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

A tooth that hurts right 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. These might be injured during the procedure, resulting in mild inflammation.

You might feel pain when chewing or biting down because this puts pressure on the healing tissue underneath.

However, some types of pain are abnormal and usually mean something isn’t right, especially if the pain is long-lasting, persistent, or intensely throbbing.

These symptoms may indicate an infection and should be addressed as soon as possible.

We will break down the different types of pain after root canal treatment, explain when you should be concerned, and guide you on what actions to take.

Mild tooth pain that worsens when chewing or biting down

After a root canal, mild to moderate pain is totally expected in the next few days, even if the treatment was successful. The underlying bone and ligaments are still inflamed and tender, so it’s normal for pain to increase when you bite down.

In any case, it should stay mild and be manageable with over-the-counter pain medication.

This type of pain isn’t a cause for concern. It’s temporary and usually fades gradually. In most cases, it doesn’t last more than two weeks.

So right after the procedure, the best thing you can do is be patient and give your tissues time to heal.

However, if the tooth feels slightly higher than the others—possibly due to a high filling—it may receive extra pressure when you bite, leading to more intense pain.

If you think this is your case, ask your dentist to adjust the filling. Reducing the height will help relieve stress and ease the pain.

How can I relieve post-operative pain?

• Avoid hard or crunchy foods and stick to a softer diet for the first week.
• Take any pain medication exactly as your dentist prescribed.
• Brush and floss your teeth gently.
• Rinse your mouth with salt water several times a day, which is known to reduce inflammation.
• 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

Unlike the mild, temporary discomfort that’s expected after a root canal, severe and intense pain is not normal. If the pain is unbearable and doesn’t respond to over-the-counter medication, it’s very likely a sign of infection.

This type of pain often starts within a few hours or days after the procedure and may be accompanied by redness, swelling, or warmth in the area around the treated tooth.

The pain typically gets worse when chewing, and you may feel like the tooth is being pushed out of its socket—this sensation is due to intense inflammation and pressure beneath the tooth.

This can occur if bacteria were pushed beyond the tip of the root or if surrounding tissues were severely irritated during treatment.

This complication is known as an endodontic flare-up. It requires immediate treatment, not only because it’s extremely painful, but also because the infection can spread if left untreated.

Treatment involves repeating the root canal procedure to clean out the infected area, draining any pus, and in some cases, prescribing antibiotics to clear the infection.

Fortunately, this complication is less common, occurring in about 3.17% of cases.

Other issues 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 that has undergone a root canal is more likely to crack because it becomes more fragile and brittle. If a fracture occurs, the crack can irritate the surrounding gum tissue, causing sharp pain when chewing. In more advanced cases, bacteria can enter through the fracture and lead to an infection, potentially resulting in 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. Rarely, an allergic reaction may occur (especially to 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 refers to discomfort that lasts unusually long—several weeks or even months. It can still occur even if the healing process went well, which can make the situation more frustrating.

This type of pain may come from the treated tooth itself if something went wrong with the root canal. But in many cases, other nearby structures—such as the gums, sinuses, jaw muscles, joints, or nerves—can actually be the source of the pain.

When the tooth is the origin of the pain, a dental X-ray can reveal hidden issues, like a deep cavity, fracture, lingering infection, or failed root canal.

However, the pain might not be tooth-related at all. Conditions such as sinus infections, joint or muscle disorders, or nerve damage can cause pain that spreads to the tooth area, seeming like a toothache.

Chronic pain needs a thorough examination to identify the true cause and avoid unnecessary treatments.

👉 You can read a more detailed article here about pain that lasts months after a root canal.

Takeaway

It's not uncommon to experience some pain after a root canal procedure. It may feel worse when you bite down, but this discomfort should remain mild and temporary.

This usually reflects ongoing inflammation in the surrounding tissues—an essential part of your body’s healing process.

However, pain is not normal if it’s persistent, too severe, or doesn’t respond to over-the-counter painkillers. If that’s your case, don’t delay seeing your dentist. It could be a sign of a postoperative complication.