Root Canal Anguish: Delving into the Causes of Treatment Pain

Embarking on the journey to achieve optimal oral health often involves navigating the complexities of various dental procedures. In this blog post, we will delve into the reasons behind the discomfort that may accompany Root Canal Treatment (RCT), a routine dental procedure. 

Gaining insights into these factors and discovering effective strategies for managing discomfort is essential for a smoother and more comfortable recovery experience.

“Doctor I am afraid, RCT procedure is very painful.” This is the most common phrase patients tell their dentists. A lot of time people fear RCT procedure due to the pain associated with it. I have met a good number of people who had pretty painful root canals and whereas some have experienced the other way round. Is the procedure actually painful? Or does it depend upon your treating dentist?

Well, there are a number of factors associated with this. To understand this we first have to understand why / when a RCT is recommended by any dentist. Our tooth is made up of three major components, Outermost layer – Enamel, Second layer – Dentin, Innermost layer – Pulp. Pulp is the part where nerves and blood supply to the tooth is present, and hence this is the part that can feel sensations like pain, hot and cold. Unless the cavity has reached up to pulpal tissues, you will not feel any kind of pain. 

When does the tooth start to hurt?

In case of fast spreading cavities, pulp tissue gets infected and inflamed very fast and starts to hurt. Depending upon your oral hygiene, eating habits, nutritional status and body threshold, your pain levels will vary. Pain can vary from mild to severe and at times may increase while sleeping. Sometimes it feels like pulsating and throbbing pain. 

This happens because the tooth is still vital, it has its blood and nerve supply intact and it’s fighting the infection from spreading. Root Canal Treatment procedure at this point will cause pain because of the severe inflammation of pulpal tissue. It’s important to remember that presence or absence of pain during a procedure doesn’t dictate its success. Though it may be painful, the outcome of RCT performed at the earliest is always the best. Such teeth have a very high success rate. 

On the contrary, in case of slow spreading cavities, there is very slow spreading infection and very mild inflammation. It may range from a period of a few months to a few years.  Due to this the pulpal tissue in such cases gradually necroses and doesn’t cause any alarming pain. Now here comes the interesting part, in these cases the patient is usually painless when he/she visits their dentist. The reason for dental visits is mostly a large hole inside the tooth and food getting stuck in there. Sounds familiar?  In these types of cases pain may be due to spread of infection from the cavity to the root end of the tooth causing abscess, facial swelling, sinus opening etc. RCT performed in such cases are painless because pulpal tissue is long dead and necrosed. But, due to chronic spread of bacteria and pathogens the treatment outcome is not very successful. 

Go through our self assessment guide to  check if you have fast or slow spreading cavities :- 

	Fast Spreading Cavity (Acute Pulpitis)	Slow Spreading Cavity (Chronic Pulpitis)
1.	Small or No hole visible on tooth	Large size hole usually
2.	Negligible food lodgement	Continuous food lodgement in tooth
3.	Pain on eating sweet, hot and cold	No effect of hot/cold
4.	Sudden and intense pain	Gradual / intermittent or No pain
5.	Sharp,severe and throbbing pain	Dull, aching and less intense
6.	Pain increases while sleeping or lying down	Not affected by sleep / posture
7.	Short term effect of pain medications	Usually subsides after pain medications
8.	Discomfort started from a few days	Discomfort from few months
9.	Immediate Root Canal Treatment required	Depending upon spread of infection – Root Canal, Extraction, surgical intervention might be required
10.	High success rate with prompt care	Requires long term management

How to manage post operative discomfort?

Some amount of pain after the procedure is expected. This is known as post operative pain. 

1. Make sure to take medications as prescribed. Usually medication includes analgesics, anti-inflammatory medications, antibiotics and depending upon other factors antacids and some other drugs may be advised.
2. Avoid chewing from the affected side for at least 5-7 days. 
3. Applying a cold compress to the affected area can help reduce swelling and numb the sensation of pain.
4. Pain should gradually subside,if it arises or discomfort increases, contact your dentist for follow up.
5. Get a crown on your tooth 2 weeks after root canal treatment to ensure proper function.x

Root canal treatment is integral for preserving natural teeth, and understanding potential discomfort is vital for a smoother recovery. Remember, open communication with your dentist is crucial for a comfortable and successful recovery.