Root Canal Therapy Side Effects: What No One Tells You

A Short Brief on Root Canal Treatment

Root canal treatment, also called RCT, is a dental procedure to clear a tooth infection. It relieves immense pain caused by an infected tooth. Certain harmful oral bacteria cause cavities and enter inside the tooth structure. They infect the tooth pulp and multiply, causing the pulp to swell and leading to throbbing pain deep inside the tooth. 

Dentists perform a step-by-step root canal procedure to remove the infected pulp and sterilize the infected root canals. They then fill them with dental filling and seal off the hole so that bacteria cannot further enter the tooth and cause re-infection. Root canal therapy is indeed one of the most commonly performed treatments with a high success rate. However, any successful medical treatment comes with potential side effects and minimal risks, and RCT is no exception.

What Are the Side Effects of Root Canal Treatment?

Getting root canal therapy is indeed associated with temporary and long-term side effects. Knowing the problems after a root canal in advance can help you prepare for potential discomfort, manage recovery, and prevent complications. Below, we discuss them in detail.

Less Severe Root Canal Therapy Side Effects

The common less severe root canal therapy side effects are temporary and subside gradually as you recover. 

• Most patients experience mild discomfort, pain, and sensitivity, especially when pressure is applied to the treated area. This can be due to the body’s natural inflammatory response, and painkillers should gradually ease these symptoms. However, a lingering pain, even weeks after the root canal procedure, should not be ignored. It can be an indication of tooth infection spread to the bone or missed root canals, causing continued infection. 
• It's common to experience sore jaws and difficulty opening the mouth after root canal treatment. This soreness can be injection-related or due to muscle tension and should subside within a few days. However, persistent pain and swelling associated with fever cannot be ignored.
• Tooth sensitivity to temperature is common for a few days. It can be due to localized inflammation or nerve sensitivity caused by pulp cleaning. Avoiding hot or cold foods during the early days after root canal treatment should ease this. You should feel better in a few days; if not, see your dentist immediately.

Long-Term Side Effects of Root Canal Treatment

Knowing root canal long-term side effects will help you recognize the potential complications early on. Besides, you can weigh the worth of root canal therapy with other alternative procedures, helping you make an informed decision. 

Tooth Discoloration

In some patients, the root canal-treated teeth may become discolored with time. Root canal therapy removes the decayed pulp, which generally contains nerves, connective tissue, and blood vessels. These components do not directly impart white color to the tooth. However, they constitute the living portion within the tooth structure and are essential for overall health and tooth color. Removing the pulp cuts off the blood supply to the interior portion of the tooth, leading to discoloration. However, this concern is largely aesthetic and can be dealt with the use of crowns or veneers. 

Sinus Congestion

Although rare, sinus congestion caused by root canal treatment can occur when the sinuses are too close to the root canals of the upper jaw. It also occurs when a dentist accidentally punctures the sinus membrane during the RCT procedure. This is often felt as temporary pressure in the sinuses, nasal congestion, runny nose, with a bad taste. The perforated sinus is also called sinus communication, and the symptoms should subside gradually. However, it cannot be ignored when the symptoms persist. Seeing your dentist or ENT specialist will help. 

Tooth Cracking 

Root canal treatment removes the entire live tissue within the infected tooth, leaving it brittle and more prone to cracks. The leftover dead tooth structure lacks nourishment provided by the pulp and blood vessels during the healthy stage. It is now susceptible to cracks and fractures even with the slightest bite force. Dentists reinforce strength by covering the RCT tooth with a crown.  

Root Canal Re-infection 

The cleaned and sterilized root canals are sealed with filling material to prevent oral bacteria from re-entering the tooth structure. However, in rare cases, dentists miss cleaning the hidden or curved canals, where bacteria still hide inside them. In some other cases, the filling material leaks, or a crown loosens, allowing bacteria to re-enter the RCT-treated tooth. This causes an onset of infection, which can be even more painful. 

Nerve Damage

Nerve damage following a root canal can be caused by excessive drilling or irritation of dental materials. This is typically manifested as irritation, prolonged sensitivity, and altered sensation. This cannot be ignored and needs expert attention. Dentists surgically intervene to deal with the symptoms associated with nerve damage after root canal therapy.^[1]  

Allergic Reaction 

Although a root canal treatment does not directly cause an allergic reaction, some candidates may be allergic to the materials used. Dentists use sealant materials like gutta-percha, sealer paste, and resin-based sealers to fill the drilled cavities. These sealants cover the cavity so the bacteria cannot re-enter the canals, revoking infection. However, some candidates may show allergic reactions to the chemical components of these materials. A few others may be allergic to the sodium hypochlorite solution used in the irrigants. This manifests as swollen facial and oral parts and requires immediate medical attention.^[2][3]

Effects of Root Canal on Systemic Health

While root canal treatment largely deals with the tooth, it does have a positive impact on overall health. Dental cavities are contagious, and the causative bacteria inside the tooth structure can spread to the other teeth. In some cases, cavity-causing bacteria spread to brain and heart. While this can be a direct spread, it can also happen through the bloodstream. The adverse effects of tooth infection are severe in immuno-compromised candidates. Persistent inflammation of the infected tooth releases harmful substances. These elicit inflammation in the immediate areas and also the overall immune system.^[4]  

Root canal treatment clears infection-causing bacteria. The dentist cleans the root canals, disinfects them, and seals them so that bacteria do not re-enter. Getting a root canal not only clears the infection but it also reduces the chances of infection spreading to other body parts, cutting the chances of systemic infection.   

How To Avoid Root Canal?

It’s wise to prevent complications rather than find effective ways for dealing with the side effects of failed root canal. Minimize root canal failure risk and side effects with these essential steps.

• Talk to your dentist during the consultation and attend a comprehensive dental examination. Know the side effects and risks specific to your case. Remember to notify your dentist about your previous history of allergies.
• Choose a qualified and well-experienced professional for your root canal treatment. Perform meticulous research and rely on patient reviews and root canal before and after the patient journey to know the clinic's commitment. 
• Adhere to strict oral hygiene for healthy teeth. This will reduce infection spread and lower the severity of the issue.

Key Measures To Follow Root Canal Before and After for Effective Outcomes

Following the right measures before and after root canal treatment can reduce discomfort and speed up your recovery. A planned and well-prepared approach will smoothen your treatment journey, assuring better results. It indeed reduces your incidence of long term effects of root canal.  

What To Do Before Root Canal Treatment?

Adopt the following steps before root canal treatment:

• Convey your complete medical history, and inform your dentist about the ongoing medications. This will prevent complications and avoid drug interactions.
• Avoid tobacco and alcohol a day before your appointment for root canal treatment.  Alcohol and nicotine leave traces in the blood for a certain period. This either leads to adverse reactions with anesthesia or delays the blood clotting process. 
• The day before root canal therapy, stay hydrated, finish your meal, and get an adequate night's sleep. This will aid in effective healing and speed up the recovery process.   

Here are a couple of questions that most patients ask before root canal treatment.

How Long Can You Wait for Root Canal Treatment?

You should not wait too long for root canal treatment. It’s recommended that you see your dentist upon noticing the signs of tooth infection. Consult your dentist when you see symptoms of throbbing pain, sensitivity, dental abscess, or tooth discoloration. The growing infection can spread to other teeth and other body parts. Neglecting treatment or postponing your dental appointments can only worsen the infection. 

Can a Root Canal Cause Nerve Damage?

Yes, a root canal can cause nerve damage, either due to over-drilling, overfilling, or chemical neurotoxicity of dental materials. Don’t ignore the symptoms of persistent numbness, burning or tingling sensation, or altered taste following root canal treatment. Any of these symptoms can be signs of damaged nerves. Note that the permanent nerve damage is quite rare. Your dentist will diagnose the underlying cause and take prompt action depending on the severity. Dentists perform apicectomy or nerve decompression to clear the neurological issues arising post-root canal treatment.^[5]  

What To Do After Root Canal Treatment?

Recovering after a root canal can be simple and does not need special care. Your dentist will brief you on effective aftercare tips. Follow these effective steps during your root canal recovery time. 

• Follow appropriate oral hygiene by brushing your teeth two times a day and flossing them regularly. This will prevent food particles from trapping between the teeth, causing infection, and you won’t end up saying a root canal ruined my life. 
• Do not apply direct pressure to the treated area, especially while brushing or biting food. Hard pressure will evoke pain and inflammation. Instead, gargle salt water to clean the area and prevent infection.
• For the initial few days, use prescribed antibiotics and painkillers. Apply a cold compress on cheek to reduce swelling, manage pain and discomfort, and prevent the infection from spreading. 
• Eat soft foods and avoid sticky, hard, and crunchy foods. Chew on the opposite side of the jaw so you don’t disturb the treated area. Avoid too hot or cold foods, as the treated area is still sensitive. Allow the gums to heal until you resume back to normal diet.
• Don’t miss your follow-up appointments. Your dentist will examine the healing process and can identify complications early on. They will also discuss the options for dental crowns if necessary. You can choose between porcelain or zirconia or look for cheaper crown options. 

How Long Do You Have To Wait Between Root Canal Treatments?

Root canal treatment is generally performed in 2-3 visits, separated by one-week intervals. While multiple teeth can be treated at the same time, dentists prefer to treat a single tooth at a time to reduce the potential discomfort. During the first visit, dentists drill a cavity in the enamel to access the tooth pulp. They remove the decayed portion and debris. Further, they clean the root canals and seal them temporarily so bacteria do not re-enter inside. After one week, the dentist cleans the tooth and places a permanent covering like a dental filling or crown to seal the cavity.  

How Long Does Pain Last After Root Canal Treatment?

Mild to moderate pain is common after root canal treatment and lasts for 2-3 days. This post-treatment pain is manageable and quite different from the throbbing pain caused by tooth infection. Pain after root canal therapy subsides gradually, and over-the-counter painkillers can be helpful. See your dentist if the pain persists for a longer duration, typically a week or two. Prolonged and severe pain can be a sign of re-infection, uncleaned root canals, or a cracked tooth. 

What Happens When You Don’t Get a Root Canal Done?

Root canal therapy removes the decayed tooth pulp, blood vessels, and debris to clear the tooth infection. Untreated root canal side effects indeed have severe consequences. Using painkillers reduces pain and discomfort but does not stop the growing infection. The bacterial spread continues to other oral and facial tissues. In some cases, the bacteria enters the bloodstream, making their way to the brain and heart, and can even cause death. 

How Often Does Root Canal Therapy Fail?

Generally speaking, root canal therapy is a highly effective procedure with an 81-93% success rate.^[6] The procedure relieves the infection, offering long-term outcomes when performed correctly. In rare cases, root canal treatment fails and would require a re-root canal treatment. Inadequate cleaning, complex root canals, delayed crown placement, and poor oral hygiene are the common causes of failure. Dentists perform a re-treatment, apicectomy, or tooth extraction followed by a dental implant to treat a root canal re-treated tooth.

Is Re-Root Canal Treatment Safe?

Root canal re-treatment is generally safe and offers successful results when done by experienced professionals using advanced technology. Modern technology ensures effective root canal cleaning and disinfection. Re-root canal treatment, indeed, is an opportunity to clear the infection while preserving the natural tooth. The dentist will initially identify the underlying cause of root canal infection, whether it's inefficient cleaning or complex, hidden, or curved root canals. Root canal re-treatment, in rare cases, can cause tooth damage. However, approaching skilled dental professionals can reduce its incidence.

References 

1. Damage To The Inferior Alveolar Nerve As The Result Of Root Canal Therapy
2. Allergy To Sodium Hypochlorite During Root Canal Therapy: A Case Report
3. Allergic Reactions to Dental Materials-A Systematic Review
4. Root Canal Infection and Its Impact on the Oral Cavity Microenvironment in the Context of Immune System Disorders in Selected Diseases: A Narrative Review
5. Treatment Of Injuries To The Inferior Alveolar Nerve After Endodontic Procedures
6. Long-Term Tooth Survival And Success Following Primary Root Canal Treatment: A 5- To 37-Year Retrospective Observation