Pain and Swelling Below the Nose After Root Canal Treatment

Pain and swelling around the area beneath the nostrils?

Ten days ago, the doctor said that the tooth (the one next to the left front tooth) was necrotic and that the root canal procedure would not be painful.
The doctor generally completed the procedure and scheduled a follow-up appointment for three days later.
However, last night I experienced mild pain that was bearable, but today the pain has become unbearable.
There is swelling about 1 cm around the area below my nostrils.
The tooth itself does not hurt, but there is a sensation of soreness and numbness.
Tapping on the tooth does not elicit any response, and using my tongue to press against the gums around the tooth does not cause pain or swelling.
However, when I press on the area below my nostrils with my finger, it is very painful, and the pain persists even when I am not moving.
Could this indicate that the root canal treatment was not adequately performed? It has been ten days since the procedure, and the pain has just started.
It is really painful, and I have to wait three more days for my appointment.
What should I pay attention to during the consultation?

Ai Li, 20~29 year old female. Ask Date: 2020/12/19

Dr. Huang Tingfang reply Dentistry

Dear Miss Ellie,
Hello! As mentioned, it is possible that there are many bacteria within the tooth or that there is a lesion at the apex of the root, which is causing inflammation at the root tip.
You will need to see a dentist for debridement, and that should lead to improvement.
Please start with ice packs! Take care!
Sincerely,
Dr.
Huang Ting-Fang
Director of Dentistry

Reply Date: 2020/12/19

More Info

After undergoing root canal treatment, experiencing pain and swelling, especially in the area below the nose, can be concerning. Your description suggests that you are dealing with a few potential issues that may arise after such a procedure.
Firstly, it’s important to understand that root canal treatment involves the cleaning and sealing of the tooth's root canals, which can sometimes lead to inflammation or infection in the surrounding tissues. The fact that you are experiencing swelling beneath the nose, along with pain, could indicate a few possibilities:
1. Infection: If the root canal treatment did not completely eliminate the infection, it could lead to an abscess, which may cause swelling and pain. This is particularly concerning if the swelling is localized and painful to touch, as it may suggest that pus is building up in the area.

2. Sinus Involvement: The upper teeth, particularly the incisors and canines, are located near the maxillary sinuses. If there is an infection or inflammation in the tooth, it can sometimes extend to the sinus, leading to sinusitis, which can cause pain and swelling in the area around the nose.

3. Nerve Irritation: The procedure may have irritated nearby nerves, leading to referred pain or discomfort in the surrounding areas, including the nose.

4. Delayed Reaction: It’s also possible for symptoms to develop days after the procedure due to the body’s inflammatory response. Sometimes, the initial healing process can mask underlying issues that become apparent later.

Given that you are experiencing significant pain and swelling, it is crucial to seek dental care as soon as possible, even before your scheduled appointment. Here are some steps you can take:
- Pain Management: While waiting for your appointment, over-the-counter pain relievers such as ibuprofen or acetaminophen can help manage your discomfort. However, be cautious with dosages and consult a healthcare provider if you have any concerns.

- Cold Compress: Applying a cold compress to the outside of your face can help reduce swelling and numb the area, providing some relief.

- Avoid Irritants: Try to avoid any activities that may exacerbate the pain, such as chewing on that side of your mouth or consuming very hot or cold foods and beverages.

When you see your dentist, be sure to communicate all your symptoms clearly. Mention the swelling, the location of the pain, and any other sensations you are experiencing. Your dentist may perform an examination, possibly including X-rays, to determine if there is an infection or other complications that need to be addressed.
In some cases, if an infection is confirmed, you may require antibiotics to help clear it up. If the root canal treatment was incomplete or if there is a persistent issue, further treatment may be necessary, which could include retreatment of the root canal or even extraction of the tooth if it cannot be saved.

In summary, while some discomfort can be expected after root canal treatment, significant pain and swelling, especially if localized, should not be ignored. Prompt attention from your dentist is essential to address any potential complications and to ensure your recovery progresses smoothly.

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