Why can tooth pain return after root canal treatment?

Doctor Aleksandra Kostrz and hygienist Wioletta Zawierucha working with a patient

You’ve probably already wondered

why after root canal treatment, which is so often performed at the dentist, the tooth may still hurt. After all, theoretically, after such a procedure, the tooth should stop causing any problems, right? Unfortunately, this is not always the case. Why is this happening? Here are some potential causes that may make your toothache come back and are worth paying attention to.

1. Inadequate cleaning of the root canals

  • During root canal treatment, the dentist removes dead pulp and bacteria from inside the tooth and root canals. If this cleaning is not performed thoroughly enough or does not cover the entire length of the canal, a source of infection may remain, resulting in the return of pain. Improperly filled root canals can also lead to recurrence of infection and pain.

2. Undetected additional root canals

  • It may happen that a tooth has additional root canals that were not discovered during preparation for treatment. Such hidden channels can harbor infections and bacteria that cause pain again. Performing an X-ray allows you to assess whether all root canals have been included in the treatment.

3. Problems of adjacent teeth

  • Sometimes the source of pain after endodontic treatment is in the adjacent tooth. Therefore, it is worth checking the condition of other teeth and checking for any cavities on the surfaces in contact with the treated tooth. An examination by a dentist can help detect any problems and solve them quickly.

4. Periapical inflammation

  • Pain after root canal treatment may result from inflammation of the tissues around the end of the tooth root, which is called the periapical area. This inflammation may be caused by a previous infection that has spread or by remnants of pulp tissue that accidentally remain after treatment. In this case, it may be necessary to use antibiotics or even repeat root canal treatment.

5. Tooth root fracture

  • A tooth root crack may be the result of mechanical damage during the procedure or appear after root canal treatment, when the tooth becomes weakened. Pain occurs when the root fragments move under the force of chewing. Treatment for such a case may include placing a crown on the tooth or, in extreme cases, tooth extraction is necessary.

It is worth noting that each case is different, and there are many factors that influence why pain occurs after root canal treatment. Therefore, it is important to consult a dentist for accurate diagnosis and appropriate treatment.

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