Can a Root Canal Hurt Years Later? Understanding the Causes and Treatment of Post-Endodontic Pain

With proper care, even teeth that have undergone endodontic treatment can last a lifetime. However, sometimes, a tooth that has been treated doesn't heal properly and can become sore or sick months or even years after treatment. If an endodontic tooth hurts years after it failed, it's often due to root canal failure or a cracked tooth. The treatment for root canal insufficiency is retreatment or root canal surgery.Some dentists have advanced training in root canal therapy, but most refer their patients to a specialist.

Therefore, an endodontic specialist (endodontist) performs the procedure due to the instruments and techniques needed to access the infection and eliminate it. Root canals fail when the original treatment doesn't eliminate all of the infection or the tooth becomes infected again. It can take weeks, months, or even years before a failed root canal comes to the surface.You may recognize symptoms of infection, such as tooth discoloration, pimples on your gums, or swelling, because you've already had endodontic treatment once. Based on what is known about the number of endodontic treatments performed annually and research findings related to post-treatment pain, many patients and dentists will experience significant frustration related to persistent pain.It is estimated that approximately 16.4 million endodontic treatments are performed each year in the United States.

Most studies that examine pain after root canal treatment show that 3% to 6% of patients will experience severe pain in the days after treatment. A recent meta-analysis of the endodontic literature suggests that 5.3% of patients who received endodontics report some type of pain 6 months or more after treatment. Extrapolating these figures, approximately 800,000 US patients will experience severe, sharp postoperative pain (in the first 7 to 10 days after treatment) every year and a similar amount will experience persistent pain (present six months or more after treatment). It has been reported that between 1.6% and 6.6% of all endodontic procedures cause significant dental pain, called post-endodontic pain.These figures are particularly important because the pain experienced during and after endodontics is known to cause a significant amount of dental anxiety and fear, represents a major obstacle to receiving dental care, and has other negative psychosocial consequences.

Acute post-endodontic pain is generally treated with several short-term prescription pain regimens taken orally when pain worsens. This approach is highly effective for most patients, but it does not address the analgesic needs of approximately 3% of patients who suffer from a pain flare-up.Research has clarified a number of risk factors associated with the development of pain after an endodontic outbreak, but most of them are not modifiable (for example, age). The possible mechanisms of persistent pain after root canal treatment are unknown, but some ideas about this phenomenon can be gained by looking at the findings of other pain models. Persistent pain after the nerve section is not a newly recognized phenomenon in health care; historical reports refer to it as “phantom limb pain”.Other strategies could include preoperative treatment for modifiable high-risk factors, as well as preventive methods to neutralize non-modifiable risk factors.

In this way, the new knowledge will lay the foundation for future clinical research that will further improve root canal therapy and, potentially, other dental and surgical procedures as well.It's normal to feel some discomfort for a few days after endodontics. However, if you have severe pain that persists or if your tooth feels better and then starts hurting again, you may be experiencing root canal failure. Some patients show no symptoms of a failed root canal, while others may look different than they did before the first root canal.These figures are particularly important since it is known that the pain experienced during and after endodontics causes a significant amount of dental anxiety and fear, represents a major obstacle to receiving dental care, and has other negative psychosocial consequences.It has been reported that between 1.6% and 6.6% of all endodontic procedures occur significant dental pain within one week of root canal therapy, known as posendodontic pain. If endodontics was unsuccessful, x-rays can guide the endodontist to determine the best course of action and treatment plan.After that, the next fundamental step in improving care would be to identify people at risk before performing endodontic therapy and to intervene to prevent the development of persistent pain and disability.

If you need a root canal from an endodontist you can trust, contact North Shore & Brookline Endodontics today at the location that works best for you.If you have severe toothache or other old symptoms of a root canal infection, don't hesitate to book an appointment with your dentist. While not all endodontic therapies work, you can explore options to aid healing if you've had a failed endodontic treatment.