Root Canal Pain

Root canal pain actually refers to pain in the part of the tooth structure known as the root canal. We all know that the tooth is made up of three main parts - enamel, dentin and pulp. The pulp is the innermost portion of the tooth that has nerves and blood vessels. The pulp of the tooth is present in the crown and the root of the tooth as well. Hence, when an infection, as is seen in cases of tooth decay, extends into the pulp of the root, then it leads to root canal pain. However, most people mistakenly identify this pain with pain after root canal treatment or pain during root canal procedure but this is in fact a misnomer.

Causes

• As mentioned earlier, pain in root canal is often due to an extension of caries from a tooth decay. These caries extend into the root after crossing the enamel and the dentin to land in the pulp of the root canal, thus, leading to pain.
• Any kind of sudden trauma, due to which there might be loss of tooth structure and resulting exposure of the pulp can easily be an open invitation to root canal infection which in turn will cause pain.
• Long standing cases of chronic pulpitis also lead to root canal pain which eventually necessitates root canal treatment.
• As is the common belief, there may be pain during or after root canal procedure.

Symptoms Accompanying Pain

• The pain experienced by the person is mostly initially dull and nagging in nature, when the infection nears and begins to encroach on the root canal. However, once the caries enters the pulp, then the pain normally becomes excruciating and unbearable.
• This pain is normally aggravated at night while sleeping or when the person lies down. The pain may also increase while chewing food, due to which the person may have loss of appetite.
• Swelling of the gums in the periapical region can be caused due to a tooth abscess. This swelling may also be visible externally if it is very large.
• Inability to open jaw completely.
• Tooth discoloration may be seen.
• The person might even experience low-grade fever at times.
• If the infection is left untreated it could spread to other parts of the head and neck region leading to other conditions like cellulitis infection, Ludwig's angina etc.

Treatment

The treatment for providing pain relief will depend on the cause and stage at which the infection has reached. If the caries has reached the root canal and is causing throbbing pain, then there will be a need to do an emergency root canal opening and root canal treatment so as to release the pressure in the root canal and ease the pain. If there is a swelling with an inability to open the mouth, then the person needs to be given antibiotics and analgesics, so as to bring down the swelling and pain respectively. If there is an emergency condition, like Ludwig's angina or cellulitis, then emergency drainage of the swelling must be done by taking an incision. However, if there is pain after treatment due to a root canal complication, that is, pain after root canal procedure, then he needs to go back to the dentist and get it checked for the possibility of a remaining infection or any other untoward cause of root canal pain.

Thus, pain can arise as a result of various root canal problems. It is important to deal with this pain on a priority basis, rather than waiting for matters to get worse and then blaming the dentist!