7 Signs You May Need Root Canal Treatment

Toothache does not automatically mean you need root canal treatment. Sensitivity, pain when biting and swelling can have several causes, and some can be treated without treating the inside of the tooth.

However, these symptoms can sometimes develop when the pulp — the soft tissue containing nerves and blood vessels inside your tooth — has become inflamed, damaged or infected.

Root canal treatment is used to remove infection from inside a tooth, clean the root canal system and seal it to help prevent further infection. The aim is to preserve the natural tooth where possible rather than remove it.

So, what should you look out for? Here are seven signs that are worth having assessed by a dentist.

1. Toothache That Does Not Settle

Persistent toothache is one of the clearest reasons to arrange a dental examination.

The pain may be constant, or it may come and go. Some people experience a dull ache, while others develop more severe or throbbing pain.

There are many possible causes of toothache, so pain by itself does not confirm that you need root canal treatment. However, if the pulp inside the tooth has become infected, root canal treatment may be recommended to remove the infection and preserve the tooth.

Rather than waiting for persistent pain to become severe, arrange an assessment so the cause can be identified.

2. Sensitivity to Hot or Cold That Feels Unusual

Many people occasionally experience sensitive teeth. A brief sensation when you eat ice cream or drink something hot does not necessarily indicate a problem with the pulp.

More persistent or pronounced sensitivity deserves attention, particularly if it affects one specific tooth.

An infected or damaged pulp can cause pain when the tooth is exposed to hot or cold foods and drinks. Tooth decay can also cause sharp sensitivity to temperature.

The important point is not to diagnose the problem yourself based on sensitivity alone. Your dentist needs to establish why the tooth has become sensitive and whether the pulp is involved.

3. Pain When You Bite or Chew

If a particular tooth hurts every time you bite down, there may be a problem with the tooth or the tissues around its root.

Pain when biting can have several causes. A tooth may be cracked, for example, or there may be inflammation or infection associated with the pulp and surrounding tissues.

You may notice pain only when chewing firmer foods, or the tooth may feel tender whenever pressure is applied.

Again, this symptom does not automatically mean root canal treatment is required. But recurring pain when biting should be investigated rather than managed simply by chewing on the other side.

4. Swelling Around the Tooth or Gum

Swelling can be a sign of infection and should not be ignored.

You might notice a swollen area of gum close to a painful tooth. In other cases, swelling associated with a dental abscess can affect the face or jaw.

A dental abscess is a collection of pus caused by infection. It requires dental treatment and will not permanently resolve by itself.

Treatment depends on where the infection has originated and the condition of the tooth. If the infection comes from inside a tooth that can be saved, root canal treatment may be one of the options considered.

If you think you have a dental abscess, seek urgent dental advice rather than waiting for a routine appointment.

5. A Recurring Abscess or Unpleasant Taste

Some dental infections can produce pus around the affected tooth. You might notice an unpleasant taste in your mouth or swelling that appears to settle and then returns.

This needs assessment even if the tooth is not particularly painful.

An important misconception is that the severity of an infection can always be judged by the amount of pain you are experiencing. That is not necessarily the case.

UK Dental Specialists notes that inflammation around the end of a tooth’s root can sometimes continue without pain and may only be discovered during an X-ray examination.

A tooth therefore does not have to be causing severe toothache to require treatment.

6. The Tooth Has Become Darker

A change in the colour of one tooth can sometimes indicate that the pulp inside it has been damaged.

This can happen following dental trauma. You might remember knocking the tooth recently, or the original injury may have happened some time ago.

Not every discoloured tooth requires root canal treatment, and there are other reasons why teeth change colour. However, a single tooth becoming noticeably darker — particularly following an injury — is worth mentioning to your dentist.

The tooth can be examined and tested to determine whether the pulp remains healthy.

7. Your Toothache Suddenly Disappears

This is perhaps the most surprising sign on the list.

If you have experienced significant toothache and it suddenly stops, it is tempting to assume that the tooth has healed.

Unfortunately, a reduction in pain does not always mean the underlying problem has resolved.

As an infection progresses, the pulp inside a tooth can die. When this happens, earlier symptoms may disappear even though infection remains within the root canal system. Symptoms can subsequently return, sometimes accompanied by pain when biting, swelling or an abscess.

If you have had significant unexplained toothache that suddenly settles, it is still sensible to have the tooth checked.

What Actually Causes a Tooth to Need Root Canal Treatment?

Root canal treatment is needed when the pulp inside a tooth becomes infected or irreversibly damaged.

There are several ways this can happen.

Deep tooth decay can allow bacteria to progress towards the pulp. A tooth that has been chipped, broken or cracked may also allow bacteria to reach the inside of the tooth. Trauma can damage the pulp even when there is relatively little visible damage to the outside of the tooth.

The purpose of root canal treatment is to remove infected tissue and bacteria from within the tooth, clean and shape the root canal system and seal it.

If the affected tooth can be successfully treated and restored, this can allow you to retain your natural tooth.

How Does a Dentist Know Whether You Need a Root Canal?

Symptoms provide useful information, but they are only part of the diagnosis.

Your dentist or endodontist will want to understand what you have been experiencing. They may ask when the symptoms started, what triggers the pain, whether it lingers and whether the tooth has previously been damaged or treated.

The tooth and surrounding tissues are then examined. Appropriate diagnostic tests and dental X-rays may also be used.

At UK Dental Specialists St Albans, the endodontic treatment process includes a pre-operative radiograph — a small X-ray of the tooth — before root canal treatment begins.

The aim is to diagnose the problem properly before deciding whether root canal treatment is appropriate.

Does Needing a Root Canal Mean the Tooth Is Going to Be Lost?

Quite the opposite: root canal treatment is performed in an attempt to save the natural tooth.

Once infection has developed inside a tooth, simply placing a filling over the top does not remove the infected tissue from the root canal system.

If root canal treatment is appropriate, the infected pulp is removed and the inside of the tooth is carefully cleaned before the root canals are filled and sealed. The tooth then needs an appropriate permanent restoration to protect it and restore function. In some circumstances, this may include a crown.

Without appropriate treatment, an infected tooth may eventually need to be removed.

Whether a particular tooth can be saved depends on its individual condition, so an assessment is essential.

What Happens During Root Canal Treatment?

Although root canal treatment has an unfortunate reputation, the procedure is carried out using local anaesthetic.

At UK Dental Specialists, treatment begins with an X-ray and isolation of the affected tooth using a rubber dam. A rubber dam is a thin sheet placed around the tooth to isolate it from the rest of the mouth during treatment.

The root canals are then cleaned using specialist instruments and disinfecting solutions. Once prepared, the canals are filled and sealed.

A temporary restoration may be used before the tooth receives its permanent restoration.

The exact number and length of appointments can vary according to the tooth and complexity of the case.

When Might You See an Endodontist?

An endodontist is a dentist with advanced specialist training in diagnosing and treating diseases affecting the pulp and tissues around the roots of teeth.

Not every root canal needs specialist treatment. General dentists also provide root canal treatment.

However, referral to an endodontist may be appropriate for more complex cases, including some teeth that have already undergone root canal treatment but have subsequently developed further problems.

UK Dental Specialists has registered specialists in endodontics who accept referrals for root canal treatment, retreatment and the diagnosis of dental pain. The practice’s endodontic service also uses technology including operating microscopes and digital imaging where appropriate.

Having specialist endodontic expertise within a multidisciplinary dental practice can also be useful when a tooth requires consideration alongside other restorative or specialist treatment.

When Should Toothache Be Treated as Urgent?

You should arrange a dental appointment if you have persistent toothache or other unexplained dental symptoms.

If you think you have a dental abscess, NHS advice is to request an urgent dental appointment or seek help through NHS 111.

Signs of an abscess can include severe tooth or gum pain, swelling, an unpleasant taste, difficulty chewing or opening your mouth, and a high temperature.

More severe swelling can require emergency medical attention. If swelling is making it difficult to breathe or causing other serious symptoms, seek emergency help.

Don’t Wait for All Seven Signs

You do not need to experience every symptom on this list before seeing a dentist.

In fact, you may have only one symptom — and some infected teeth can produce surprisingly little pain.

The seven signs to be aware of are:

1. Persistent toothache.
2. Unusual sensitivity to hot or cold.
3. Pain when biting or chewing.
4. Swelling around the tooth or gum.
5. A recurring abscess or unpleasant taste.
6. A tooth becoming darker.
7. Toothache that suddenly disappears.

None proves by itself that you need root canal treatment. What these symptoms tell you is that the tooth should be assessed.

If root canal treatment is necessary, identifying the problem and treating the infection may provide an opportunity to preserve your natural tooth rather than lose it.

If you have persistent tooth pain or have been advised that you may need root canal treatment, a specialist endodontic assessment at UK Dental Specialists can establish the diagnosis and explain the treatment options available to you.

FAQs

Does Toothache Always Mean I Need Root Canal Treatment?

No. Toothache has several possible causes, and not every painful tooth requires root canal treatment. A dental examination is needed to establish what is causing the pain.

Can I Need Root Canal Treatment If My Tooth Does Not Hurt?

Yes. Infection or inflammation around a tooth can sometimes exist without obvious pain and may be identified during an examination or on a dental X-ray.

Why Has My Toothache Suddenly Stopped?

There are several possible explanations. In an infected tooth, symptoms can sometimes reduce as the pulp dies, even though the underlying infection remains. A tooth that has been significantly painful should therefore still be assessed if the pain suddenly disappears.

Can Root Canal Treatment Save an Infected Tooth?

Root canal treatment is intended to remove infection from inside a tooth and preserve the natural tooth where this is clinically possible. Whether an individual tooth can be saved depends on factors such as its remaining structure and the nature of the problem.

What Is an Endodontist?

An endodontist is a dentist with advanced specialist training in diagnosing and treating problems affecting the pulp and tissues around the roots of teeth. They commonly manage root canal treatment and more complex cases, including retreatment.