Being a dentist, I have been questioned several times related to root canal treatment or RCT. Questions like – Does a root canal pain? If yes, then how much does it hurt? The plain and simple answer is ‘Yes’. But root canal pain is not the same for everyone. It entirely depends upon the underlying cause which led to the treatment and your threshold to bear the pain.

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Moving further in this article, you will get to know the overview of a root canal treatment and details about the degree of pain a patient endures within and after this treatment.

You will also get to know the ways in which we can prevent the need for root canal treatment by taking good care of your oral health.

What to expect from a root canal treatment?

A root canal is a treatment to repair and save an infected or injured tooth. The procedure merely involves removal of the damaged areas of the tooth i.e. pulp, irrigating and disinfecting the area and finally filling and sealing it.

The common causes affecting the pulp are cracked tooth, a deep cavity, repeated dental treatment to the tooth or trauma. The term “root canal” comes from cleaning of the canals inside the tooth’s root.

If a dentist suspects you may need a root canal, he will first take X-rays or examine existing X-rays to show where the decay is located.

Local anesthesia is a numbing medicine administered to the affected tooth and adjacent tissue. Against popular belief, a root canal is no more painful than a filling.

An opening is made, and the diseased tooth pulp is removed. The roots of the tooth once opened (to get rid of the diseased pulp) are filled with gutta-percha material and sealed off with cement

Why do we have root canal pain and how painful is the procedure?

Most people report a feeling of little sensitivity or tenderness of the tooth for a few days after having a root canal. There are several reasons for this –

The tissue around the gums remains swollen or inflamed

Even though the dentist has removed the nerve roots from the tooth which is responsible for pain, there are still small nerves in the ligaments and tissue surrounding the tooth.

When this area is inflamed, such as after a dental procedure, these nerve endings can also register discomfort and pain.

Complications of RCT – Mid treatment flare-ups during an RCT

Even after the best efforts of your dentist to treat and seal off an infection, new complications and relapse of the previous infection might occur even after a root canal treatment.

There can be complications in between the ongoing procedure as well, like severe pain or bleeding from canals, these are called mid-treatment flare-ups.

The most likely reasons for such uncalled for complication may be one of the following:

  • A left out untreated root canal when there are multiple canals.
  • An undetected fracture in the tooth.
  • Contamination of the prepared tooth with saliva or saline water.
  • The inadequacy of filling material
  • Overfilled canals
  • Underlying undetected infection
  • Poor response of the tooth to the treatment might be due to improper patient compliance.
  • Trauma to the treated tooth.

Instrumentation damage

It is likely that a dental instrument which we use to clean out the root canal might damage the sensitive surrounding soft tissue.

Temporary filling placed higher than surrounding teeth

If a dentist put in the temporary filling with Zinc Oxide Eugenol material and did not smooth it out enough. If this filling is even just a little higher than the surrounding tooth, it can cause the mouth to bite harder on that spot. This would make the tooth sore. (1)

A reasonable degree of pain to expect from RCT

In almost all cases, root canal pain, sensitivity, and discomfort should reduce within a few days.

If it does not get better in about three days or if the pain gets severe or unrelieved by home measures like ice packs and clove oil, it is essential to call the endodontist or dentist for an evaluation.

Managing post root canal pain

Mid-treatment root canal pain is controlled by the dentist with the health of local anesthetics. Though these anesthetics keep the treated are numb for hours after completion of treatment, pain might return once the effect of anesthesia wears off.

There are various methods in which the pain can be managed and they are –

  • Take prescription painkiller medication given by the dentist.
  • Saline lukewarm water mouth rinse after at least 6 hours of filling.
  • Ice packs placed externally on the treated area at an interval of 4 hours.
  • Eating semi-solid and easy to chew food.
  • Avoid beverages that are extremely hot or cold.

However, if there is root canal pain is unbearable and persists over three days, then consult your dentist as it can be due to one of the post-ops complications of RCT.

What happens when you avoid an RCT?

Sometimes people get so scared of root canal pain that they postpone it. But root canal pain is way less than the pain that might occur if some serious dental complication happens because of delay in treatment.

Some obvious implications of delaying root canal treatment are as follows –

  • The tooth infection might spread from the roots of the tooth to the glands below the jaws, sinus around our nose or neck spaces. This spread of infection might cause unbearable pain and swelling in these areas leading to lethal complications.
  • A bone loss might occur from around the tooth causing o premature exfoliation of tooth and mobility in the adjacent healthy tooth as well.
  • Abscess formation at the tip of the root. The abscess can further progress into a granuloma, cyst or even osteomyelitis if ignored for a long time.

Preventing the root canal pain

The best way to avoid root canal pain to avoid root canal treatment by practicing following good oral care practices –

  • Brush twice a day.
  • Always remove the food that is left in your mouth with floss or an interdental brush.
  • Avoid eating too many sweets to avoid decay of tooth.
  • Limit your intake of soft drinks as they make your teeth very sensitive, yellow and decay them faster than usual.
  • Always use a good mouth gargle to rinse your mouth after each meal. Salt water gargle can also come in handy.

Final words on root canal pain

Oral health constitutes healthy gums and a set of 32 healthy pearly whites. But you may have to endure root canal pain if you have neglected to take a good care of your teeth and gums in the past.

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Root canal treatments are carried out millions of times each year. In most cases, endodontic treatment can successfully save a tooth that has been infected or damaged.

New technologies and anesthetics help to ensure that a root canal procedure is as comfortable as possible and pain is well managed. People who experience severe or lasting pain should report it to the endodontist for further evaluation. Nonetheless, fear of pain should not make you put off the treatment as that leads to complications.

Root canal pain entirely depends upon the underlying cause which led to the RCT and your threshold to bear the pain.
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