After Endodontic Treatment

Endodontic treatment (root canal therapy) is the final option to save a tooth that would otherwise have to be extracted. Teeth that need root canal therapy either have a dead (necrotic) pulp, often resulting in a bacterial infection called an abscess, or have developed decay that has extended into and permanently damaged the nerve in the tooth. In our office, endodontic treatment is typically performed in two visits.

At the first visit, the pulp tissue (the nerves and blood vessels that normally keep the tooth alive) is removed, as well as any decayed or damaged tooth structure. The internal structure of the tooth is rinsed with a potent disinfectant, and a long-term disinfectant is placed inside the tooth to eliminate as much bacteria as possible prior to sealing the tooth. A temporary filling is placed at this visit.

At the second visit, the temporary filling and disinfectant are removed, and the space inside the tooth is further cleaned and prepared for a final seal. The tooth is then sealed from the tip of the root up. Most often, the tooth will be prepared for a crown the same day, because endodontically-treated teeth are at a much higher risk of fracturing or breaking due to more extensive loss of natural tooth structure.

Numbness and Local Anesthesia

• The local anesthetic used for a dental procedure will numb the region as few as 30 minutes or as long as 4-6 hours.

• It is normal to have some discomfort at the injection site for up to 2 to 3 days.

• In rare cases, topical anesthetic or local anesthetic can cause an inflammatory reaction in the soft tissue at the injection site. This most often looks like an ulcer or cold sore, but can also result in redness or more serious swelling in the area. If this happens, notify us immediately. This is rarely a true allergic reaction, but early treatment can prevent a painful sore from developing.

Post-operative Pain

• Some degree of post-operative pain is to be expected with root canal therapy. Ideally, the instruments used to clean and shape the tooth operate as close to the end of the root as possible. This ensures that as much affected tooth structure as possible is removed and improves the outcome of the procedure, but it typically triggers some inflammation in the area. Our recommended protocols to limit pain are listed below. Most patients return to normal within 2-4 days.

• Some amount of swelling is also possible after beginning or completing endodontic treatment. Mild swelling is usually due to inflammation and not bacterial infection. However, some abscessed teeth will not respond to attempting to save the tooth with a root canal and must be extracted. If you develop significant pain and swelling following treatment, contact us to determine the next steps.

Eating and Drinking

• Be extremely careful if eating or drinking while you are still numb. It is not uncommon to bite or chew a numb lip or tongue, which can be very painful when sensation returns! This is most common in young children, who often can’t help but play with the numb tissue. Keep a close eye on your little ones!

• A soft diet is recommended between starting and completing a root canal.