Root canal pain sometimes persists after excellent treatment. It persists for the same reason that amputees have pain after surgery. The pain is described as a phantom pain after leg surgery. Unfortunately, some people have a genetic predisposition to this phenomenon. Below you can see the treatment steps for root canal therapy. Yet the pain persists. Some patients simply have irregular healing. The pain cannot be reversed with another procedure. Additional procedures worsen the pain.
Part of what happens is that a portion of the nerve that branches from a connecting branch becomes amputated, just as the nerves in a leg are amputated by surgery. The part of the nerve outside of the tooth becomes modified and fires off pain signals to the brainstem without provocation. This now becomes a non-dental pain source and can be treated primarily with medication.
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