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Root Canal

I had a root canal done 3 days ago on my upper molar. I have been having a lot of pressure in the area and when I tap the tooth I get a sharp pain. I also have a lot of pressure when biting. However it is no longer sensitive to temperature. Help! Is this normal?
Poster
  • Female | 21 years old
  • Complaint duration: 3 days
  • Medications: ibuprofen

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Featured Answer

30 UpVoted this answer Thuy Nga L. Vu, DDS Dentist, Roseville
What you are experiencing is 100% normal. I advise all of my patients upon completion of endodontic therapy to expect the time period between 48 and 72 hours to be the peak of discomfort and that discomfort is going to be to biting and pressure. I advise them they will most likely avoid chewing on this side for a while. How long is a while? Everybody is different. I once had a root canal on myself and it took 4 months before I was completely unaware of the tooth. Additionally, I point out that this does not mean that the discomfort magically dissipates after the 72 hours, that is simply when the inflammatory process is at its peak. It has to do with the was we heal, the release of certain inflammatory mediators called prostaglandins and the resultant buildup of lactic acid. For this reason, I advise all of my patients who are able to take nonsteroidal antiflammatory medications to take 800 mg of Ibuprofen every 6 hrs for the 48 hrs following therapy then as needed beyond that. The purpose of the Ibuprofen is not for pain control, although it helps, but to reduce prostaglandin production, thereby reducing the inflammation in the area. An antibiotic is ONLY indicated if you have fever or tenderness in the lymph nodes, indicating systemic infection. We dentists are notorious for overprescribing antibiotics when there is absolutely no evidence based reason for which to do so. A couple of additional things to add: If you feel that your bite is "high" and you are hitting this tooth first, then disregard everything I just said and go see your dentist as soon as possible. This area will most likely remain inflamed until the bite is corrected. Secondly, quit tapping on the tooth with your finger; that is an unnatural force upon the tooth, and I have repeatedly seen healthy, perfectly functioning endodontically treated teeth that have been in the mouth for months or years that "only hurt when I tap on it" I tell them to quit tapping on it.
8 UpVoted this answer Thuy Nga L. Vu, DDS Dentist, Roseville Orangecrest Family Dental, DDS Dentist, Riverside
The cause of postoperative pain after endodontic treatment can be due to inflammation or infection or both in the tissue around the root of the tooth. In your case I believe it is due to inflammation as a response to irritation during the root canal procedure. The Ibuprofen that was prescribed should help with the mild pain you are describing. If you feel the tooth when biting down you shoud have that checked for possible adjustment needed on the restoration( filling or crown). I would avoid eating anything hard on that side until pain subsides.
7 UpVoted this answer
Sounds as though the temporary filling covering the root canal access may be high and that when you bite down is is irritating the root apex of the tooth which is still recovering from a root canal
James A. Vito
7 UpVoted this answer Thuy Nga L. Vu, DDS Dentist, Roseville
When a root canal is done an inflammatory result usually occurs in the periapical (root tip) area in the bone around thr root which has live nerve endings. The tooth acts like a piston against this area which is already inflamed (irritable) and chewing and other stimuli cause pain in these nerve endings (not the tooth). If the tooth is will in occlusion (high,) the piston rffect keeps the tooth in trauma. Shortening the tooth and Ibuprofen (antiinflammatory) helps solve the problem.
6 UpVoted this answer
If you feel you are contacting your upper molar prematurely or first when you come to close your teeth together, you might be hitting too high. Follow up immediately to have your dentist or specialist adjust the filling as needed. You don't want to ignore it. That is good it is no longer sensitive to temperature if your root canal has been completed! You may experience post-treatment discomfort or achiness. Root canals are on the more invasive end of the treatment spectrum in dentistry (besides tooth extractions). I let my patients know that typically after a root canal, it is not uncommon to have localized discomfort in the first 3-4 days after treatment due to the instrumentation and/or removal of the infection. Continue to follow your dentist's or specialist's post-operative care instructions and avoid chewing on the involved side for the next 3-4 days. Good luck!
6 UpVoted this answer Thuy Nga L. Vu, DDS Dentist, Roseville
Sounds like the pressure pain/discomfort is the start of an infection.

The first thing to have the dentist who did your root canal to check is the bite, then place you on an antibiotic to control a possible infection.

Sometimes it is difficult to see an acute infection starting on a X-ray.

Even under the best conditions residual bacteria can cause this, or there is an invisible crack in the root that the bacteria can enter back into the root.

If possible, ask your dentist to refer you to get a CT scan (3D) X-ray which will identify if there was an existing infection to start with.

Just be aware that hairline cracks running vertically down the root are not visible on the CT scan, however the bone surrounding the tooth responds to a crack by creating a space between the bone and the tooth just in the area going down the crack line.

If this is the case, I would plan to have the tooth taken out as it may heal short term, however long term, it affects your body.

An chronically infected upper molar causes significant sinus issues, and affects your general health long term.

If you get the CT scan done and all is clear, and the tooth heals and all pain/ pressure gone, then make sure you get a crown on it as soon as possible, then 6 months from now get another CT to make sure that the root canal was successful.
Sumeet Beri
5 UpVoted this answer Thuy Nga L. Vu, DDS Dentist, Roseville
I don't believe that your symptoms are normal given these circumstances. Sometimes there are discomforts that patients experience following dental treatment...most are minor and resolve spontaneously. Ibuprofen generally helps a lot but it sounds like your problems aren't getting better. Remember, your tooth just had a major surgery so there may be a recovery time depending on the severity of your problem/treatment. I'm sure that your dentist/root canal specialist would want to see you as soon as possible to help you resolve this problem. There can be many reasons that a root canal treatment becomes unsuccessful. Some of these reasons are normal and some aren't. Pressure and sharp pain aren't generally expected after root canal treatment. Fixing this problem can range from retreatment to extraction to antibiotics to waiting for healing. Without a precise diagnosis one isn't able to be more exact in an advice column. Please see your dental practitioner right away for further advice and help.
4 UpVoted this answer
After a root canal procedure , inflammation produced at the root level is normal for several days and is best dealt with Advil (Ibuprofen). If the bite is not sitting too high and you are only experiencing pain on biting for a period of time after then we should suspect a cracked tooth. Depending on the progression of the crack , this tooth may need to be temporarily crowned to evaluate if the biting pressure pain disappears . If it does , we proceed to final crown fabrication but the status of the tooth is guarded. If the pain to biting continues then we advise removal of this tooth and looking at alternatives: nothing , denture, bridge ,implant .
3 UpVoted this answer
it is not uncommon to feel these symptoms for few days following root canal treatment.You are OK in taking Ibuprofen which should help with the swelling and pain.Call and discuss your symptoms with your Dentist and you may need to be evaluated sooner if it is deemed necessary.
Vinay Jerath
3 UpVoted this answer
It sure can be. You don't indicate what it's condition was before the treatment, but in any case, you've just had a lot of manipulation of a tooth in its socket, and just as with any other body part it can be sore for a while and take some time down. Keep whomever did the treatment informed of your concerns and whatever problems you are having, but what you describe does not sound unusual. On the other hand, it does not rule out a problem either. Should you have swelling or increasing pain, or if it does not improve over a week or so, you should have it checked out.