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How do you know when your tooth needs root canal treatment?


How do you know when your tooth needs root canal treatment?

It will take an examination by your dentist to determine if your tooth requires root canal treatment. And when making this determination, they must not only establish that it seems the right solution for your problem but also that the overall condition of your tooth warrants the time, expense and follow-up work required.

What are the signs that a tooth needs root canal treatment?

A) Some teeth display few or no symptoms.

There can be instances where a tooth has never given any sign (at least one that's perceivable to the patient) that suggests that there is a problem with its "nerve." And with this type of case, the dental patient may have difficulty understanding why root canal treatment is required.

B) The symptoms of many teeth will be quite obvious to the patient.

For many people, the signal that indicates that their tooth is in need of root canal treatment is the presence of pain and/or swelling (severe, moderate or even just mild). And with these cases dental patients usually have little difficulty comprehending that endodontic therapy is needed.

A) Situations where a tooth's need for root canal treatment isn't so obvious.

The death of a tooth's "nerve" (more accurately "pulp tissue") is not always a painful event. It is possible that the pulp inside a tooth can degenerate without producing any obvious symptoms at all.

An x-ray of a tooth needing root canal treatment.

With these types of cases, here are some scenarios that describe how a tooth's need for endodontic therapy might be discovered.

1) Problem teeth identified by x-rays.

Low-grade tooth infections may not produce any noticeable symptoms due to the fact that the person's immune system is able to keep them relatively in check. With this type of situation, the tooth's need for root canal treatment may remain undiscovered, even for some years.

Why routine dental x-rays can be important.

Dentists often discover these types of teeth during routine x-ray evaluations. In the most obvious cases, the dental x-ray will show a dark spot right at the tip of the tooth's root.

This dark spot, termed a "radiolucency," is an indication that the density of the jawbone in this region has changed due to a reaction triggered by the infection housed within the tooth.

2) The presence of a persistent or recurring pimple on the gums.

An infection located inside a tooth may cause the formation of a pimple-like lesion on a person's nearby gum tissue. The size of these lesions (dentists call them "fistulous tracts") typically wax and wane over time. Because they are literally drains for pus, the person might notice that they discharge a bad taste.

It's not terribly uncommon that a dentist will discover this type of lesion while performing a routine oral examination, even though the patient hasn't noticed it at all.

3) The presence of an individually darkened tooth.

A tooth which has darkened as a result of trauma.

Teeth that have been traumatized in an accident sometimes require root canal treatment. (Wearing an athletic mouthguard can help to prevent this.)

Immediately after the traumatic event, the outlook for the tooth's nerve can be difficult to predict. In some cases, and possibly even many years later, the tooth's nerve tissue may go ahead and degenerate (often without symptoms).

When a tooth's nerve tissue necroses, the byproducts that are created can penetrate into the hard tissues of the tooth (dentin and enamel) and produce a staining effect. It is very common that a dentist's initial suspicions of a tooth are based solely on the fact that it has a slightly darker appearance than its neighbors.

Exposure of a tooth's nerve during dental work.

4) Exposure of a tooth's nerve.

There can be times when the dental work that a patient requires results in the exposure of their tooth's "nerve." The term "exposure" means that the dentist has literally been able to visualize the tooth's pulp tissue. Sometimes the patient will feel a little prick of pain when the exposure occurs. Just as likely, they don't even know it happened.

An exposure can trigger pulp tissue degeneration. Because of this, a dentist may determine that it's best to go ahead and perform root canal treatment now, so to avoid possible problems and complications later (such as a painful tooth abscess).

B) What are the signs of needing root canal treatment that a patient might notice?

Here are some of the types of symptoms that could suggest that your tooth needs root canal therapy:

  • The tooth is currently causing you pain, or else has a history of being painful.
  • You have noticed gum tenderness and/or swelling in the area around the tooth.

We're being purposely vague about symptoms here, for a couple of reasons …

1) Every dentist has, at some point, had a patient who tried to fake the symptoms of needing root canal treatment in an attempt to gain a prescription for narcotics. We simply have no interest in providing information that could assist someone in doing so.

2) There is no reason to provide this type of information anyway because dentistry is not a self-help field. If you have a problem, you require the attention of a dentist. And it's their job to make the diagnosis.

3) As any dentist will tell you, there are a wide range of different situations that can lead to the need for root canal treatment. And arriving at a correct diagnosis can, in many instances, be difficult (and that's using all of the knowledge, experience and equipment that a dentist has available to them). Attempting self-diagnosis from a website seems a likely source for misdiagnosis.

4) Some patients won't seek treatment promptly if, in their mind, they think it's already too late, or it will cost too much money or else the idea of having the treatment is too scary to them. Making a misdiagnosis about the need for root canal treatment (by way of using website information) may deter some from people seeking treatment promptly, during that stage when a simple, cheap and easy repair might have been made.


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