My tooth after a root canal hurts when I chew or press on it

tooth pain after a root canal
A tooth that hurts after a root canal is so common and should not be a cause for concern. In fact, what triggers the pain is not the tooth itself, but the tissues around it. They might be injured during the procedure, which caused slight inflammation.

This is why you may feel pain, especially when biting or putting pressure on the tooth. By doing so, you are putting stress on the underlying healing tissue.

Although the pain is frequently temporary and reversible, it is not always the case.

Unbearable, long-lasting pain that does not subside with OTC pain medications indicates something wrong. In this case, the first thing to do is to consult your dentist or endodontist to assess the situation.

You will learn in this article the different sorts of pain after root canal treatment, when you should be worried, and the measures to take.

Slight, mild tooth pain aggravated by pressure

After a root canal, mild to moderate pain is more likely to occur in the next few days, even if the treatment was done well. It may be ongoing or triggered only by chewing or pressure. In any case, it should be bearable and manageable with over-the-counter pain medication.

This type of pain refers to the onset of inflammation, an essential step in starting the healing process.

For this reason, it should not concern you as it is temporary and reversible. Usually, it does not exceed two weeks.

According to one study, the frequency and intensity of pain after a root canal gradually decreased from 40% (24 hours after the procedure) to 11% (1 week after).

Therefore, you need to be a little patient to give your tissues time to heal.

On the other hand, if the tooth is in a higher position, it will receive more pressure from chewing forces, causing overload and persistent pain.

If you think your tooth is overfilled, ask your dentist to reduce the height of the filling so that the pressure from chewing is evenly distributed.

How to relieve the temporary pain at home?

  • Avoid hard foods and eat softer, more liquid foods for the first week or two.
  • Try over-the-counter pain medications such as ibuprofen or paracetamol.
  • Brush and floss your teeth, being gentle with the root canal tooth.
  • Rinse your mouth with salt water, which is known to be decongestant and soothing.
  • Apply clove oil to the painful area. Cloves contain eugenol, which has anti-inflammatory, analgesic, and antibacterial properties. This means they can relieve your pain, reduce inflammation and prevent bacteria from growing.

Severe, unbearable pain a few hours or days after root canal treatment

After a root canal, severe and intense pain is abnormal. Unlike the previous one, this pain is unbearable and does not subside with painkillers. It usually appears a few hours or days after the procedure and can be associated with redness and swelling near the treated tooth area.

The pain is aggravated when you chew, and you may feel that your tooth is longer and tries to get out of its place (due to the intense inflammatory reaction).

It usually occurs if your dentist has severely damaged the tissue around the tooth or pushed bacteria past the root tip. This will trigger an acute inflammation that will cause spontaneous pain aggravated by pressure.

If you are experiencing the same symptoms, make an appointment as soon as possible with your dentist or endodontist, as this is considered a complication (also known as a flare-up) and has nothing to do with healing. Repeating the root canal treatment and draining the accumulated pus will give you relief.

Fortunately, this complication is less common. According to one study, its incidence is about 3.17%.

Other factors that can lead to severe pain include:

  • Missed canal: Sometimes, an extra root canal could go unnoticed by your dentist. In that case, the same pain will persist even after the treatment. In the next visit, your dentist may suggest a 3D dental x-ray which provides an accurate view of the tooth and the surrounding tissues.

  • Tooth fracture: A tooth with a root canal is more likely to crack as it is more fragile and emptied of its internal contents. If a fracture has occurred, the fracture line can irritate your gums, causing sharp pain when you chew. In advanced cases, bacteria can get in and cause an infection, with a complication of an abscess.

  • Filling flows past the root tip: If the filling material extends beyond the root canal, pain may occur as soon as the numbing effect wears off. In rare cases, an allergic reaction may occur (zinc oxide-eugenol-based dental materials), resulting in pain and swelling of the gums, lips, or cheeks.

Long-lasting (chronic) pain after root canal treatment

Chronic pain is when it persists for an abnormally long time, several weeks, or even months. It can occur even if the recovery has gone well, making things more frustrating.

This type of pain is more complex because it can involve the tooth itself or other nearby structures (sinuses, muscles, joints, or nerves).

When the tooth is involved, a dental X-ray can show what's hidden inside the root canal. This could be a deep cavity, fracture, infection or gum disease.

However, the pain may not be related to the tooth but to the surrounding tissues. It could be sinusitis, joint and muscle pain, or nerve damage. These conditions can be chronic and cause pain to spread, simulating a toothache.

Chronic pain requires a thorough examination to identify the real cause and avoid unnecessary treatments.

Here you will find a more in-depth article on pain months after a root canal.
In summary, it is not uncommon to experience pain after a root canal procedure. It can be spontaneous or triggered only by chewing or pressure. This is due to inflammation of the surrounding tissue, which may result from injury during the procedure.
Although the pain is often temporary and reversible, it is important to pay attention to its intensity and duration. If the pain persists and does not respond to over-the-counter pain relievers, don't hesitate to talk to your dentist to assess the situation.

  1. Pain prevalence and severity before, during, and after root canal treatment: a systematic review, doi: 10.1016/j.joen.2010.12.016./
  2. Endodontic interappointment flare-ups: a prospective study of incidence and related factors, DOI: 10.1016/S0099-2399(06)81413-5
  3. Clinical and pharmacological management of endodontic flare-up, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3467928/
  4. Allergic Reactions to Dental Materials-A Systematic Review, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4625353/