Chronic Post Root Canal Pain Happens and What Can Be Done?

Series on Reviews puts post root canal chronic pains >6 months anywhere from 5% to over 7%.  Cases have been treated with Botulinum.

J Endod. 2010 Feb;36(2):224-30.
Frequency of persistent tooth pain after root canal therapy: a systematic review
and meta-analysis.
Nixdorf DR, Moana-Filho EJ, Law AS, McGuire LA, Hodges JS, John MT.  free article here

Conclusions— “Frequency of all-cause persistent tooth pain following endodontic procedures was estimated to be 5.3%, with higher report quality studies suggesting >7%.”

Causes listed  include:

 

  • an untreated or incompletely obturated canal,
  • failed coronal seal,
  • tooth fracture,
  • pain associated with an adjacent tooth,
  • referred pain from a nonodontogenic structure,
  • deafferentation pain.

 

Comments – do patients know they are going to end up  potentially with chronic pain? – this is another case  similar to the post hernia surgery cases that don’t realize the could end up in pain after surgery.

At the Montreal Pain Congress I came across the suggestion that botox injected into the base of the tooth could help the pain  – a study needs to be done on that..

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