Why Your Tooth Still Hurts After a Root Canal (And When to Worry)

Root canal treatment has a reputation for pain—but the reality is that modern root canals are meant to relieve pain, not cause it. So when a patient still feels discomfort days or even weeks after treatment, it can be confusing and concerning.

As an endodontist, this is one of the most common questions I hear:

“Is it normal that my tooth still hurts after a root canal?”

The short answer: sometimes yes—but sometimes no.

Here’s how to tell the difference.

WHAT NORMAL PAIN AFTER A ROOT CANAL FEELS LIKE

Some level of post-treatment discomfort is expected. A root canal is a medical procedure that involves cleaning and shaping the inside of a tooth, and the surrounding tissues need time to calm down.

Normal symptoms may include:

• Mild to moderate soreness when biting

• Tenderness in the jaw or gum near the treated tooth

• Sensitivity that gradually improves over a few days

This type of discomfort usually peaks within the first 48–72 hours and steadily improves over the next week.

WHY PAIN CAN PERSIST AFTER A ROOT CANAL

Inflammation Around the Tooth

Even after the infection inside the tooth is removed, the tissues around the root may remain inflamed—especially if the infection was present for a long time before treatment.

The Tooth Is Taking Too Much Bite Pressure

If the treated tooth hits first when you chew, it can feel sore or bruised. A simple bite adjustment often resolves this immediately.

Cracks or Fractures in the Tooth

Some teeth have small cracks that don’t appear on X-rays but can cause persistent pain, especially when chewing.

Complex Anatomy or Extra Canals

Some teeth have extra canals or unusual anatomy that may require additional treatment if symptoms persist.

A True Root Canal Failure (Less Common)

In rare cases, pain may indicate reinfection, leakage from a delayed crown, or the need for retreatment.

WHEN PAIN IS NOT NORMAL

You should contact your dentist or endodontist if you experience:

• Severe or worsening pain

• Swelling of the gums or face

• Pain lasting more than a week

• Pain returning months or years later

WHY SEEING AN ENDODONTIST MATTERS

Endodontists have specialized training, advanced imaging, and tools designed to diagnose and treat complex cases—often saving teeth that might otherwise be lost.

BOTTOM LINE

Pain after a root canal doesn’t automatically mean something went wrong—but it does mean your symptoms deserve attention. Most post-treatment pain can be successfully treated once the cause is identified.