Why does facial pain still persist after RCT?

Question

Hello doctor,

For the past two to three weeks, I have had a burning sensation around my eyes and face. I have been diagnosed with irreversible pulpitis or pulp necrosis on my left side, first upper molar. I had a root canal done for the same before 72 hours, but still, my facial pain persists. I have been prescribed Carbamazepine, and later, I was given Panadol and Ibuprofen. Can I know how long this pain should last? I am very anxious. Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern.

The medication prescribed is not a potent analgesic; it is Acetaminophen and Ibuprofen. That is why the pain persists. Secondly, Carbamazepine (Tegretol) is given for trigeminal neuralgia and not for irreversible pulpitis. Would you please confirm with your doctor what treatment you are undergoing and whether it is trigeminal neuralgia instead of irreversible pulpitis?

Because both have different medications, and treatment options are entirely different. I request you to mention any allergies to medicines to confirm your diagnosis and give appropriate treatment suggestions.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

Thank you for the clarification. As per the details given, it is irreversible pulpitis. Treatment requires both RCT (root canal treatment) and medications. Now since the RCT is done, mechanical removal of the infection is done. Now it requires analgesics, and antibiotics are what I will suggest.

Would you please discuss this with your doctor and get his consent?

Treatment plan:

RCT (root canal treatment).
Tablet Amoxicillin 500 mg twice daily for five days (please inform me if you are allergic to this medication).
Tablet Aceclofenac 100 mg once daily for five days.

Thank you.