Why Is My Root Canal Tooth Hurting Again? Possible Causes Explained

A few years ago, I had a root canal on a tooth, and it has started to hurt again?

Hello Doctor, I am currently abroad and unable to return to the clinic where I initially received treatment, so I would like to inquire about a tooth that I had root canal treatment on a few years ago due to decay.
After the procedure, I only had it filled and did not get a crown.
Recently, that tooth has started to hurt again.
When I visited a clinic, the dentist mentioned that since the nerve has been removed, it shouldn't be painful.
They suggested that it might be due to clenching my teeth tightly at night or unconsciously during the day, and noted that the tooth is quite loose.
The dentist recommended that I get an invisible night guard to prevent grinding.
However, I feel that the tooth pain may not be related to clenching or grinding.
Therefore, I would like to ask if there could be other reasons for the pain?

Chen, 20~29 year old female. Ask Date: 2020/05/30

Dr. Huang Tingfang reply Dentistry

Dear Mr.
Chen,
Hello! The tooth that has undergone root canal treatment is starting to hurt again and feels loose.
It is possible that there is severe periodontal disease requiring extraction, or there may be a fracture in the tooth that needs to be removed.
It might also be necessary to extract the entire tooth.
An X-ray is needed for confirmation.
Please take care of yourself! Wishing you peace and smooth recovery!
Sincerely,
Dr.
Huang Ting-Fang, Dentistry

Reply Date: 2020/05/30

More Info

Experiencing pain in a tooth that has undergone root canal treatment can be concerning and frustrating. There are several potential reasons why a tooth that has had its nerve removed might still cause discomfort. Understanding these causes can help you address the issue more effectively.

1. Residual Infection: Even after a root canal, there can be residual infection in the surrounding tissues. This can occur if the root canal treatment was not entirely successful in removing all the infected tissue or if new bacteria have entered the tooth through cracks or other openings. An infection can lead to inflammation and pain, even in a tooth that has had its nerve removed.

2. Cracks or Fractures: Teeth that have undergone root canal treatment are often more susceptible to fractures. If the tooth has developed a crack or fracture, it can lead to pain, especially when biting down or applying pressure. This is particularly relevant if the tooth feels loose, as you mentioned. A crack can allow bacteria to enter the tooth, leading to further complications.

3. Changes in Bite or Occlusion: If your bite has changed due to tooth loss or other dental work, it can place undue stress on the treated tooth. This can cause discomfort, especially if you are unconsciously grinding your teeth at night (bruxism). The dentist's suggestion of using a night guard is a common recommendation to help alleviate this issue.

4. Periodontal Issues: Sometimes, pain can originate from the surrounding gum tissue rather than the tooth itself. Periodontal disease can cause inflammation and discomfort in the gums, which may be mistaken for tooth pain. It’s essential to ensure that your gums are healthy and that there is no underlying periodontal disease contributing to your symptoms.

5. Referred Pain: Pain can sometimes be referred from other areas of the mouth or jaw. For instance, issues with the temporomandibular joint (TMJ) or other teeth can manifest as pain in a tooth that has undergone root canal treatment.
6. Psychological Factors: Stress and anxiety can exacerbate pain perception. If you are worried about the condition of your tooth, this can lead to increased sensitivity and discomfort.
Given your situation, it’s crucial to seek a thorough examination from a dental professional, even if you are currently abroad. They may recommend imaging studies, such as X-rays, to assess the condition of the tooth and surrounding structures. If there is evidence of infection or other complications, further treatment may be necessary, such as retreatment of the root canal or even extraction if the tooth is deemed non-restorable.

In the meantime, using a night guard can help protect your teeth from grinding and may alleviate some discomfort. Additionally, maintaining good oral hygiene and avoiding hard or chewy foods can help minimize pain until you can see a dentist.
In conclusion, while the nerve has been removed from your tooth, pain can still arise from various sources, including residual infection, fractures, changes in bite, periodontal issues, referred pain, and psychological factors. It’s essential to address these potential causes with a dental professional to find an appropriate solution.

Similar Q&A

Understanding Tooth Pain After Root Canal Treatment: Causes and Solutions

Six months ago, I underwent root canal treatment due to a deep cavity, and I also have a dental crown. Recently, I've been experiencing intermittent pain in the tooth that had the root canal. I'm not sure why this is happening.

Dr. Huang Tingfang reply Dentistry
Dear Ms. Nana: Basically, root canal treatment is a deep procedure, and there may be some pain during the process, so it is advisable to take pain medication. Removing the dental crown may also provide more comfort. Please communicate more with your dentist. Thank you! Wishing ...

Understanding Tooth Pain After Dental Procedures: Causes and Solutions

Hello Doctor: I have had root canal treatment, a post placement, and a crown on my molar. Recently, after chewing on something hard, the tooth started to feel strange, and I experience pain when biting with that tooth. Does this mean my tooth is inflamed again?

Dr. Yang Zhiren reply Dentistry
Hello: Based on your statement, it is possible that the root canal treatment was not completed properly, and there may be lesions at the apex or cracks in the tooth itself that could cause this situation. Taking a periapical X-ray can help determine what the issue is. Dr. Yang Zh...

Understanding Post-Root Canal Pain: Causes and Solutions

Hello Doctor: I had a root canal treatment on my lower right molar over a decade ago, and after filling it with silver amalgam, everything was fine. A few months ago, during a dental cleaning, a dentist found some decay and removed the silver filling to refill it. Two weeks later...

Dr. Huang Zhicheng reply Dentistry
Hello: A tooth with a long-dead nerve is often associated with chronic inflammation around the root apex and the root canal, which typically presents no clinical symptoms and has normal occlusion. However, when the pulp chamber is reopened, the balance is disrupted, leading to an...

Understanding Persistent Tooth Pain After Root Canal Treatment

The upper left molar underwent root canal treatment two years ago and has been experiencing intermittent pain since then. The discomfort is described as a dull ache, particularly when biting down, with a sensation of pressure and pain near the gums. There is also pain when using ...

Dr. Huang Tingfang reply Dentistry
Dear Ms. DN, Hello! Based on what you've described, it sounds quite uncomfortable. Although it's common for teeth that have undergone root canal treatment to sometimes feel abnormal (such as experiencing pain near the gums, discomfort when using dental floss, and occas...