Most patients experience only mild discomfort following routine root canal procedures. Any time dental treatment is provided, the body responds with inflammation – the reaction of the body’s own defence system. One can expect that the gums may be sore in the area around the tooth where the treatment was performed. This is partly from the holder that is placed for the rubber dam, and also partly from the actual work inside the tooth. The tooth itself will likely be somewhat tender to biting for a few days following any dental treatment, and the jaw joints may be sore due to stretching open for the appointment.
Flare-ups – A minority of patients (approximately 5%) may experience more than average discomfort. This may involve pain and/or swelling within the first 72 hours following the root canal treatment. If you experience these symptoms, please contact our office.
Pain – Generally, discomfort following root canal procedures is minimal to moderate, and can be controlled by over the counter non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin or Advil). Ibuprofen has been clinically proven to be more effective than acetaminophen (Tylenol) for post-operative dental pain because it fights inflammation, which is the body’s natural response to invasive procedures including dental treatment.
Swelling – Patients may occasionally experience localized mild swelling around the area of the tooth being treated. This is not generally a sign of infection, but of inflammation – the natural course of healing following invasive procedures.
Medications – ibuprofen (Motrin or Advil) or acetaminophen (Tylenol)
Patients are advised to take ibuprofen following their root canal appointment, preferably while they are still frozen. It is advisable to take double the regular dose of ibuprofen (Motrin or Advil) for the initial dose in order to increase the concentration of the drug in one’s blood stream to speed its onset of action. This means that patients should normally take 600 – 800 mg of ibuprofen in the immediate post-operative period.
Patients should stay on a regular schedule with ibuprofen and take it every 6 hours according to the clock for the first 24 – 48 hours following their appointment, even if this means setting one’s alarm at night to wake up to take the medication. Subsequent doses of ibuprofen after the initial double dose should be the regular dose (400 mg). Patients should not exceed 3200 mg of ibuprofen over 24 hours. For patients not able to take ibuprofen, acetaminophen (Tylenol) is a reasonable alternative medication, but it does not fight inflammation, only the symptom of pain.
Antibiotics are not generally indicated with routine root canal treatment. In some cases, an antibacterial paste will be placed directly inside the canals of the tooth at the root canal treatment appointment.
Oral Hygiene – Patients should continue to clean the area as best as possible, but should avoid chewing on the temporary restoration for at least 24 hours.
Final Restoration – Patients must see their general dentist to have the temporary restoration replaced with a permanent restoration as soon as possible after the root canal treatment has been completed. Generally, this should be completed within one month of the completion of the root canal treatment. In addition, in many situations, a full coverage crown (also knows as a “cap”) will be required after the root canal treatment. This procedure is also done by your general dentist.