll refer you to an endodontist.
So Now What?
Once the local anaesthetic from the treatment wears off, your tooth should only feel a little sensitive or tender for a few days afterwards. There could be several reasons for this.
RCT involves putting a rubber dam around the tooth to isolate it. In order to keep it in place during the treatment, a tight clamp is used, and that could lead to slight gum inflammation around the tooth.
The treatment is generally done in stages which may take a couple of hours every visit. Your jaw could get tired from keeping your mouth open for so long. You can ask for a bite block that will allow your jaw to relax while keeping it open.
The long treatment stages also mean that your dentist will most likely put a temporary filling over the hole once the RCT is complete. They’ll permanently fill or crown it on another day so you don’t have to keep your mouth open longer than you have to.
However, occasionally the temporary filling may sit a bit high, causing the mouth to bite harder on that spot, making the tooth sore. If you find that to be the case, ask your dentist to smooth out the top so that you can occlude properly on that tooth.
This sensitivity can be relieved through normal paracetamol or ibuprofen and it should settle after a few days. Dentists often schedule a short review a week after to see how you’re going. Keep thoroughly brushing and flossing daily to maintain good oral hygiene.
What If the Pain Gets Severe?
If the pain gets severe, go to your dentist before the week review. It may be that the RCT has failed which is rare but it does happen. Failure may be due to an undetected, deep root fracture, the presence of an extra, narrow canal that was not picked up in the X-ray, or just a leak in the temporary filling on the top.
Your dentist will possibly propose four options if the initial RCT fails or experiences complications:
- Permanent filling: if it’s just an issue with the temporary filling, your dentist will just clean out any infection allowed by the leak and then permanently seal up the tooth so no leak will remain
- Root canal retreatment: they go into the tooth again and clean out any additional canals that have been missed
- Apicoectomy: an endodontic surgical procedure that removes the root apex
- Tooth extraction: pulling out the tooth as it is unsaveable and the crack is too deep
It may be that they only provide you with one or two options out of the list above as the rest are unsuitable to your particular situation. In any case, your dentist will direct you to the most suitable solution and detail all the risk factors involved.