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Q. I got root canal treatment for irreversible pulpitis, but i still have pain. Why?

Answered by
Dr. Bharat Joshi
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Dec 31, 2021

Hello doctor,

For the past 2 to 3 weeks, I have had a burning sensation around my eyes and face. I have been diagnosed with irreversible pulpitis or pulp necrosis on my left side, first upper molar. I had a root canal done for the same before 72 hours, but still, my facial pain persists. I have been prescribed Carbamazepine, and later, I was given Panadol and Ibuprofen. Can I know how long this pain should last? I am very anxious. Please help.

Thank you.

#

Hello,

Welcome to icliniq.com.

I can understand your concern. The medication prescribed is not a potent analgesic that is Panadol (Acetaminophen) and Ibuprofen. That is why the pain persists. Secondly, Carbamazepine (Tegretol) is given for trigeminal neuralgia and not for irreversible pulpitis. Would you please confirm with your doctor what treatment you are undergoing and whether it is trigeminal neuraglia instead of irreversible pulpitis? Because both have different medications, and treatment options are entirely different. I request you to mention any allergies to medicines to confirm your diagnosis and give appropriate treatment suggestions.

Thank you.

Hi doctor,

My GP thought it was trigeminal neuralgia; I believe this was a misdiagnosis. The issue is the referred pain I am feeling (burning sensation) has persisted three days after a root canal. The endodontist said the pulp was irreversibly inflamed during the root canal, with prolonged response to liquid nitrogen testing. I am scared that this burning sensation and pain along the top of my head will not go away. How long does this referred pain last? Please help.

Thank you.

#

Hello,

Welcome back to icliniq.com.

Thank you for the clarification. As per the details given, it is irreversible pulpitis. Treatment requires both RCT (root canal treatment) and medications. Now since the RCT is done, mechanical removal of the infection is done. Now it requires analgesics, and antibiotics are what I will suggest. Would you please discuss this with your doctor and take his consent?

Thank you.


Probable diagnosis:

Irreversible pulpitis (chief complaint)

Treatment plan:

RCT.
Tablet Amoxicillin 500 mg twice a day for five days (in case you have an allergy to this medication, do report me) and
Tablet Aceclofenac 100 mg for five days.

Preventive measures:

Warm saline rinses every six hours a day for five days.

Regarding follow up:

Please go by instructions and then update me if the problem still persists.


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