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CBCT Abscess

Reasons Root Canal Therapy May be Painful

Risks of Root Canals

It is no surprise that one of the most feared dental procedures is the root canal. This is unfortunate because root canal therapy carries a much higher success rate than most medical procedures. Nearly 9 out of 10 teeth treated with root canals remain comfortable and functional for many years! However, sometimes there is lingering pain after root canal procedures are performed.

A study done by the National Dental Practice-Based Research Network, which receives funding from the National Institute of Dental Research, has shown that there are specific circumstances that may cause teeth to hurt after root canals have been completed by both general dentists and endodontists (root canal specialists). According to the results of that study, which came from evaluations of actual patients in actual dental offices, the chances of having persistent pain after root canal therapy are higher if:

  • The tooth hurts for longer than a week before having a root canal.
  • The tooth hurts when it is tapped on (percussion).
  • The patient is a woman.
  • There is a history of any type of chronic pain in the face, like trigeminal neuralgia, atypical odontalgia, or muscle pain.

The more intense the toothache is the week before the root canal is done is a significant predictor of how much pain can be expected afterwards. Furthermore, the patient’s attitude about how successful the root canal will be significantly affects postoperative root canal pain. For example, if a person had a previous painful experience with a root canal, they likely will have more pain post-operatively because his or her brain is “programmed” to expect pain.

So, the take home message is this: Call your dentist as soon as a tooth starts hurting. Keep in mind that just because a tooth starts hurting and then stops does not mean that it does not require treatment. Many serious dental infections begin as a toothache that disappears relatively quickly and then develops into a severe abscess.

The good news is that persistent pain following root canal procedures occurs in only about 10%, or one out of ten teeth. Persistent pain following many other medical surgeries is about 30%. Root canal treatment typically gets a bad name because of procrastination.

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