Differential Diagnosis for Pain with Chewing after a Root Canal
- Single most likely diagnosis
- Post-operative flare-up or incomplete healing: This is a common issue after a root canal, where the tooth may take longer to heal, or the procedure may have caused inflammation that has not fully resolved, leading to pain during chewing.
- Other Likely diagnoses
- Cracked tooth syndrome: The tooth that underwent the root canal may have a crack that is causing pain when chewing, especially if the crack has propagated since the procedure.
- High occlusion or bite issue: The tooth may be hitting too hard against the opposing tooth, causing pain and discomfort during chewing.
- Sinusitis: If the root canal was performed on an upper tooth, especially a molar, the pain could be referred from the sinuses, which are located close to the roots of these teeth.
- Do Not Miss diagnoses
- Abscess or infection: Although less likely if the root canal was successful, an abscess or infection could develop, especially if the tooth was not properly cleaned and filled, or if there was a complication during the procedure.
- Osteonecrosis of the jaw: This is a rare but serious condition that could be triggered by the root canal procedure, especially if the patient has a history of bisphosphonate use.
- Rare diagnoses
- Neuropathic pain: In some cases, the root canal procedure could cause nerve damage, leading to neuropathic pain that may be felt during chewing.
- Eruption of a neighboring tooth: If a neighboring tooth is erupting or has recently erupted, it could be putting pressure on the tooth that had the root canal, causing pain during chewing.
- Temporomandibular joint disorder (TMJ): Although less directly related to the root canal, TMJ disorders can cause pain during chewing and may need to be considered in the differential diagnosis.