How do I know if I need a root canal?

There are several symptoms that indicate you may need a root canal. One is increased sensitivity. You may feel discomfort when your tooth comes in contact with heat or cold. Similarly, your tooth might hurt when you bite down or if you apply pressure to it. Swelling and discoloration may indicate an infection, and if your tooth is chipped or damaged, your pulp may have been damaged as well. If you experience any of these symptoms for an extended period of time, you should consult your dentist for a proper diagnosis. If a root canal treatment is necessary, they will help you set up an appointment to have the procedure.

If you have cold sensitivities that leads to pain and does not go away quickly; a "pimple" in the gum next to the tooth; or simply just a large "hole" in the tooth, etc.; all can indicate the need of root canal treatment. The best way to determine the course of treatment is to visit a dentist. The dentist can verify whether the cavity has progressed to the center of the tooth via x-ray and check the tooth in question carefully.

You may or may not be able to know if you need root canal treatment (RCT) because not every case will produce symptoms. It is best to go to your dentist regularly for prevention and early detection so that a more simple procedure can be performed and avoid the need for RCT. The most common  symptom that usually needs RCT is sharp shooting pain that keeps you up at night. Now, wouldn't you want to avoid that!

Root canals are indicated in teeth that are usually infected due to different causes such as large cavities, fractured teeth or in some instances when very little tooth structure is left and in order to rebuild the tooth you have to place a post inside of it, and then restore the tooth. To find out for sure if a tooth needs root canal you need to see a dentist and have exam and x-ray done to find out if this tooth is a good candidate for root canal treatment.

In all honesty, you’ll almost always know that “something” is wrong – in most cases where a root canal may be necessary, the area will hurt. But in the end, your dentist will tell you whether you need a root canal or not. Sometimes, a large filling will handle the issue, and other times, an extraction might be the best course of action. Your dentist will examine you, make his or her best recommendation, and present you with options for treatment, one of which may be a root canal. 

Root canal treatment or endodontic therapy is often the indicated treatment when someone has a toothache. The symptoms are spontaneous pain, lasting sensitivity to cold which is then relieved by heat in the earlier stage of pulpal deterioration and lasting sensitivity to heat which is relieved by cold in later stages of pulpal degeneration. As the pulp ("nerve area") dies an abscess may form which creates pain on biting and touch, tenderness to palpating tissue near the involved tooth and possibly swelling. This is due to the infection at the tip of the tooth.

Obviously it is best to avoid dental emergencies by taking good care of your teeth and scheduling regular dental visits and examinations by your dentist. Often there may be evidence on radiographs (x-rays) of a chronic infection at the tip of the tooth or decay which is either into the pulp or very near it. Both of these conditions are indications for root canal treatment prior to an emergency. DON'T WAIT TILL IT HURTS.

Also, there are situations when a tooth has an extensive large filling and requires a crown. In this case it may be indicated to electively have the endo treatment performed prior to the crown services.

Unfortunately, there are times when you have the symptoms indicating the need for endodontic treatment, but the tooth is so broken down that it is not fixable. In this situation extraction is the only solution to the problem.

Your Dentist needs to find out why your tooth is painful before a root canal is done. Not all sensitive teeth require root canal therapy. A diagnosis is made by testing the tooth- checking to see if the tooth nerve is alive by using a cold spray (this is called a pulp test). A radiograph of the tooth and the bone surrounding the tooth will be taken to see if there is an infection. Your Dentist may tap on the tooth, or have you bite on something to see if it is painful. 

If the nerve on the tooth is not alive, or an abscessed area on the radiograph is found, there is a good chance you will need to have root canal therapy. The goal of this therapy is to remove the dead nerve and treat the infection in the bone. Typically a patient with an abscess will wake up and night with pain- also will have pain for no apparent reason (achy, throbbing).

If the nerve is found to be alive, but extremely painful- reacting in an irregular way to normal stimuli, you may also need root canal therapy. For example, if you have ice cream and the tooth hurts you for 20 minutes, and aches- and you need to reach for Advil- that is abnormal. The diagnosis may be "irreversible pulpitis”, and only root canal therapy will relieve your pain. 

Sometimes there is a fracture in the tooth. Typically the patient cannot bite on the tooth. Many times we cannot find them and an Endodontist needs to look with a microscope. These teeth have the worst outcome if the fracture is in a root. Unfortunately, some need to be extracted. 

In most cases, after a successful root canal therapy, the tooth will require some sort of a full coverage restoration- like a crown or an onlay. Left on its own, without being restored, the tooth is subject to fracture and reinfection. 

 

The most common symptoms are pain to hot and cold liquids. When you bite on the tooth and it elicits discomfort. Sometimes mild sensitivity is a symptom, although it may be from other causes such as recession or hard tooth brushing that removes enamel.

There are instances where there are no symptoms but your dentist sees infection on the x-ray. 

Only a dentist can tell you if you indeed require root canal therapy based on your symptoms and x-rays.