You just had a root canal. The procedure went well, the infection has been treated, and you’re relieved it’s over. But now the anesthesia is wearing off, and you’re feeling some discomfort.
Is this normal? When should you be concerned?
Here’s what to expect during the days and weeks after root canal treatment—and the warning signs that mean you should call your endodontist.
What’s Normal After a Root Canal
Some degree of discomfort after a root canal is completely normal. Even though the infected nerve tissue has been removed, the tissues surrounding the tooth—the ligament, bone, and gums—need time to heal. The general pattern: discomfort peaks within the first 1–2 days, then steadily improves. Each day should feel a little better than the last.
The first 24–48 hours
This is when you’ll feel the most discomfort. Typical symptoms include:
- Mild to moderate soreness in the treated tooth and surrounding area
- Tenderness when biting on the tooth
- Slight swelling of the gum tissue around the tooth
- Jaw stiffness from having your mouth open during the procedure
This is your body’s normal inflammatory response to treatment. The tissues around the root tip were likely inflamed or infected before treatment, and they need time to settle down.
Days 3–7
Most patients notice significant improvement by day 3. The soreness decreases gradually, and biting sensitivity fades. By the end of the first week, many patients feel close to normal.
Weeks 2–4
Any lingering sensitivity should resolve during this period. The tooth may occasionally feel slightly different from your other teeth, but active discomfort should be gone.
Managing Post-Treatment Discomfort
Over-the-counter pain relief
For most patients, OTC medication is sufficient:
- Ibuprofen (Advil, Motrin): 400–600 mg every 6–8 hours. This is the most effective option because it reduces both pain and inflammation. Take it with food.
- Acetaminophen (Tylenol): 500–1000 mg every 6–8 hours. Good alternative if you can’t take ibuprofen.
- Combination approach: Taking ibuprofen and acetaminophen together (alternating every 3–4 hours) is more effective than either alone. This combination has been shown to be as effective as prescription painkillers for dental pain.
Start pain medication before the anesthesia wears off. Taking ibuprofen immediately after your appointment—while you’re still numb—helps prevent the discomfort from building.
Other helpful measures
- Eat on the opposite side for the first few days
- Avoid hard, crunchy, or sticky foods near the treated tooth
- Don’t chew on the tooth until your permanent crown is placed
- Keep your head slightly elevated when sleeping the first night
- Apply a cold compress to the outside of your cheek (20 minutes on, 20 minutes off) if you have swelling
- Maintain gentle oral hygiene — continue brushing and flossing, but be gentle around the treated area
What about prescription painkillers?
Most root canal patients don’t need them. Studies show that the ibuprofen-acetaminophen combination works as well as opioid painkillers for post-root-canal discomfort, without the side effects or addiction risk.
If you had a particularly complex procedure or had a severe infection before treatment, your endodontist may prescribe something stronger. Take medications only as directed.
When Pain Is NOT Normal
While some discomfort is expected, certain symptoms suggest something may need attention. Contact your endodontist if you experience any of the warning signs below.
Severe or increasing pain after day 2
Normal post-treatment discomfort should be improving by day 2–3. If pain is getting worse instead of better, or if it’s severe enough that OTC medication doesn’t help, something else may be going on.
Significant swelling
Mild gum swelling near the treated tooth is normal. But swelling that:
- Extends to your face, cheek, or under your eye
- Is visibly noticeable from the outside
- Continues to grow after the first 48 hours
- Is accompanied by fever
This could indicate an infection that needs additional treatment or antibiotics.
Fever
A temperature over 101 degrees F (38.3 degrees C) after a root canal is not typical and may indicate spreading infection. Contact your endodontist promptly.
Your bite feels “high”
If the treated tooth hits before your other teeth when you bite down, the temporary filling may need adjustment. This is a simple fix—your endodontist can adjust it in minutes—but if left alone, the constant pressure on the tooth will cause persistent pain.
The temporary filling falls out
The temporary filling placed after your root canal protects the inside of the tooth until your permanent crown is placed. If it comes out or cracks, bacteria can re-enter the canal. Call your endodontist for a replacement.
Pain that returns after initially improving
If your tooth felt fine for a week or two and then starts hurting again, this warrants evaluation. It could indicate a new issue or a complication with the initial treatment.
Allergic reaction
Rarely, patients may react to materials used during treatment. Signs include a rash, itching, or hives. Contact your endodontist or seek medical attention.
How Long Should Recovery Take?
| Timeframe | What to Expect |
|---|---|
| Day 1 | Moderate soreness, tenderness when biting. Manageable with OTC medication. |
| Days 2–3 | Discomfort begins improving. Still tender when chewing on the tooth. |
| Days 4–7 | Significant improvement. Mild soreness may remain. |
| Weeks 2–4 | Most patients feel completely normal. Occasional mild sensitivity possible. |
| After crown placement | Tooth should feel and function like a normal tooth. |
Important: This timeline applies to uncomplicated cases. If you had a severe infection, abscess, or particularly complex treatment, recovery may take longer. Your endodontist will let you know what to expect based on your specific situation.
Factors That Affect Recovery
Some patients recover faster than others. Factors that can extend recovery include:
- Pre-existing infection. If you had a significant infection or abscess before treatment, the surrounding tissues need more time to heal. You may also be on antibiotics.
- Complexity of the procedure. Teeth with curved canals, calcifications, or multiple canals may require more extensive treatment, which can mean more post-operative soreness.
- Previous inflammation. If you had pain for weeks or months before treatment, the chronic inflammation in the area may take longer to resolve.
- Clenching or grinding. If you clench or grind your teeth (bruxism), the additional force on the treated tooth can slow healing and increase discomfort. Consider a night guard if this is a concern.
The Crown: Don’t Skip It
After your root canal, your general dentist will place a permanent crown to protect the tooth. This step is critical.
A root-canal-treated tooth without a crown is vulnerable to fracture. The tooth becomes more brittle over time, and normal chewing forces can crack it—potentially causing a vertical fracture that makes the tooth unsaveable.
Get your crown within 2–4 weeks of your root canal. Don’t delay this step. A broken tooth after a successful root canal is one of the most frustrating outcomes in dentistry—and it’s preventable.
When to Call Us
At Phan Endodontic Partners, we’re available to our patients during recovery. Contact us if:
- Pain is severe or worsening after 48 hours
- You develop facial swelling or fever
- Your bite feels off
- The temporary filling breaks or falls out
- You have any concerns about your recovery
We’d always rather hear from you and confirm that everything is fine than have you suffer in silence wondering if something is wrong.
Call (310) 378-8342 — same-day emergency appointments are available.