Looking after a root-treated tooth: the first days, weeks and years

Root canal treatment seals the inside of the tooth; the years it gives you depend on what happens next. Most of it is straightforward, but a few things make a real difference.

The first 24 hours

• Avoid eating until the anaesthetic has worn off, to avoid biting your cheek or tongue.
• Expect the tooth and the gum around it to feel bruised. Paracetamol and, if you can take it, ibuprofen — as directed on the packet — are usually enough. Taking the first dose before the anaesthetic wears off helps.
• Chew on the other side. The tooth may be tender to bite on for a few days.
• Carry on brushing and flossing normally, taking care around the treated tooth.

The first week

Tenderness on biting should ease day by day. A slightly "different" feeling when you bite is normal and settles as the ligament around the root calms down. If a temporary filling has been placed, treat it gently: it is meant to last a few weeks, not to withstand toffee or hard crusts.

When to contact us

• pain that increases after the first two or three days instead of settling;
• swelling of the gum, cheek or lip;
• the temporary filling falling out or breaking;
• a high bite — the tooth hits first when you close — that does not ease within a few days;
• any reaction to medication.

None of these is common, and all are manageable, but they are worth a phone call.

The restoration: the most important step

A root-treated tooth is sealed from below but is weaker than it was and is often hollow inside. Back teeth in particular need a crown or onlay to hold them together; without one, they are prone to cracking, and a crack that reaches the root cannot be repaired. Front teeth can sometimes be restored with a filling. Your own dentist places the final restoration — ideally within a few weeks of treatment — following the recommendation in our report. Delaying it is the single most common reason a good root canal treatment is lost.

The review

Healing of the bone around the root happens over months and is checked on an X-ray at a review visit, typically six to twelve months later. The tooth will not feel any different; the X-ray simply confirms that the infection has resolved.

The years ahead

• Keep up normal brushing, flossing and check-ups; a root-treated tooth can still decay around the edges of its crown.
• If you grind your teeth, a night guard protects the crown and the tooth beneath it.
• Avoid using the tooth to crack nuts, ice or boiled sweets.
• If the tooth becomes tender or a swelling appears, even years later, have it assessed: retreatment is often possible.

What a root-treated tooth should feel like

After the first couple of weeks, like any other tooth. It will not respond to hot and cold, because the nerve has gone, but it bites, chews and looks normal. With a good restoration and ordinary care, there is no reason it should not last as long as its neighbours.