Care Guide After Root Canal Treatment

You have had root canal treatment. We cleaned out the inflamed or dead nerve tissue from inside your tooth, then filled and sealed the canals. The aim was simple: to keep your tooth instead of taking it out.

The source of your pain is gone. But the tissue around the tip of the root carries on healing for a few more days, so you may not feel perfect straight away. That is normal.

On this page we explain what to do, which things are normal, and when to call us. If anything is on your mind, call us. There is no such thing as calling for nothing.

Note: This page gives general information. If your dentist told you something different, follow what your dentist told you.

Know Which Treatment You Had

Not every root canal treatment follows the same path. If you are not sure which of these three applies to you, call us and ask.

Rules for Everyone

These Are Normal, Do Not Worry

• Tenderness when biting for a few days is normal. Cleaning the canals irritates the ligament at the tip of the root. That ligament is the cushion attaching your tooth to the jaw and it is very sensitive to pressure. So even when the tooth is not aching, you feel it when you bite. It usually fades within 2 to 5 days.
• It is normal that the tooth no longer feels hot and cold. The nerve tissue that produced that sensation has been removed, so the tooth cannot send that signal any more. But the tooth is not a dead lump. The tissues around it are alive and you will still feel pressure and touch. Your tooth carries on doing its job.
• It is normal for the tooth to feel different in your mouth. The shape of the surface has changed a little and your tongue notices immediately. You get used to it within a few days. But if that tooth touches before the others when you bite, that is a different matter and we cover it below.
• An odd taste from the temporary filling is normal. Temporary filling material has a taste and smell of its own. It fades within a few days. If an unpleasant taste becomes constant, let us know.
• Slight wear on the temporary filling is normal. It is made soft on purpose so it can be removed easily, so the surface flattens off a little over time. Breaking, losing a piece or the whole filling coming out is not normal, and you should call us.
• If the tooth was badly infected, it is normal that the pain does not stop at once. If you came in with a tooth that was already very painful, the tissue around it was already inflamed. It takes a few days to calm down. What we expect is pain that is less each day than the day before.
• A root-treated front tooth can darken slightly over time. Teeth that have had the nerve removed can turn a little grey or yellow over the years. It is not a health problem. If it bothers you, it can be treated with whitening from inside the tooth or with a crown.

Call Us Straight Away

The following are outside what we expect. Told early, they are simple to deal with.

• If the pain is increasing instead of easing. Pain can fluctuate a little in the first two or three days, but the overall direction should be downwards. Pain that keeps building, or wakes you at night, needs looking at.
• If your face is swollen. Swelling means the infection has spread outside the tooth. Do not wait, call the same day. If the swelling is moving towards your eye or your neck, or you have trouble swallowing or breathing, and you cannot reach us, go straight to the nearest hospital emergency department.
• If the temporary filling has broken or come out. This needs dealing with quickly, but it is not something to panic about. Stop chewing on that side and call us. There is more detail below.
• If that tooth hits before the others when you bite. The filling may be sitting a hair's width too high. This feeling does not go away by itself. A tooth left high carries the load alone every time you bite, which both prolongs the pain and can crack the tooth. It takes a few minutes to correct.
• If you have a temperature above 38 degrees or a bad-smelling discharge. This can mean the infection is spreading. Call the same day.
• If a piece has broken off the tooth. A root-treated tooth is fragile. Even a small piece needs checking, because how far down the fracture goes is what matters.

If You Have a Temporary Filling

If your treatment is being done over several visits, the filling on your tooth is temporary. It is deliberately made from a soft material so it can be removed easily at your next appointment, and that is what makes it delicate.

• Do not chew anything hard or sticky on that tooth. Sticky things like chewing gum, toffee and caramel can pull the temporary filling straight out. Hard things break it. Give that side a rest until your next appointment.
• Do not pull floss upwards on that tooth. Once the floss is between the teeth, pulling it up sharply can lift the filling out. Slide it out sideways instead.
• If the filling comes out, call us the same day. Once it is out, saliva and bacteria start seeping into the cleaned canals. The longer it stays open, the greater the chance the canals will need cleaning all over again. This is why we do not treat a lost temporary filling as something that can wait until your next appointment.
• If you cannot reach us, keep the area clean. Rinse gently with warm water after meals and do not chew on that side. Do not pack cotton wool, chewing gum or anything else into the cavity. Make sure you call the next day.

About Your Medication

• Not every patient is given antibiotics. Root canal treatment is itself the procedure that removes the source of the infection. Antibiotics are only needed when the infection has spread outside the tooth, with swelling or a fever. If you were not given any, nothing has been left out. Your dentist decided they were not necessary in your case. If antibiotics are not on your prescription, please do not buy them yourself at a pharmacy.
• If you were given antibiotics, finish the course. Stopping early because you feel better lets the surviving bacteria multiply again and the infection becomes harder to treat. Keep going until the last tablet.
• Take your painkiller before the pain starts. If you take the first dose while the anaesthetic is still working, the pain never gets a chance to settle in. A painkiller taken afterwards works much less well. Stick to the intervals you were given and do not increase the dose on your own.
• Do not stop your regular medication. Carry on as normal with medication for blood pressure, diabetes, your heart or blood thinning, unless your dentist has told you otherwise.

Why This Matters So Much

• A root-treated tooth breaks more easily than other teeth. Clearing out decay and infected tissue leaves less sound structure inside the tooth, and the tooth has also lost the living tissue that kept it moist. The remaining walls are far more likely to crack under chewing forces. A crown wraps those walls from the outside and spreads the force across the whole tooth.
• Delaying the crown can cost you the tooth. A fracture in a weakened tooth usually runs below the gum line, sometimes into the root itself. A crack along the root cannot be repaired and the tooth has to be taken out. In other words, a root canal that went perfectly can be wasted by a crown that was never fitted in time.
• The seal on top matters as much as the root filling. The canal system is a complex network of branches you cannot see, and once cleaned it has to be completely sealed off from the mouth. Saliva seeping past the edge of a filling or crown travels down the canal and starts a new infection at the root tip. That is why we make so much of the seal on top of the tooth.
• A root-treated tooth still decays, but it will not warn you. Most of our patients think that once the nerve is out the tooth cannot decay. It can. The only difference is that the decay does not hurt. With no warning signal, it can progress unnoticed. Six-monthly check-ups exist for exactly this reason.
• The end of the pain is not the end of the healing. If there has been an area of infection at the root tip for a long time, it takes months for new bone to fill it in. It can be six months, sometimes a year, before healing shows on an X-ray. Feeling well during that time is a good sign, but it is not enough on its own. A follow-up X-ray is the only way we can see it.
• Grinding your teeth breaks a root-treated tooth sooner. The force landing on your teeth during night-time grinding can go well beyond normal chewing force. A tooth that is already weakened cannot carry that load for long. If you grind, wearing a night guard adds years to the tooth.

In Short

• First day: do not eat while numb, chew on the other side.
• Tenderness when biting lasts a few days and eases daily.
• If the temporary filling comes out, call the same day.
• Do not delay your crown. It is what stops the tooth from breaking.
• Facial swelling or increasing pain: do not wait, call us.

You can find our other aftercare guides on the Patient Guides page. If a crown is planned for your tooth, read After Porcelain Veneers and Zirconia Crowns as well. You can book your crown appointment through online appointment, and you can reach us on +90 212 823 79 72 with any question at all.