Pain after root canal treatment – what could be the cause?
Possible causes of pain after root canal treatment, the process of root canal treatment, and a summary of possible and even recommended actions in a marathon-sized article. Find out about root canal treatment prices, more articles and our doctors here. On each page you will find a login form where you can also request a callback.

What can be the reason for pain after a root canal?
During a root canal, the dead tooth nerve is removed from the tooth by the dentist. The root canal tooth is therefore no longer painful. The pain is caused by inflammation of the tissues surrounding the tooth. The pain from a root canal is typically not as severe as the inflammatory pain from a live tooth, which is why many people delay going to the dentist and do not take the signals from the tooth seriously enough. But deep down, the inflammation persists, and there are consequences. If you have a complaint about a tooth that has had a root canal treatment, you should see a dentist as soon as possible! Ask, call, check in!

Pain after fresh root canal treatment or how long a root canal can hurt
During a root canal treatment, the dentist will explore the canals in the root (a tooth can have more than one root, and a root can have more than one root canal), clean and disinfect it, and then seal the tooth by filling the root canal to prevent bacteria from entering the tissues. The root canal must reach the tip of the tooth root, otherwise bacteria can remain in the root canal. Root canal treatment is a meticulous task that requires a lot of attention, and there may be several triggers for the subsequent sensitivity or pain. Read more or contact us. During root canal treatment, the root canal needle may reach the tip of the root, causing temporary tenderness in the days after root canal treatment. This kind of tenderness or pain will gradually go away nicely, as there is no longer any inflammation feeding the inflammation here, this tenderness is due to the tissue being disturbed during the treatment. What to do: wait patiently for a few days. If pain decreases significantly day by day, the case is going in the right direction. If the pain does not go away, the problem is elsewhere, you should go back to the dentist. It is possible that the root canal was done on a tooth that has been inflamed for a long time. In this case, the inflammation will no longer feed from the tooth that has been sealed with a root canal, but the old inflammation will need to clear up from the root canal, this may take a few days. What to do: wait patiently for a few days. If pain decreases significantly day by day, the case is moving in the right direction. If the pain does not go away, the problem is elsewhere, you should go back to the dentist.

Complicated anatomy makes the situation more difficult, but tooth extraction should only be a last resort!
In teeth with complex anatomy, the dentist may not be able to find all the root canals, or may not be able to explore them in their entirety. Failure to find all the canals in an infected tooth means that there will be canals or parts of canals left in the tooth that still contain bacteria. These bacteria can continue to release toxins into the root canal tissues, so they can maintain inflammation. What to do: you can try re-rooting the tooth. Laser disinfection of the root canal, which also kills bacteria in the dentin tissue at a depth of about 1000 nm, can help a lot. If the condition of the tooth does not improve despite more treatment and disinfection, or if the root canal is divided and cannot be explored, tooth extraction is an option. In the case of an inflamed tooth socket, if the root canal treatment fails to open up all the root canals for the above reasons, inflamed nerve contents may remain in the unexplored canal. This can cause severe pain. What to do: you should always try to re-root the tooth. There are substances that can help to induce sterile necrosis in the tooth, thus aiding treatment. Laser disinfection of the root canal, which also kills bacteria in the dentin tissue at a depth of about 1000 nm, can help a lot. If the condition of the tooth does not improve despite more treatment and disinfection, or if the root canal is divided and cannot be explored, tooth extraction is an option.

What could be the reason if a tooth that has been root canal treated for a long time is sensitive to pressure?
If a tooth that has had a root canal treatment in the past becomes sensitive to pressure, it may be suspected to be infected with root canal inflammation. In such cases, an X-ray is necessary for a definitive diagnosis. The x-ray allows a good inspection of the root apex to determine whether there is fresh or chronic inflammation – i.e. a dental abscess – around the root apex. What to do: since pressure sensitivity may raise the suspicion of root-tip inflammation, i.e. dental calculus, it is advisable to consult a dentist as soon as possible to clarify the suspicion of a calculus.

What do we mean by inflammation of a root canal tooth?
The root canal tooth itself no longer contains a nerve, so in this case the tooth is not inflamed. If bacteria have somehow remained in the root canal, their toxins can pass through the root canal and irritate the tissues surrounding the tooth, especially the root canal pulp. The immune system senses the toxins and sends inflammatory tissue elements to the site to destroy the enemy, thus causing inflammation. The primary purpose of inflammation is to prevent bacteria and their toxins from entering the large bloodstream. Inflammation is therefore primarily a defence mechanism, but at a local level, inflammation causes the bone to slowly break down, so that the tissue around the root tip slowly disappears. This bone loss is usually visible on X-ray as a well-circumscribed dark spot. Types of this inflammation include granulomas or cysts around the root of the tooth. It is important to stress that such inflammation is caused by bacteria inside the tooth. In such cases, antibiotic therapy can only provide temporary relief and does not change the underlying cause. Antibiotics do not reach the inside of the tooth! What to do. You should see a dentist as soon as possible and give the tooth a chance to be explored and a thorough and all-encompassing disinfection.

What to do if a root canal tooth is pulsating?
If a root canal tooth is pulsating, this is typically due to two reasons: 1. Despite the root canal filling, bacteria remain in the canal, causing inflammation around the root apex. This inflammation can have acute, flare-up phases and chronic ‘quiet’ phases. 2. If the root canals could not be fully explored due to some anatomical variation, there may be living nerve tissue remaining in the root canals. In such cases, pulsation may also occur, but this is mainly a feature of fresh root canal treatment, before the medicinal phase of root filling.

When is root extraction an option?
Extraction of a root canal tooth is considered when

• if the root canals cannot be properly explored and cleaned due to anatomical variations
• if the tooth does not become symptom-free despite repeated root canal treatment – this may be due to: undetectable root canals, cracks, periodontal problems
• if the root filling is adequate, but there is a problem with the bony root of the tooth, e.g. excessive erosion of the bone and gum around the tooth, making it mobile
• if there is a general health condition that puts you at high risk of retaining a root canal tooth, as a root canal tooth can also present a gum
• if the root canal tooth cracks or breaks in such a way that it can no longer be restored with the help of a dental crown and a prosthesis

What is the lifespan of a root canal tooth?
There is no general rule for the lifespan of root canal treated teeth. Root canal treatment is a last resort to save a tooth. It is not root canal treatment that preserves tooth health, but proper oral care (primary prevention) followed by timely fillings (secondary prevention).

If primary and secondary prevention fails and the tooth needs to be root canaled, this is called tertiary prevention, i.e. it is a treatment that tries to prevent the tooth from having to be removed.

Some of the root canal treatments fail because of anatomical variations, infections and other problems in the tooth, even with the most careful dental treatment – it becomes a complaint again, a cyst or other nodular inflammation develops.

A successful root canal treatment is one where, 4 years after the root canal treatment, the tooth is free of symptoms, no symptoms of nodular disease are present, and the tooth is perfectly healthy on X-ray.

The longevity of root canal treated teeth is influenced by 2 basic factors:

1. the root canal treatment and root canal filling itself – how well all the root canals are uncovered, cleaned, disinfected and then filled with perfect precision

2. the structure of the root-filled tooth – how well the tooth can be safely reconstructed. In order to preserve the function of the root canal tooth in the mouth for as long as possible, it is recommended to reinforce it with a dental crown (e.g. zirconia porcelain crown). A root canal tooth loses its moisture retention and therefore becomes more porous, brittle and fragile. A crown is a good remedy for this brittleness.

Why do the dentists of Budapest Dental Dentistry achieve excellent results in the field of root canal treatment?
The dentists at Budapest Dental Dentistry pay special attention to root canal treatment. We make root canal treatment a priority in our practice, and we support it with precise background technology, so we have a higher success rate than practices that do not offer these technologies

1. Laser root canal disinfection
2. Antimicrobial photodynamic therapy
3. specialised mechanical root canal exploration
4. Digital root canal tracing
5. Digital intra- and extraoral radiographs
6. Follow-up examination of root filled teeth, automatic retrieval every six months
7. Protection of impacted teeth with crowns