A systematic review of root canal pain (Pak and White, Journal of Endodontics, 2011) found that about 81 per cent of patients had pain before treatment, around 40 per cent a day afterwards, and about 11 per cent a week later, with the remaining pain usually mild. In other words, many people feel better soon after a root canal than they did before it. Some tenderness for a few days is common, and knowing what is expected makes it easier to spot the rare case that needs a review.
Before the numbness wears off
The local anaesthetic usually lasts a few hours. Until the feeling comes back, it is safest not to eat, because you can bite your cheek, lip or tongue without noticing. Warm drinks can also be risky while you cannot judge temperature. Once normal feeling returns, choose soft food and chew on the other side.
If the tooth was sealed with a temporary filling between visits, it may feel slightly rough or high at first. That often settles within a day or two. If your bite still feels high after that, let the practice know, because a high spot can keep the tooth sore.
Tenderness usually fades over the first week
A dull ache or tenderness when biting is the most common feeling after treatment. It comes from the ligament and tissue around the root, which were often inflamed before treatment and take a little time to settle. For most people it is noticeably better each day and minimal by the end of the first week.
During this time, keep brushing and cleaning between your teeth as usual, gently around the treated tooth. Avoid hard, chewy or sticky foods on that side, particularly if there is a temporary filling that could be dislodged.
Simple pain relief is usually enough
Most people manage well with over-the-counter pain relief such as ibuprofen, or paracetamol for those who cannot take anti-inflammatories. Follow the directions on the packet and check with your pharmacist or GP if you take other medicines or have health conditions. Taking a first dose before the numbness wears off may help you stay comfortable. A cold pack held against the cheek for short periods may ease any puffiness.
Pain that needs more than this, keeps you awake or is getting worse rather than better is not expected and should be checked.
The tooth still needs its final restoration
Root canal treatment removes the infected or inflamed tissue inside the tooth, but it does not rebuild the tooth. Many treated teeth already have large fillings or decay, and back teeth take heavy chewing forces. A US study that followed about 200 root-filled teeth (Aquilino and Caplan, Journal of Prosthetic Dentistry, 2002) found that teeth not crowned after treatment were lost at about six times the rate of crowned teeth, although a study of this kind shows an association rather than proof of cause. Your dentist will advise whether the tooth needs a crown or whether a bonded filling is enough.
Until that final restoration is placed, treat the tooth gently and do not leave it longer than your dentist recommends. You can read more about whether a root-filled tooth always needs a crown and what getting a crown involves.
Signs that need a call to the practice
Contact your dentist promptly if you notice:
- pain that is increasing after the first two or three days instead of easing
- swelling of the gum, cheek or face
- a fever or feeling generally unwell
- a bad taste or discharge from around the tooth
- a temporary filling that has come out, or a tooth that feels cracked
If swelling spreads quickly or makes it hard to swallow or breathe, seek emergency medical care straight away.
Most treated teeth heal without problems. Occasionally a tooth does not settle and needs root canal retreatment or, less often, surgery at the root tip. If you are still deciding whether to have treatment at all, our guide to root canal versus extraction sets out the options.
Common questions after a root canal
Can I go back to work the same day?
Most people return to their usual activities the same day or the next. Some prefer a quiet evening after a long appointment.
What should I eat for the first few days?
Soft foods such as eggs, yoghurt, pasta and soup are easy choices once the numbness has gone. Chew on the opposite side until the final filling or crown is in place.
Why does the tooth hurt when I bite?
Tenderness to biting is common while the tissue around the root settles. If it is not improving after a few days, or your bite feels high, ask the dentist to check it.
Will the tooth feel completely normal again?
Many root-filled teeth feel normal once healed and restored, although the tooth no longer senses hot and cold the way a living tooth does. With good care and regular check-ups, a treated tooth can last for many years.
If you have had a root canal and something does not feel right, or you are due for a check-up, the team at Lumi Dental can help. See our current offers or book a visit.
This article is general information and is not a substitute for personal dental advice. If you have pain, swelling, or concerns after treatment, contact your dentist.
