Patient Care Instructions for Endodontics

See below for care instructions related to specific dental procedures.

It is normal for your tooth to be sore for the first few days after root canal therapy has been completed.  Initially, soft foods are recommended, as the will provide less discomfort during chewing.  The soreness may continue for up to one week.  Your tooth may feel differently the second and third weeks.  By the fourth week, it should feel like your other teeth.

You will be given Ibuprofen to aid post-operative healing and to help manage any discomfort.  It is an anti-inflammatory pain medication that will reduce the inflammation in the area that was treated.  If the Ibuprofen does not alleviate your symptoms, please call the office and let us know.

A very small percentage of the patients (less than 5%) experience post-operative swelling in the area that was treated.  If this happens, please contact our office immediately to speak with the doctor.

For female patients, there may be an interaction between antibiotics and oral contraceptives.  If you are presently taking antibiotics or if our office has prescribed them, please use alternative means of birth control for your entire cycle that month.

If you have any questions or concerns following your treatment, please do not hesitate to call our office.  If your call is after office hours or on the weekend, a doctor's cell phone number will be available.

What should I expect after my root canal?
Your tooth and its surrounding gum tissues may be somewhat tender for several days. This is a result of the infection that brought you into our office as well as the endodontic manipulation during treatment. This is absolutely normal and is part of the healing process. You can expect your tooth to be sore for about 3-5 days. When you touch it, brush it, and chew, it will be tender. Remember: the more your tooth hurt to biting prior to the procedure, the more tender it will be after the procedure. Also, lower teeth that are retreated (with a “black spot” on the x-ray) tend to be the most uncomfortable after treatment.

Every patient is different and there are varying levels of discomfort. Some patients may even have discomfort for longer (i.e. two weeks). As long as it lessens every day, then you are headed in the right direction. Please make sure you continue to brush and floss the area normally.


How should I manage my discomfort?
To minimize your discomfort you were given over-the-counter pain medication, prior to anesthesia [600mg Ibuprofen or 650 mg acetaminophen]. We gave this to you to stay ahead of any discomfort. It is recommended that you continue to take the medication, if you have PAIN or NO PAIN, around the clock every 6 hours for the next 3 days [600mg Ibuprofen or 650 mg acetaminophen]. A good way to remember this is to take a dose, with food, at morning, noon, dinner and bedtime. By taking your post operative medications in this manner, you will keep your discomfort to a minimum. If you allow the pain to return because you skipped a dose, it will be harder to get rid of the discomfort. It’s a good idea to keep your pain medication on your nightstand so that you can take a dose at night. If you sleep longer than 6 hours or skip a dose, be aware that your tooth may be more tender in the morning.

Please see the chart for dosage recommendations, based on level of pain.  Start your pain medications at the Mild Pain level and increase as needed.

Pain Management Medications – Take Every 6 Hours
 Patients who can take NSAIDSPatients who CANNOT take NSAIDS
Mild Pain600 mg Ibuprofen650 mg Acetaminophen
Moderate Pain600 mg Ibuprofen + 650 mg Acetaminophen Hydrocodone (7.5mg/325mg) + 325 mg Acetaminophen
Severe PainFollow the Moderate Pain regimen. We may need to add an antibiotic and possibly a steroid. Please contact our office.


Just so you know:

Advil or Motrin = Ibuprofen.  Do not exceed 3200mg/24 hours.  If NSAIDS cannot be used for pain management, the tooth tends to be more sore after treatment and healing tends to take longer.

Tylenol = Acetaminophen.  Acetaminophen comes in two doses, Regular (325mg) and Extra Strength (500mg).  Do not exceed 3000mg/24 hours. Note: Hydrocodone already contains 325mg Acetaminophen per dose.

Aleve = Naproxen Sodium. We suggest taking Ibuprofen instead of Aleve because you can take Ibuprofen more often. If you prefer Aleve, please check the dosage on the bottle.  

If you were given a prescription pain medication like Hydrocodone, the best way to take this is in conjunction with your over-the-counter medication -- do not stop taking the Ibuprofen or Acetaminophen. For the most effective pain management, alternate between the medications every 3 hours (For example: you would take your over the counter medication at noon, 6 pm, midnight, 6 am; while the Hydrocodone you would take at 3 pm, 9 pm, 3 am, 9 am. Your schedule will vary.)

If your pain is still too severe and you are taking both 600mg Ibuprofen and Hydrocodone or Acetaminophen, please call the office for additional information and possibly a different prescription. At this time, we may prescribe you an antibiotic and/or a steroid.


What if I have swelling after treatment, or if my pain is not going away?
If you experience any swelling after treatment (for example, your face looks asymmetrical when you look in the mirror), or your pain is not responding to the medication, please call the office and we will prescribe you an antibiotic and/or steroid. Do not be alarmed if this happens as it sometimes can occur after treatment. This is most common in patients who have a "black spot" associated with their tooth in the x-ray. If you have been given an antibiotic, it is important that you complete every pill in your bottle, following the recommended dosage. If swelling occurs while on an antibiotic, we may have to switch your antibiotic. If you have been prescribed an antibiotic and are experiencing significant diarrhea, discontinue the antibiotic immediately and call our office. This side effect can happen with any antibiotic, but is more common with Clindamycin. We also suggest taking a probiotic or eating yogurt when taking any antibiotic.


What if my temporary filling falls out?
Your tooth has been restored with a temporary filling. It is a soft filling and needs 30 minutes to harden. It is important that your tooth remain sealed between appointments. It is possible for the filling to sink a little as you chew with it. This is ok, but if you feel that you have lost a significant amount of temporary filling, please call our office during normal business hours and we will schedule a convenient time for you to come in to replenish your temporary filling. If this should occur over the weekend, this does not constitute an emergency -- please call our office the next business day.


What should I do after my root canal is completed?
If endodontic therapy has been initiated on your tooth, it is essential that treatment be completed. If it is not, the tooth will become uncomfortable and may eventually be lost. It is possible that your root canal may take more than one visit if it was too infected or difficult. Once the root canal is done, you will need a final restoration such as a crown, so that the tooth is properly sealed and protected.


What if I need to speak to someone after hours?
If you should need to speak to someone after hours, call the office at 803.648.0056 and leave a message in the emergency mailbox.  For the most timely response, call our office during normal business hours when possible. Please be aware that the after-hours service is available for patients of record only. Also, if you feel like a prescription is necessary, we do ask that you try to call before 10 pm and after 8 am as these are the hours that the pharmacy is open. Have your pharmacy phone number ready and make sure to spell your name, leave your date of birth, and leave a phone number when using the after-hours service.

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