After Your Root Canal: Recovery, and Why the Crown Comes Next

Root canal treatment removes the infected or inflamed pulp inside a tooth and seals the canals, but the appointment is only half the story. How the tooth is looked after in the following days, and how it is rebuilt afterwards, have a great deal to do with how long it lasts. This guide is for patients from Los Altos Hills and nearby who have just had a root canal, or have one scheduled, and want to know what recovery involves.

The first evening

You will leave with the tooth still numb, and it can take a few hours for sensation to return. Until it does, avoid eating on that side and be careful with hot drinks, since it is easy to bite a cheek or scald your mouth without noticing. You will be alert throughout; a root canal is done with local anaesthetic, so you can drive yourself home and many people return to work the same day.

The first few days

Mild tenderness is normal once the numbness fades. The tissues around the root tip have been through inflammation or infection, and they need a little time to settle. The tooth may feel bruised when you bite, or slightly different from its neighbours. This usually responds well to over-the-counter pain relief and eases steadily over a few days.

Some things are not part of normal recovery. Call us if you notice:

• Pain that is getting worse rather than better after the first couple of days.
• New or increasing swelling, inside the mouth or on the face.
• A bite that feels high, so the treated tooth hits first when you close.
• A temporary filling that falls out or feels broken.
• Any sign of a reaction to a medication you were given.

Protecting the tooth before it is rebuilt

After treatment, the access opening in the tooth is usually closed with a temporary or permanent filling. Until the final restoration is in place, the tooth is at its most vulnerable. Treat it gently:

• Chew on the other side where you can.
• Avoid hard foods such as nuts, ice and crusty bread on that tooth.
• Skip very sticky foods that could pull at a temporary filling.
• Keep brushing and flossing normally, gently around the tooth.

A well-treated tooth that cracks before it has been properly protected can be difficult, or impossible, to save, which is why these weeks matter.

Why back teeth usually need a crown

A tooth that needed a root canal has often already lost structure to decay, old fillings or a fracture, and the treatment itself requires an opening through the top. Over time these teeth can become more brittle. Molars and premolars take heavy chewing forces, and without coverage their cusps can split. A crown wraps the tooth and holds it together, which is why most treated back teeth are crowned. Front teeth, which bear less load, sometimes need only a permanent filling.

For some premolars with thick remaining walls, a partial crown called an onlay can be enough. Our article on crowns versus onlays explains how we decide.

How soon should the crown go on?

Once the tooth has settled and is comfortable to bite on, there is little reason to delay. Waiting weeks or months with only a temporary filling leaves the tooth exposed to fracture and to bacteria leaking back in. We generally aim to restore the tooth promptly after treatment.

In many cases the crown can be designed, milled and fitted in a single appointment in the studio, so you are not left managing a temporary crown. Our same-day crowns guide describes the process. Occasionally, for a highly visible tooth, a laboratory crown gives a better match, and our note on when a lab crown is the better choice covers those cases.

Looking after it for the long term

With a good final restoration and routine care at home, teeth treated with a root canal often function for decades. Endodontic research consistently puts success rates in the 90 to 95 percent range. To give your tooth the best chance:

• Floss around the crown daily. A treated tooth has no nerve to warn you of new decay, and decay at the crown margin is a common reason for later problems.
• Keep your regular check-ups. X-rays let us confirm the bone around the root has healed and stays healthy.
• Protect against grinding. If you clench or grind at night, a night guard takes pressure off crowned teeth.
• Do not ignore changes. New tenderness, a bump on the gum or swelling near a treated tooth should be checked.

A few common questions

Will the tooth feel the same as before?

It will not feel hot and cold the way it used to, because the nerve has been removed, but you will still feel pressure through the surrounding tissues. Most people forget which tooth was treated once the crown is on.

Is it normal for the tooth to feel slightly different when I bite for a while?

Mild awareness for a short time is common. Persistent or worsening soreness is not, and we would like to see you.

Will insurance cover the crown as well?

Most PPO plans cover part of both the root canal and the crown. We are in-network with all major PPO plans and give you a written estimate in advance.

We are here for the follow-through

If you are recovering from a root canal and want the tooth properly protected, or you have questions about how it is healing, we are glad to help. From Los Altos Hills, the Mountain View studio is reached along Foothill Expressway and San Antonio Road. Read more on our endodontics page, or call (650) 917-8348.