A toothache in my upper right molar wouldn’t go away, so my dentist sent me to a specialist for a second root canal on the tooth last month. The endodontist checked my tooth almost two weeks ago. He said there was no swelling around the tooth, and the pain would gradually go away. This week, my tooth is still sore, my gums throb on and off, and it’s worse when I exercise. Ibuprofen and aspirin don’t agree with me, so the endodontist prescribed a pain reliever, but it makes me sleepy, so I only take it when I’m at home. I took antibiotics before the root canal treatment, so I’m wondering why the infection is continuing. I’m scheduled to start Invisalign treatment in mid-July, but it looks like I will have to delay it again. Will you please let me know what might be causing the problem before calling the endodontist or my dentist? I want to have some background information to help me know if their answer about the lingering pain sounds reasonable. Thanks. Morgan from Tuscaloosa, AL
Your concerns are valid. Your tooth should be feeling better. Although tenderness in a tooth after root canal treatment is common, you should be noticing a gradual improvement. It is best to delay Invisalign treatment. The pressure from the aligners will further irritate your tooth.
Antibiotics After Lingering Root Canal Pain?
Antibiotics help your body fight an infection, but they won’t eliminate the source of infection. Although your tooth will feel better while you’re taking the medication, when you stop, the pain will return. And you can develop an antibiotic-resistant infection.
If your pain isn’t increasing and there’s no significant swelling around your tooth, it’s unlikely that the infection is spreading. That’s good news.
Why Isn’t Your Tooth Healing?
After a first root canal fails, retreatment has a 50-80 percent success rate. Your options are limited. The endodontist might recommend root canal surgery to remove the infection and try to save the tooth, but there is no guarantee that it will work. If you’re uncomfortable with the endodontist’s recommendation, you can see another specialist for a second opinion.
If your dentist or endodontist needs to extract your tooth, your dentist will coordinate the timing of tooth replacement with your Invisalign treatment. It takes patience, but you can get your oral health back and enjoy your new smile after Invisalign.
David Finley, DDS, a fellow of the Academy of General Dentistry, in Monroe, LA, sponsors this post.