Tooth pain, sensitivity to hot or cold, swelling of the gums — all these are symptoms that may indicate serious problems with the tooth’s root system. Often patients try to relieve pain with painkillers or postpone visiting the dentist, hoping that the discomfort will pass on its own. However, such delaying tactics often lead to complications. Root canal treatment is one of the key stages in combating deep caries, pulpitis, periodontitis, and other inflammatory processes that develop in the deeper structures of the tooth.

At «Oxford Medical» dentistry we use modern endodontic treatment methods, which allow us to preserve even a severely damaged tooth. In this article we will look at when endodontic intervention is necessary, how this procedure is performed, and why a tooth may sometimes hurt even after high-quality canal filling.

When should root canals be treated?

What is root canal treatment?

“Root canal treatment” refers to endodontic therapy — a procedure in which affected or inflamed dental nerves (pulp) are removed, the root canals of the tooth are carefully cleaned, the cavities disinfected, and hermetically sealed. The goal of this procedure is to stop the inflammatory process, prevent its spread to bone tissue, and avoid tooth extraction.

The pulp contains not only nerve endings but also blood vessels, so its inflammation is accompanied by severe pain. If the process is not stopped, it may lead to root inflammation, abscess formation, swelling, or even tooth loss.

Root canal treatment can be performed both in adults and in children, depending on age, condition of the teeth, and the clinical situation. In any case, the decision on the need for intervention is made by an endodontist based on thorough diagnostics.

Main indications for endodontic treatment

Indications for root canal treatment are usually associated with deep damage to the hard and soft tissues of the tooth, infection penetration into the pulp or surrounding structures.

The most common indications for endodontic treatment are:

  • Deep caries. When the carious process reaches the pulp chamber, the pulp becomes infected, leading to inflammation — pulpitis. In such a situation, simple restoration of the crown part of the tooth is insufficient, as the infection has already penetrated the root system. Full endodontic therapy with cleaning and sealing of canals is required.

  • Pulpitis. This is inflammation of the neurovascular bundle of the tooth (pulp), usually accompanied by intense pain that may worsen at night, with thermal or mechanical stimuli. If treatment is not started in time, acute pulpitis may progress to chronic form or complicate into periodontitis.

  • Periodontitis. If the infection spreads beyond the root canal, inflammation of the periodontium — the tissues surrounding the root — develops. This may be accompanied by pain when pressing on the tooth, swelling, pus discharge. This condition indicates inflamed canals and requires immediate endodontic treatment.

  • Tooth trauma. Mechanical damage (blow, crack, chip) can disrupt blood supply to the pulp, leading to its necrosis even without obvious signs of damage. In such cases, canal treatment is necessary to prevent infection.

How is canal cleaning and filling performed?

Root canal treatment is a step-by-step process that usually requires 2–3 visits to the dentist. The number of visits depends on the degree of tooth damage, anatomical features of the canals, the presence of inflammation beyond the root, and the patient’s general condition.

At «Oxford Medical» dentistry, endodontic treatment is carried out in accordance with modern protocols, using high-quality instruments and materials.

Main stages of root canal treatment:

1st visit. Diagnosis, anesthesia, and medication application. The dentist conducts an examination, X-ray diagnostics, determines the diagnosis and scope of intervention. After local anesthesia, access to the root canals is opened, if necessary — the pulp is partially or completely removed. The canals are treated with antiseptic solutions, anti-inflammatory or antiseptic medication is placed into the cavity (in case of acute or chronic inflammation), and a temporary filling is applied. This reduces inflammation and prepares the tooth for the main stage.

2nd visit. Endodontic treatment and canal filling. After evaluating the dynamics (absence of pain, reduction of inflammation), complete cleaning and shaping of the canals is performed using special instruments. The canals are disinfected, dried, and hermetically sealed. Then a temporary filling is placed again until the crown part of the tooth is fully restored.

3rd visit. Final restoration of the tooth. After completion of the endodontic stage, the dentist restores the crown part of the tooth. If tissue loss is small, a permanent filling is placed. In cases of significant tooth destruction or extensive treatment, an orthopedic construction — for example, a crown — is indicated, ensuring long-term protection and restoration of chewing function.

This step-by-step approach minimizes complication risks, ensures quality cleaning and sealing of canals, and allows tooth restoration considering all anatomical and functional features.

Why may a tooth hurt after canal filling?

Patients sometimes complain: the tooth hurts after canal filling. Mild pain or discomfort after endodontic treatment is a common occurrence, which in most cases is a normal post-procedural reaction of the body. These symptoms arise due to intervention in deep tooth tissues and manipulations in the root canals, which may cause microtrauma of surrounding tissues.

Normal manifestations include:

  • moderate pain or sensitivity when biting for 2–5 days after treatment;

  • a feeling of pressure or discomfort in the treated tooth area;

  • minor reaction to touch or chewing, which gradually decreases.

These symptoms usually resolve on their own and do not require additional intervention.

Repeat endodontic treatment

In some cases, after canal treatment, pain, swelling, or discomfort persist. This is no longer normal, but a sign of complications requiring repeat endodontic treatment. Its goal is to correct deficiencies of the primary intervention or eliminate new pathological processes.

Possible causes: missed or inadequately cleaned canals, poor or incomplete filling, violation of restoration sealing, root crack, as well as complex anatomy — for example, a sclerosed canal that could not be fully treated during previous therapy.

Repeat intervention involves removal of the old filling material, thorough canal re-treatment, disinfection, and new filling. In complex cases, this may be the only way to save the tooth.

Dental health is not only about aesthetics but also comfort, proper nutrition, and overall quality of life. When pain, sensitivity, or other symptoms appear, it is important not to delay. Endodontic treatment is an effective way to preserve even a severely affected tooth, prevent complications, and restore confidence and peace of mind.

Frequently Asked Questions

When is root canal treatment needed?

Root canal treatment is required in cases of deep caries, pulpitis, periodontitis, trauma, or complications after previous treatment. If severe pain, swelling, temperature sensitivity, or tooth discoloration occurs — you should immediately see a dentist.

Why does a tooth hurt after canal cleaning?

After canal treatment, moderate pain or sensitivity when biting is a normal reaction to intervention. It disappears in a few days. If the pain increases, lasts more than a week, or is accompanied by swelling — you should see a dentist for reevaluation.

Can root inflammation be prevented?

Yes, inflammation can be prevented with regular check-ups, timely treatment of caries, and proper oral hygiene. It is also important not to ignore tooth pain and not to postpone a dentist visit at the first signs of discomfort.