Post-Root Canal Symptoms: When to Seek Further Treatment

After root canal treatment

Hello, doctor.
Previously, one of my lower right teeth started to hurt after drinking something cold, and the pain spread to my upper teeth, making it impossible to sleep.
On the day of the examination, only the upper teeth were painful.
The dentist identified that one of my upper right teeth had a necrotic nerve.
After the first root canal treatment and temporary filling, I still felt soreness when biting, but only on the side near my tongue; the outer side had no sensation.
An X-ray revealed a possible second root canal on the side where I still felt discomfort, so I underwent a second root canal treatment.
A few days later, the biting pain subsided.
On the day I was supposed to get the permanent filling, I suddenly felt some sensation when biting.
At the clinic, the dentist first used the temporary filling material.
Since I wasn't given anesthesia, I felt that some areas were completely painless while scraping inside the tooth, but the scraping on one side caused soreness.
I informed the dentist, who said it was normal since there were still periodontal nerves present, and proceeded with the filling.
During the filling, I felt some soreness in the second root canal, but it has since resolved after four days.
Just now, when I tried to restore normal biting on the right side, I suddenly felt a brief contraction of the nerve with a slight sour sensation.
I tried a few more times, and this temporary contraction and sour feeling appeared again after a few seconds.
When I pressed with my tongue, it wasn't the tooth that had the root canal but the one behind it, which had a faint sensation, but it seemed to be fine when not biting down.
I would like to ask if this is a sign of a problem? Does it need treatment? Thank you.

bru, 30~39 year old female. Ask Date: 2020/04/22

Dr. Huang Tingfang reply Dentistry

Dear Ms.
Bruce_yl,
Hello! As mentioned, please make sure to check thoroughly to see if the issue is with the lower right or upper right area.
Take care! Wishing you peace and smooth recovery!
Sincerely,
Dr.
Huang Ting-Fang, Dentistry

Reply Date: 2020/04/22

More Info

After undergoing a root canal treatment, it is not uncommon to experience some lingering symptoms, which can sometimes be confusing and concerning for patients. Based on your description, it seems you have had a complex dental situation involving multiple teeth and nerve issues. Let's break down your symptoms and discuss when it might be necessary to seek further treatment.

Understanding Post-Root Canal Symptoms
1. Normal Post-Operative Pain: After a root canal, it is typical to experience some discomfort or sensitivity in the treated tooth and surrounding areas. This can last for a few days to a week. The pain you felt initially, which radiated to other teeth, could have been due to inflammation or irritation of the surrounding tissues.

2. Sensitivity to Pressure: The sensation of pain or discomfort when biting down, especially if it is localized to one side, can indicate that the tooth is still healing or that there may be residual inflammation. The fact that you mentioned feeling pain only when biting on one side suggests that the tooth may still be sensitive, which can be normal after such a procedure.

3. Nerve Sensitivity: The feeling of "nerve tightness" or a brief sensation of discomfort when biting could be related to the nerve endings in the area still being sensitive after the procedure. This is particularly true if the tooth had significant nerve involvement prior to treatment.

4. Potential Issues: While some discomfort is expected, certain signs may indicate a need for further evaluation:
- Persistent or worsening pain that does not improve over time.

- Swelling or tenderness in the gums around the treated tooth.

- Pain that radiates to other areas or is not localized to the treated tooth.

- Any signs of infection, such as fever or discharge.

When to Seek Further Treatment
Given your symptoms, it is advisable to monitor the situation closely. If the discomfort you are experiencing continues or worsens, or if you develop any new symptoms, it would be prudent to return to your dentist or an endodontist (a specialist in root canal treatments). Here are some specific scenarios where you should seek further treatment:
- Persistent Pain: If the pain does not subside after a week or two, or if it becomes more intense, this could indicate an issue with the root canal treatment or an underlying infection.

- Changes in Symptoms: If you notice any new symptoms, such as swelling, fever, or a bad taste in your mouth, these could be signs of infection that require immediate attention.

- Sensitivity Beyond Normal: If the sensitivity to pressure or temperature does not improve or if it becomes more pronounced, this may warrant further investigation.

Conclusion
In summary, while some post-root canal discomfort is normal, it is essential to be vigilant about your symptoms. If you experience persistent or worsening pain, or if any new symptoms arise, do not hesitate to reach out to your dental care provider. They can perform a thorough examination, possibly including X-rays, to determine if further treatment is necessary. Remember, your comfort and health are paramount, and addressing any concerns early can help prevent more significant issues down the line.

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