How to know when it’s time for a root canal

Orlando Healthy SmilesLake Mary, FL

A root canal is not a treatment you schedule by preference. It becomes the sensible option when the nerve inside a tooth is inflamed or infected and cannot recover on its own.

The nerve of a tooth sits in a narrow canal inside the root. When decay, a deep filling, a crack or an injury lets bacteria reach it, the tissue becomes inflamed or infected. The tooth does not usually heal by itself at that point, and the options narrow to root canal treatment or extraction.

Signs that point towards the nerve

• Pain that lingers. A tooth that aches for minutes after hot or cold food, rather than settling within seconds, is more concerning than a brief twinge.
• Pain on biting or pressure. Often a sign the tissue around the root is inflamed.
• Spontaneous pain, especially at night. Throbbing that wakes you up usually means the nerve is involved.
• A bad taste or a pimple on the gum. This can be a sign of a chronic infection draining through the bone.
• Swelling. Facial or gum swelling is a reason to call the same day.

None of these signs is conclusive by itself. An examination, tapping tests, cold tests and an X-ray are what actually confirm the diagnosis. Sometimes a tooth with a dead nerve causes no pain at all and is only found on a routine X-ray.

What the appointment involves

Root canal treatment removes the inflamed or infected tissue from inside the tooth, cleans and shapes the canal, then seals it. The tooth is usually restored with a filling or a crown afterwards, because a tooth that has had this treatment is more brittle.

Most cases are completed with local anaesthetic. The tooth may be tender for a few days afterwards, which is usually managed with ordinary pain relief.

When extraction is the better answer

If there is not enough tooth structure left, if the root is fractured, or if the bone support is poor, removing the tooth may be more predictable than trying to save it. That is a conversation to have with the X-ray in front of you, not a decision to make from a webpage.

Do not wait for the pain to decide

Waiting usually makes the problem bigger: an infection can spread, and a tooth that could have been saved may not be restorable later. If you have pain that lingers or swelling, call the office at (407) 790-4181. If you have trouble breathing or swallowing, or swelling that is spreading quickly, seek emergency medical care.