Read official publications written by the endodontists at JCV.

This is a frequently asked question, Yes, a tooth with an existing endodontic treatment can still hurt. However, the pain from a tooth with Endodontic treatment originates from the supportive tissues rather than the tooth itself. Any load is transmitted through the tooth onto the supportive tissues. The tooth then would hurt to touch or if subjected to a biting force. You can also experience swelling. 

Common toothache usually originates from the pulp or commonly called “nerve”.  Pain originating from the pulp is usually a more severe sharp pain often triggered by cold temperature or spontaneous constant throbbing pain.  If you have had a root canal treatment you may be familiar with these symptoms.

Why does my root canal tooth hurt?

There are different reasons a tooth with an existing root canal treatment can hurt. A recently completed root canal treatment is a common reason.  This is usually due to an inflammatory response of the surrounding supportive tissues to the procedure, just like any post-op surgical procedure symptoms you would have in any part of your body.  

 The discomfort experienced after a root canal treatment should subside within a few days or up to a couple of weeks. If the pain persists then this could be due to the top restoration being “high”, which can cause severe additional and continuous trauma.  After the root canal treatment is completed, a top restoration is done.

When doing so, the occlusion (bite)  is adjusted so the loads are evenly distributed. Occasionally high spots are missed and this can lead to severe pain.  If this happens, you will need to return to your clinician as soon as possible to have the bite adjusted. This severe pain would subside soon after the adjustment.

If my tooth had a root canal several years ago and now it is painful. Does this mean my root canal treatment failed? 

If the root canal treatment is several years old and you start experiencing pain, this is most commonly caused by an infection or abscess. Root canal treatments fail if bacteria gain access to the sealed root canal system. Bacteria present in your saliva can gain access through broken down margins of restorations, decay, fractures or an inadequate root canal treatment where bacteria was left behind.  This type of pain is most commonly described as “pressure” pain, sore to touch or bite down on and swelling around the affected tooth.  

Where does the pain of a root canal come from?

The pain experienced in this situation is originated in the supportive tissues around the apex of the root. This means any load applied on the tooth will be transmitted to the tissues and this causes pain. It is natural for the patient to report that the pain is coming from the tooth but in reality, it is not the tooth itself, it is the bone and tissues surrounding the tooth.

Some failed root canals can be re-treated and the tooth can be saved. Advanced and specialised equipment is required to retreat a tooth. At JCV Endodontics we are equipped with microscopes and advanced tools to carry out such a technically challenging procedure.

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