A root canal is the name of the dental procedure that cleans out the decay in your tooth’s pulp and root.
Your teeth have an enamel layer on the outside, a second layer of dentin, and a soft inside core that extends into the root in your jawbone. The core contains the dental pulp, which consists of nerves, blood vessels, and connective tissue.
When decay gets into the soft core, the pulp can become inflamed or infected, or even necrotic (dead). A root canal is needed to clean out the decay.
So, how do you know if you need a root canal? Are there telltale signs? Keep reading to learn more about the symptoms that may indicate you need a root canal.
A root canal procedure is like a tiny Roto-Rooter, cleaning out decay and preserving the infected tooth.
During a root canal procedure, your dentist will:
- extract bacteria and decay from the tooth pulp, root, and nerve
- disinfect the area with antibiotics
- fill the empty roots
- seal the area to prevent new decay
A root canal can be done by your general dentist or a specialist known as an endodontist.
The root canal treatment leaves your natural tooth in place and prevents further decay. But it makes the tooth more fragile. That’s why a tooth that’s had a root canal is often covered with a crown.
- According to the American Association of Endodontists (AAE), more than 15 million root canals are performed each year in the United States.
- More than 41,000 root canals are performed each day, according to the AAE.
- Root canal procedures are commonly thought to be the most painful kind of dental treatment, but studies found that only 17 percent of people who’ve had a root canal described it as their “most painful dental experience.”
- A 2016 study found that root canal symptoms varied depending on the type of bacteria in the infection.
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The only way to know for sure if you need a root canal is by paying a visit to your dentist. But there are several warning signs to be on the lookout for.
If you notice any of these symptoms, it’s important to see your dentist as soon as possible. The sooner your tooth can be treated, the better the outcome will likely be.
1. Persistent pain
Persistent tooth pain is one of the signs that you may need a root canal. The pain in your tooth might bother you all the time, or it might go away from time to time but always return.
You may feel the pain deep in the bone of your tooth. Or you may feel referred pain in your face, jaw, or in your other teeth.
Tooth pain may have other causes besides root canal. Some other possibilities include:
- gum disease
- a cavity
- referred pain from a sinus infection or another problem
- a damaged filling
- an impacted tooth that may be infected
No matter what the cause, it’s a good idea to see your dentist if you have tooth pain, especially if the pain is persistent. Early diagnosis and treatment for tooth pain typically leads to a better outcome.
2. Sensitivity to heat and cold
Does your tooth hurt when you eat warm food or when you drink a cup of coffee? Or perhaps your tooth feels sensitive when you eat ice cream or drink an icy-cold glass of water.
The sensitivity could feel like a dull ache or a sharp pain. You may need a root canal if this pain lingers for an extended period of time, even when you stop eating or drinking.
If your tooth hurts when you eat or drink something hot or cold, it may be an indication that the blood vessels and nerves in your tooth are infected or damaged.
3. Tooth discoloration
An infection in the pulp of your tooth can cause your tooth to become discolored.
Trauma to the tooth or the breakdown of the internal tissue can damage the roots and give the tooth a grayish-black appearance.
According to Kenneth Rothschild, DDS, FAGD, PLLC, who has 40 years of experience as a general dentist, this discoloration is easier to see in a front (anterior) tooth.
“Tooth pulps can die when there’s an inadequate blood supply, thus signaling a possible need for a root canal,” Rothschild explained.
Although tooth discoloration can have other causes, it’s always a good idea to see your dentist if you notice that a tooth is changing color.
4. Swollen gums
Swollen gums near the painful tooth can be a sign of an issue that requires a root canal. The swelling may come and go. It may be tender when you touch it, or it may not be painful to the touch.
“Swelling is caused by acidic waste products of dead pulp tissues, which may lead to swelling (edema) outside the root tip area,” explained Rothschild.
You may also have a little pimple on your gum. This is called a gum boil, parulis, or abscess.
The pimple may ooze pus from the infection in the tooth. This can give you an unpleasant taste in your mouth and make your breath smell bad.
5. Pain when you eat or touch the tooth
If your tooth is sensitive when you touch it or when you eat, it could indicate severe tooth decay or nerve damage, which may need to be treated with a root canal. This is especially the case if the sensitivity persists over time and doesn’t go away when you stop eating.
“The ligament around the root tip of an infected tooth may become hypersensitive from the pulp dying. The waste products from the dying pulp may irritate the ligament, causing pain from biting pressure,” said Rothschild.
6. A chipped or cracked tooth
If you’ve chipped or cracked your tooth in an accident, in a contact sport, or by chewing on something hard, bacteria can set in and lead to inflammation and infection.
Even if you injure a tooth, but it doesn’t chip or crack, the injury may still damage the nerves of the tooth. The nerve can become inflamed and cause pain and sensitivity, which may require root canal treatment.
7. Tooth mobility
When your tooth is infected, it may feel looser.
“This can be caused by other factors besides pulpal necrosis (nerve death), but it can be a sign that a root canal is necessary,” said Rothschild. “Acidic waste products from nerve death can soften the bone around the root of a dying tooth, causing mobility.”
If more than one tooth feels loose, the mobility is likely to have a cause other than an issue that may need a root canal.
A root canal procedure sounds scary, but with today’s technology, it’s typically not a whole lot more different than having a deep filling. There’s little to no pain because your dentist will use local anesthesia to numb your tooth and gums so you’re comfortable during the procedure.
If you need a root canal and have facial swelling or a fever, your dentist may give you antibiotics beforehand to kill the infection. This may also help reduce your pain.
The root canal procedure itself is similar to getting a large filling, but it’ll take longer. Your mouth will be numbed while the dentist cleans out the decay, disinfects the roots, and then fills them in.
Your dentist will use a rubber dam around the root canal tooth. This will help prevent any infected material from spreading to the rest of your mouth.
Your mouth may feel sore or tender after the root canal. Your dentist may suggest that you take an over-the-counter pain medication such as acetaminophen (Tylenol) or ibuprofen (Advil).
A 2011 review of 72 studies of root canal patients looked at pre-treatment, treatment, and post-treatment pain.
The analysis found that pre-treatment pain was high, but dropped moderately within a day of treatment, and then dropped substantially to minimal levels within a week.
To prevent a root canal, it’s important to follow the same dental hygiene habits that help prevent cavities and other tooth problems. To keep your teeth healthy, try to get into the habit of following these steps:
- Brush your teeth at least twice a day.
- Floss between your teeth at least once a day.
- Use fluoride toothpaste or a fluoride rinse.
- See your dentist for checkups every 6 months.
- Have your teeth professionally cleaned by your dentist at least once a year.
- Try to limit the amount of sugary food and refined carbohydrates you eat. These foods have a tendency to stick to your teeth. If you eat sugary foods, try to rinse your mouth or brush your teeth shortly afterward.
Yes, it’s possible to have pain in a tooth that’s had a prior root canal.
Some causes of this pain may be due to:
- your root canal not healing properly
- your root canal not being completely disinfected because of complicated root anatomy
- new decay can infect the root canal filling material, causing a new infection
- a tooth injury that allows new decay to enter the tooth
According to the AAE, re-treatment — meaning another root canal — is the best option to treat the pain and any other symptoms.
Other questions about a root canal
(Video) Root canal #shorts
Other questions about a root canal
Do you always need a crown if you have a root canal? Will a root canal be done by your dentist or an endodontist? We posed these questions to Rothschild.
Q&A: Advice from a dentist
Question: Do you usually need a crown on a tooth that has a root canal?
Rothschild: No, I do not believe a crown is always necessary after a root canal. It often is the restoration of choice for posterior teeth such as molars and bicuspids, as opposed to a filling. This is because of the greater structural demands for chewing function with molars and bicuspids. Teeth treated with root canals are structurally weaker after a root canal.
Anterior (front) teeth may often be restored with a composite filling instead of a crown after a root canal, if the tooth’s structure is largely intact and it is deemed aesthetically acceptable.
Question: What determines whether your general dentist or an endodontist treats your root canal?
Rothschild: That depends largely upon the general practitioner’s comfort level with performing root canals.
Many general practitioners prefer not to perform endodontics. Others will treat anterior teeth only, which generally are much easier than molars and even bicuspids.
Kenneth Rothschild, DDS, FAGD, PLLC, has 40 years of experience as a general dentist and is a member of the Academy of General Dentistry and Seattle Study Club. He’s been awarded a fellowship in the academy, and he’s completed mini residences in prosthodontics and orthodontics.
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(Video) When Do You Need a Root Canal?🦷 #shorts #rootcanalspecialist #teeth
An infection inside your tooth’s pulp and root can cause discomfort and pain. If you have persistent tooth pain or other symptoms, see your dentist as soon as possible to get a diagnosis and treatment.
Although the term “root canal” seems to provoke fear in many people, the dental procedure doesn’t involve any special pain. Almost all people feel better shortly after treatment.
FAQs
Root Canal Symptoms: 6 Ways to Tell If You Need a Root Canal? ›
In short, when you need a root canal, it may feel like throbbing pain due to infection inside of the root of your tooth. A visible fistula, swelling, or temperature sensitivity might be present. Bacteria can also lead to foul-tasting drainage along the gum tissue near your root.
What symptoms indicate a root canal is needed? ›- One Of The Signs You Need A Root Canal Is Persistent Pain. ...
- Chipped Or Cracked Tooth. ...
- Sensitivity To Heat or Cold. ...
- Gum Area Is Swollen. ...
- Dark Discoloration Of The Tooth. ...
- Prolonged Sensitivity. ...
- Deep Decay. ...
- Don't Panic, Get It Taken Care Of Today!
In short, when you need a root canal, it may feel like throbbing pain due to infection inside of the root of your tooth. A visible fistula, swelling, or temperature sensitivity might be present. Bacteria can also lead to foul-tasting drainage along the gum tissue near your root.
What kind of tooth pain indicates root canal? ›Symptoms That Indicate You May Need Root Canal Therapy
You may need a root canal if you experience: Pain when chewing, biting, or otherwise applying pressure to the tooth. Pain after encountering extreme temperatures, as with ice or hot coffee; the pain continues after the cause is removed.
Root canal therapy may be needed if you have a decayed tooth that has reached the pulp and caused an infection. This option is chosen for severe cases when dental fillings are no longer a viable option. Persistent or severe tooth pain may be a sign you need a root canal.
Why would a dentist say I might need a root canal? ›Why Do I Need Tooth Canal Therapy? A tooth canal treatment is necessary when the pulp inside the root canal of a tooth becomes inflamed or infected. That could be the result of deep tooth decay, a crack or chip, or an injury to your tooth. If left untreated, pulp inflammation can cause pain or lead to an abscess.
Does the pain from needing a root canal come and go? ›The pain can range from a dull ache to a sharper shooting pain. It can be constant or come and go but pain almost always accompanies the need for a root canal treatment.
What does tooth nerve pain feel like? ›Tooth nerve pain can feel severe like a sharp, stabbing pain or as little as a dull ache. If your tooth nerve is exposed, particular foods and drinks will probably trigger the pain. Pain in an exposed tooth nerve can be triggered by foods and drinks that are hot or cold, sugary, acidic, or sour.
How much does a root canal cost? ›The most common procedures and typical amounts charged by dentists are: Root Canal – Front Tooth (approximately $620 - $1,100 Out-of-Network) Root Canal – Premolar (approximately $720- $1,300 Out-of-Network) Root Canal – Molar (approximately $890 - $1,500 Out-of-Network)
Does a tooth with a root canal still have sensation? ›Even though the pulp tissue is gone following a root canal, the tooth still retains some sensation. It just isn't the same sensation as before. “It still has a nerve sensation coming from the structures that are supporting it into the jaw bone,” Richards said.
Can an xray determine if you need a root canal? ›
X-ray results, fistulous tracts, tooth discoloration, and nerve exposure are the main indicators that a root canal is necessary. Dentists may also use testing methods to determine the need for a corresponding treatment.
What happens when a root canal starts hurting? ›A root canal causes mild pain for a few days. The discomfort is temporary and is manageable with over-the-counter pain relievers and practicing proper oral hygiene. However, if the discomfort lasts over three days, you must see your dentist for advice.
How do I know if my toothache is a cavity or root canal? ›When you need dental fillings, you may have a throbbing pain in your tooth, especially when you chew. When you need a root canal, the pain can be much more severe, and that pain may worsen when your tooth is exposed to hot or cold temperatures.
What is a shooting pain in a tooth that comes and goes? ›A Sharp, Shooting Pain in Tooth
Usually, sharp, shooting pain in a tooth indicates a cavity. At this stage of tooth decay, the cavity has most likely made its way down to the tooth root (pulp chamber). The tooth's root is filled with blood vessels and nerves that keep the tooth alive.
If the infection has seeped into the tooth's pulp, then root canal therapy becomes unavoidable. On the contrary, fillings can be used instead of a root canal if the tooth has a smaller cavity or a minor decay, which has not yet reached the pulp.
Can I just get a filling instead of a root canal? ›Sometimes, a root canal might not be necessary and a patient will only require a filling. Fillings will be recommended if the tooth has a smaller cavity or minor tooth decay that hasn't reached the pulp of the tooth.
Why does my dentist say I need root canal but no pain? ›You might still need a root canal even if you do not feel any pain because not all infection results in pain. The purpose of a root canal is to handle any infection that has developed in your tooth pulp, not just stop you from feeling pain. A root canal can save your infected tooth from having to be extracted.
What are the alternatives to a root canal? ›Dental treatment alternatives to a root canal include direct pulp capping, pulpotomy, pulpectomy, endodontic retreatment, endodontic surgery, tooth extraction, dental implants, bridges, or dentures.
How do I make sure I don't need a root canal? ›- Brushing and Flossing. Brushing and flossing are the two most straightforward ways to prevent issues that can lead to a root canal. ...
- Avoid Sticky or Hard Foods. ...
- Wear a Mouthguard. ...
- Watch What You Drink. ...
- Get Regular Checkups.
On average, a tooth can last between 10 to 15 years after undergoing a root canal treatment. However, the lifespan can increase significantly if the dentist includes a dental crown along with the treatment.
What to do while waiting for root canal? ›
- Discuss a Pain Treatment Plan With Your Dentist or Endodontist.
- Avoid Cold and Hot Beverages and Food.
- Say No To Sugar and Acid.
- Try Over-the-Counter Pain Relief.
- Oil of Cloves (Eugenol) Might Help.
- Brush and Floss.
If you have recently had your root canal at Smillie Dental, a little bit of pain and discomfort is normal as you heal. Usually, this will be quite minor. Your tooth may feel sore and tender, and you should be able to mitigate the pain with over-the-counter medication like acetaminophen or naproxen.
How do you know if your tooth nerve is inflamed? ›If you notice a tingling sensation in one of your teeth or sharp pain when eating something hot or cold that goes beyond regular tooth sensitivity, you may be dealing with pulpitis. Pulpitis occurs when the inner pulp portion of the tooth, which is made up of blood vessels and nerves, becomes inflamed.
What aggravates tooth nerve pain? ›Avoid too hot or cold beverages like coffees, teas, sodas, ice cream, or water. Avoid too hot food. Avoid sugary items such as soda, cookies, and candy. Avoid acidic items such as lemon juice, tomatoes, and apple cider vinegar.
How do you calm down nerve pain in your teeth? ›Take an over-the-counter pain reliever – Acetaminophen, ibuprofen, and other pain relievers can ease the pain. Use a cold compress – An ice pack or cold damp cloth can numb the area and can be especially helpful if you are experiencing swelling. Swish salt water or peroxide – These rinses can relieve inflammation.
How much is a root canal in the US without insurance? ›Average Root Canal Costs
The average cost of a root canal in the United States is between $600 and $1,600 without insurance. The cost is going to be based on which tooth needs the procedure and where it is located in your mouth.
In general, tooth extractions are cheaper than root canals, and they can be performed by general dentists as well as endodontists. Many people choose extraction instead of root canals simply because of the cost. However, getting a dental implant to replace your natural tooth can cost a lot of money.
How much is a crown without insurance? ›The average cost of a crown without insurance will range from $1,093 to $1,430. With insurance, the average out-of-pocket cost will range from $282 to $1,875. Many dentists offer payment plans, so you don't have to pay the full cost of dental crowns up front.
Why do root canals take 2 visits? ›The root canal procedure is completed in two separate visits to ensure that the tooth is thoroughly cleaned out, sealed up, and protected from further damage.
What is Ghost pain after root canal? ›Phantom tooth pain most often comes about after dental surgery. Whether it's a root canal, extraction, or filling, phantom tooth pain is the result of a damaged or dysfunctioning nerve that sends signs to the brain saying that there is pain in a tooth that may no longer be there.
Do I need a crown after a root canal? ›
Because a tooth that needs a root canal usually has a large filling or is weakened from extensive decay, a crown or other restoration usually needs to be placed on it. A crown can help protect the tooth from future damage and return it to normal function. It will also prevent it from breaking.
What is the test for root canal? ›Before beginning your root canal, your healthcare provider will take dental X-rays of the affected tooth. This helps determine the extent of damage and ensures that root canal therapy is the appropriate treatment option. Here are the steps that will be completed during your root canal procedure: Anesthesia.
Can a CT scan detect a root canal? ›How A CT Scan for Root Canal Can Be Used In Dental Treatment Complications? Case studies show CBCT scans can detect root canal complications. The condition may have been missed using the traditional x-ray methods. This technology is highly recommended for the detection of early resorption.
How is root canal checked? ›To confirm that a tooth does indeed require root canal treatment, the dentist will take an X-ray of the root and may perform a pulp vitality test. Most pulp tests involve placing a cold stimulus on the tooth to check for a healthy response. Many teeth will be tested to compare the responses.
Why does my root canal tooth hurt with pressure? ›If your tooth is still sensitive after a root canal or you experience other pain or swelling in the area, see your dentist or endodontist to discuss your options. You may need retreatment to save the tooth or you might consider endodontic surgery.
How can I relieve root canal pain at home? ›- Place ice over the area that's sore or tender.
- Apply a hot pack to the side of your jaw.
- Take over-the-counter pain relievers (Advil, Tylenol, etc.)
- Swish a combination of salt and warm water around your mouth.
Typical pain or discomfort following a root canal is most often described as mild soreness. If you experience severe pain or if your discomfort lasts longer than 3 days, contact your dentist. Severe and persistent pain could indicate a postoperative infection that may need to be addressed with an antibiotic.
Why can't I tell which tooth hurts? ›When it comes to a toothache, the brain doesn't discriminate. A new imaging study shows that to the brain, a painful upper tooth feels a lot like a painful lower tooth. The results, which will be published in the journal Pain, help explain why patients are notoriously bad at pinpointing a toothache.
How do you know if a cavity has reached the nerve? ›- Toothache when pressure (such as chewing) is applied to the tooth.
- Tooth sensitivity to heat or cold.
- Discoloration of the tooth.
- Swelling or tenderness of the gums.
How Long Does Nerve Pain Last in A Tooth? On average, a tooth nerve pain can last from as little as just a few days to as long as 4-6weeks or, in some instances, even longer.
What pain mimics a toothache? ›
Maxillary sinusitis 'mimicking' toothache
The pain is usually unilateral, dull, throbbing and continuous. Quite often the patient feels unwell generally and feverish. It can mimic the maxillary sinusitis-like symptoms in temporomandibular disorders (TMD)9 or neuropathic pain.
If the pain suddenly stops, it does not mean the infection has gone away. Rather, it probably means that the nerve inside the tooth has died. The infection could continue to spread and affect nearby tissues. It could even cause systemic illness.
How do you know if you need a root canal instead of a filling? ›Signs That You May Require a Root Canal
Tooth pain and sensitivity could indicate that you need a filling or a root canal. If the pain is persistent and strong, or if your teeth feel particularly weak, it is likely that your tooth's pulp is damaged and that you will need a root canal.
If the filling is too close to the nerve, it may get infected slowly. Dentists can't predict the time frame for the tooth to become infected. If infected, you may experience a throbbing pain or a dental abscess.
How do you know if cavity has reached the pulp? ›In the case of a deeper cavity that has reached the pulp or nerve canals, you may notice a bad taste in your mouth. Severe spontaneous pain, pain to pressure, pain that wakes you up at night and pain to hot are often signs of an infected nerve.
Can you naturally heal a tooth that needs a root canal? ›The short answer is no, a tooth that needs a root canal cannot heal itself naturally. The long answer is fairly straightforward. The infected tissue inside a tooth cannot heal by itself and will only get worse over time if left untreated. Even if you experience no pain, you should still seek treatment.
Can you avoid root canal with antibiotics? ›Although antibiotics will not be effective in lieu of a root canal, your provider may prescribe a preventive course of these medications following your root canal treatment. This is to reduce your risk of developing infection in the bone surrounding the tooth, which prophylactic antibiotics are very effective at doing.
Do I need a root canal if I have no symptoms? ›You might still need a root canal even if you do not feel any pain because not all infection results in pain. The purpose of a root canal is to handle any infection that has developed in your tooth pulp, not just stop you from feeling pain. A root canal can save your infected tooth from having to be extracted.
What happens if you need a root canal but don't do it? ›The Consequences of Avoiding a Root Canal
If the infection is concerning and left untreated it can cause you to lose your tooth or part of your jaw or even lead to dental abscesses or a life-threatening stroke, sepsis, or heart attack. As the infection progresses so will the pain which will be excruciating.
An untreated root canal can not only result in bone loss and infection but can also result in an acute abscess. An abscess is the formation of pus on the infected tissue or the area of decay.
How long can I wait to have a root canal? ›
You must undergo a root canal within a few weeks to fully eliminate the infection and save your tooth.
What does a missed root canal feel like? ›Tenderness or pain in the tooth when applying pressure, even after recovering from treatment. Swelling after recovery or pimple-like structures developing and leaking pus in the area. Temperature sensitivity, such as a quick, sharp pain after taking a sip of hot coffee or cold soda.
Can a root canal infection heal itself? ›A root canal infection will never go away on its own. An untreated root canal infection can severely comprise that tooth and can even lead to a systemic infection, especially in those people with weakened immune systems.
Can I take antibiotics instead of root canal? ›Although antibiotics will not be effective in lieu of a root canal, your provider may prescribe a preventive course of these medications following your root canal treatment. This is to reduce your risk of developing infection in the bone surrounding the tooth, which prophylactic antibiotics are very effective at doing.
What do holistic dentists do instead of root canal? ›Metal-free dental implants use a biocompatible zirconia post to replace the tooth root. Since implants are placed in the jaw, they provide unparalleled strength and durability and can last a lifetime. The implant is topped with a dental crown to restore the overall tooth structure and complete your smile.
Can I wait 6 months to get a root canal? ›If you wait to have a root canal, you're only providing that infection more time to gain strength and spread. Infection can spread from the tooth into the bloodstream, and then you have a much more serious issue than a common and routine dental practice.
How long can an infected root canal go untreated? ›In case a person does not treat a dental abscess in its initial stage, then the infection may last anywhere between 5 months to 12 months or even more. Moreover, if no treatment is meted out to the condition, the precious dental pulp will die away and may get another abscess.
Does Listerine help with tooth infection? ›Yes, applying a cotton ball soaked in regular Listerine on an infected tooth will relieve tooth pain. Listerine is about 27% alcohol, and alcohol numbs nerve endings.
How long can a dead tooth stay in your mouth? ›A dead tooth can stay in the mouth for days, or even months. The problem, however, is that leaving the tooth in your mouth can leave you susceptible to infection, it can cause pain and discomfort, and it will also look very unsightly as well.