Post-Root Canal Pain: Managing Swollen Gums After Crown Placement

The lower left molar has undergone root canal treatment and is experiencing gum swelling and pain after being fitted with a crown?

On September 15, I completed a root canal on my lower left molar.
On September 21, I felt soreness and tenderness when applying pressure to the tooth, but I still had a crown placed on September 23.
Starting on October 3, my gums became swollen, and I experienced soreness and tenderness when applying pressure to the tooth.
I noticed that the molar felt loose when I wiggled it, and by nighttime, the swelling was particularly severe, preventing me from sleeping.
I found some relief by applying ice, drinking cold water, or taking anti-inflammatory medication.
On October 6, during a follow-up appointment regarding the crown, I informed the dentist about the swollen gums.
The dentist suggested that the crown might be putting pressure on the gums and performed a fine needle puncture around the gum area of the molar.
However, that night, the swelling worsened, and I still couldn't sleep.
I am wondering if further examination or treatment is necessary, as I am also concerned about any overlooked issues.
Thank you in advance for your advice, doctor!

Miss Lin, 30~39 year old female. Ask Date: 2020/10/07

Dr. Huang Tingfang reply Dentistry

Dear Ms.
Lin,
Hello! You still need to return to the clinic for an X-ray examination to determine the cause.
Take care! Wishing you peace and smoothness in everything!
Sincerely,
Dr.
Huang Ting-Fang, Dentistry

Reply Date: 2020/10/07

More Info

Post-root canal pain, especially after the placement of a crown, can be a concerning issue for many patients. It is not uncommon to experience discomfort or swelling in the gums following these procedures, but the severity and duration of the symptoms can vary significantly from person to person.
In your case, it seems that you are experiencing significant swelling and discomfort in the gums surrounding your lower left molar after undergoing root canal treatment and subsequently having a crown placed. The timeline you provided indicates that the discomfort began shortly after the crown was placed, and it has progressively worsened to the point where it is affecting your ability to sleep.

There are several potential reasons for the symptoms you are experiencing:
1. Post-Operative Inflammation: After a root canal, it is normal for some inflammation to occur as the body heals. However, if the inflammation persists or worsens, it could indicate an underlying issue.

2. Crown Pressure: As your dentist suggested, the crown may be putting excessive pressure on the surrounding gums, leading to irritation and swelling. This can happen if the crown is not properly fitted, causing it to sit too high or misaligned with your bite.

3. Infection: One of the more serious concerns is the possibility of an infection. If bacteria have infiltrated the area, it can lead to abscess formation, which often presents as swelling and pain. The presence of pus or a foul taste in the mouth can also be indicative of an infection.

4. Residual Pulpitis: Sometimes, the nerve tissue may not be completely removed during the root canal procedure, leading to continued inflammation and pain. This can occur if there are multiple canals in the tooth that were not adequately treated.

5. Gum Disease: Pre-existing gum disease can also exacerbate post-operative symptoms. If the gums were already inflamed before the procedure, they may react more severely after dental work.

Given your symptoms, it is crucial to follow up with your dentist for a thorough examination. Here are some steps you can take:
- Return to Your Dentist: Schedule an appointment as soon as possible. Your dentist may want to take X-rays to check for any signs of infection or issues with the root canal treatment.

- Discuss Your Symptoms: Be sure to communicate all your symptoms clearly, including the swelling, pain, and any changes in your ability to eat or sleep.

- Consider Pain Management: While waiting for your appointment, continue to manage your pain with over-the-counter anti-inflammatory medications, as advised by your healthcare provider. Ice packs can also help reduce swelling.

- Follow-Up Care: If your dentist determines that the crown is indeed causing pressure on the gums, they may need to adjust or replace it. If an infection is present, you may require antibiotics or further treatment.

In summary, while some discomfort after a root canal and crown placement can be expected, significant swelling and pain warrant further investigation. It is essential to address these symptoms promptly to prevent any complications and ensure proper healing. Your dentist is your best resource for determining the cause of your discomfort and providing appropriate treatment.

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