Aftercare after root canal treatment: the first days and the first year

Root canal treatment ends when the canals are sealed, but the tooth's recovery does not. What you do in the following days — and the following weeks — has a real bearing on how long the tooth lasts. Here is what to expect and what to do.

The first few hours

You will be numb for two to four hours. Avoid eating on that side until the feeling has fully returned, so that you do not bite your cheek or tongue, and be careful with hot drinks for the same reason. The tooth will have a temporary or permanent filling in the opening; do not chew anything hard on it.

Tenderness is normal

The tooth and the gum around it will feel bruised for two or three days, sometimes a little longer, and biting on it will be uncomfortable. This is inflammation in the ligament around the root settling down, not a sign that anything has gone wrong. Ordinary painkillers from the pharmacy, taken regularly for the first day or two rather than waiting for the pain to peak, usually manage it comfortably; your pharmacist can advise on what suits you.

What is not normal

Pain that gets worse rather than better after the third day, a swelling that appears or grows, a high temperature, or a temporary filling that falls out should all prompt a call. None of these is common, and all of them are more easily dealt with early. A swelling that spreads quickly, or difficulty swallowing or breathing, needs medical attention through NHS 111 or A&E straight away.

Eating and cleaning

Eat on the other side for a few days and avoid very hard or sticky foods on the treated tooth until it has been permanently restored. Brush and floss as normal — the tooth is not fragile to cleaning, and the gum around it will settle faster if it is kept clean.

The crown, and why it cannot wait too long

A root-treated back tooth should be protected with a crown or onlay, ideally within a few weeks. The tooth has lost its blood supply and some of its internal structure, which makes it more brittle; a molar left with only a filling may crack under chewing forces, and a crack that reaches the root cannot be repaired. Your own dentist fits the restoration, and the report sent to them after treatment says what is recommended. Some front teeth can be restored with a filling alone.

The review

Where there was infection in the bone around the root, healing is checked on an X-ray some months after treatment, and sometimes again at a year. Bone takes time to regrow, so the picture improves gradually. If you had no symptoms before treatment and none afterwards, the review may simply be part of your dentist's routine X-rays.

How long will the tooth last?

A tooth that has been well treated, promptly crowned and kept clean can last for decades, often for the rest of your life. The things that shorten that life are delay in fitting the crown, new decay at the edge of the restoration and unprotected teeth cracking. All three are avoidable — which is why the aftercare matters as much as the treatment. See also why root canal treatments fail.