Why is “Acute Apical Sensitivity” normal in the first week after root canal treatment in vital teeth?

In teeth that have undergone root canal treatment while still alive, due to deep decay or fracture and no infection, a sharp pain or sensitivity (post-operative pain) in the first few days after the procedure, especially when putting pressure on the tooth or chewing, is a completely normal physiological response clinically. During the procedure, the dentist detaches the vascular and nerve bundle inside the root canal from the root tip. At this detachment site, that is, in the periodontal space where the tooth joins the jawbone, a microscopic wound surface and inflammation (edema) develops. When weight is placed on the tooth, this edematous tissue is compressed and sends a pain signal to the brain. In this process, which is a kind of surgical wound healing, the edema spontaneously decreases and completely disappears within 3-7 days with the use of mild analgesics (anti-inflammatory drugs) recommended by the dentist.

Updated date June 10, 2026

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