Question 1

How many days of pain after a root canal is normal?

Accepted Answer

Mild to moderate soreness for 2–5 days is normal and is well-controlled by ibuprofen 400–600 mg every 6 hours (or acetaminophen if NSAIDs aren't an option for you). The pain should be trending down each day — not staying the same or getting worse.

Question 2

What are the red flags I should call about?

Accepted Answer

Call the endodontist if you have: pain that is getting worse instead of better after day 3, visible swelling of the gum or face, fever, a bad taste/discharge from the area, severe pain that wakes you at night, or pain on biting that doesn't improve with a high bite adjustment. These suggest residual infection, a high bite, or — rarely — a missed canal.

Question 3

Could my pain mean a canal was missed?

Accepted Answer

It's possible but uncommon when the treatment is done by a specialist endodontist under a microscope. The most common missed canal is the MB2 in upper first molars (present in ~90% of patients). If pain persists beyond two weeks and a CBCT scan shows an untreated canal, retreatment is straightforward.

Question 4

Why does it hurt when I bite down?

Accepted Answer

Almost always because the temporary or permanent filling is slightly high — your tooth is hitting first when you close. A 60-second bite adjustment fixes it. If biting pain persists after a bite adjustment, the tooth's periodontal ligament may still be inflamed (give it 7–10 days) or there may be a hairline crack worth investigating.

Question 5

Do I need antibiotics if my root canal still hurts?

Accepted Answer

Usually no. Pain alone is not an indication for antibiotics — current AAE guidance reserves antibiotics for systemic involvement (fever, swelling spreading, lymph-node involvement). If you have swelling or fever, call the office; if it's just pain, ibuprofen + ice + time is the right call.

My Root Canal Still Hurts 3 Days Later — Is That Normal? · Specialist Endodontist