After Completion of Endodontic Treatment FAQ

Teeth need some type of restorative procedure after a root canal is completed. For back teeth, this is usually a crown. A crown covers and protects the tooth to prevent it from fracturing. This is a procedure that is done by your general dentist and is not a part of endodontic therapy. In some cases, you may already have a crown on your tooth prior to the root canal treatment. In these cases, we will cut a small hole to gain access to the roots without removing the crown. When the root canal is completed, we may be able to place a filling in the access hole so that you do not have to make a special trip back to your dentist. Some general dentists prefer that we not place the final restoration. Because they are responsible for the longevity of your dental restorations, your dentist may prefer to place the filling with a material they are familiar with. When your treatment is complete, we will instruct you on any further after care procedures that are necessary. We will send a report to your dentist informing him/her of the treatment we provided and our recommendation for any follow up procedures to be done at their facility. Your dentist’s office may contact you to schedule this, but it is your responsibility to schedule such appointments. If you are not clear on what you need to do, please ask us. Please be sure to have the restoration of your tooth started within about a month of completing the root canal. Included in your treatment is a follow-up examination to evaluate the progress of healing. This appointment will require only a few minutes and no additional fee will be charged for the first check-up visit.

Because there is usually an underlying inflammatory condition or chronic infection when you need a root canal, it is normal for there to be some discomfort afterwards. Usually this is noticed while chewing or the area may feel “bruised”. Expect that the tooth will be tender to biting for several days after your treatment, and it may feel “different” for several months after the procedure. For most cases, the discomfort is managed with over the counter anti-inflammatory medications such as ibuprofen, Advil, or Aleve. We usually recommend that you take one of these medications before your anesthetic wears off. Tylenol is not an anti-inflammatory, but is recommended if you cannot tolerate or have been advised by your physician to avoid taking the anti-inflammatory medications. In some cases we may prescribe stronger medications. For management of moderate to severe pain, see our pain control strategies guide (link to our pain control strategies guide PDF). Occasionally, a “flare-up” can occur several days after your root canal therapy. These can sometimes occur in teeth that were not causing any pain prior to the treatment, but suddenly become symptomatic two or three days later. This can sometimes be accompanied by swelling of the gum or face. If this occurs, please call our office. We will evaluate your circumstance and recommend how to best manage the condition.

In most cases, antibiotics are not required after endodontic therapy. You will be given a prescription for antibiotics if we feel it is necessary. Your dentist may have placed you on an antibiotic prior to your appointment. We will let you know if you should continue this. Some medical conditions, such hip joint replacements, require special doses of antibiotics an hour before treatment to reduce the risk of infection of the joint. If you have been told by your physician to pre-medicate with an antibiotic for dental treatment, make sure to fill your antibiotic prescription before your appointment date and take the antibiotic as it is prescribed. This special pre-medication dose is still needed even if you have been taking a daily regime of antibiotics for several days already. If you have any questions about this, please call our office.

In most cases, you should consider this appointment no more involved than a routine dental filling. Unless we prescribe anti-anxiety medications to take during the appointment, or you have been taking narcotic pain medications, then you should be able to drive yourself to and from the appointment. If you felt well enough to work prior to your appointment, then you should feel well enough to return to work afterwards.

If we placed a temporary filling, avoid drinking hot beverages or chewing on the tooth for several hours until it has had time to harden up. To avoid cracking the tooth, it is best to avoid heavy chewing until you get the permanent crown placed. Temporary restorations cannot be expected to last for more than 30 days. Failure to return to your dentist for final restoration could result in recontamination or fracture of the tooth, which could result in loss of the tooth. Please make sure you understand what type of restoration was placed in your tooth at the time of root canal treatment, and whether you need to contact your dentist for further restoration.

Root canal therapy removes the nerves within the pulp of the tooth, the nerves that are a part of the tissue that formed the tooth. There are still millions of nerve fibers in the ligament that lines the socket of the tooth. The inflammation that began in the pulp of the tooth is a chemical cascade that spreads outside the tooth through the natural openings at the ends of the roots where the blood vessels enter. This inflammation is similar to a sunburn, where touch becomes painful instead of just the sensation of touch. As with a sunburn, time will heal the inflammation and the tooth will return to feeling normal.