Some patients say it hurts during irrigation, or pain starts suddenly. Is this because the anaesthetic has worn off? I do not use an irrigation needle.

This is generally associated with extrusion of the solution. In this situation, the solution in the canal should be withdrawn using negative pressure and the contents diluted with physiological saline. If the pain persists, anaesthesia can be administered. Inflammation can be reduced by placing ice wrapped in gauze between the patient’s cheek and the tooth. The tooth can be taken out of occlusal contact. If severe extrusion is suspected, an antibiotic may be prescribed. An anti-inflammatory medication may be prescribed.