Expert: Lawrence Spindel DDS, www.lspindeldds.com - 12/22/2009

Question
I had a simple root canal in third "molar" from the back, lower teeth.  I apparently only had one root.  My dentist is expert and kind. The entire procedure lasted only about 20  minutes.  I felt almost no discomfort for a day and a half after the procedure.  Then on the second day, the pain gradually intensified.  Touching my tooth hurt; biting hurt, my temple hurt, my jaw hurt!  Advil didn't help.  The endodonist started me on antibiotics. Two days later pain had not decreased, I went back to the endodonist.  He said that he saw no sign of infection, but that my inflamed jaw ligaments had caused my tooth to rise,  so he readjusted the seal for a better bite.  I had the procedure last Thursday.  Now Monday night, five days later I've been hiding in the bathroom to cry so I won't bother my husband.  I am still on antibiotics amoxi.  My tooth hurts, biting even gently hurts, my temple hurts, my jaw hurts.  Any advise?  I had no pain before the procedure.  I need some other work, but no additional root canals.  I NEVER want to return to a dentist's chair!  Please advise.  Thank you.

Answer
Dear Katherine,

As your endodontist explained to you, sometimes after a root canal, there can be inflammation in the ligamental tissues of the tooth. This might account for your discomfort when biting down. That  being said, you should be able to bring your teeth together without any pain. If you close your mouth without any food in it and you feel pain, you most likely still have a high bite and you should return to your endodontist to have the bite adjusted.

Taking over the counter Ibuprofen is probably a good idea, since it is an anti inflammatory and will promote healing. If your pain is due from inflammation then if the root canal is a success your sensitivity will slowly go away. Sometimes it can take up to six months or more.

If you were my patient I would follow you over the next six months and see how you did. I would not restore your tooth with a permanent restoration until it became assymptomatic.  Although you symptoms will probably go away, in a small percentage of times patients require a retreatment of the root canal. Also it is possible for a tooth to sustain a small crack while the root canal is performed and this can cause pain. This occurs infrequently, but if it does occur it does not bode well for the tooth. I do not assume this to be the diagnosis without some radiographic evidence of infection.

I have written a post on Ask Dr Spindel about pain after root canal that you may want to look at. I have included the link below and you may copy and paste it into the browser to see it.

http://lspindelnycdds.blogspot.com/2009/06/why-does-my-tooth-hurt-after-root-can...

I hope this information is helpful and please feel free to contact me again with any future dental questions.