How Do You Know if You Need a Root Canal?

Mention a root canal procedure to most people, and they’ll shudder in horror at the potential pain. But root canal treatments are designed to help rescue teeth that are badly decayed or infected, and whose nerve is either dead or dying — the root canal isn’t painful, it’s the period leading up to the procedure that can be excruciating. Once your root canal is done, your tooth will once again be pain-free.

Rozenberg Dental NYC, located on the Upper East Side of Manhattan and led by board-certified cosmetic dentist Dr. Lana Rozenberg, offers patients two decades of experience performing successful root canals. Whether your problem is caused by tooth decay or gum disease, we can help.

Tooth basics

Your teeth are covered in a hard enamel shell, but it’s what’s inside that matters more when discussing root canals. Underneath is the pulp, or pulp chamber, a soft area that contains the nerve, blood vessels, and connective tissue. The tooth's nerve runs inside the "root,” which is anchored in the jaw bone. There are from 1-3 canals within the root, depending on which tooth it is. The canals travel from the tip of the root in the bone up into the pulp chamber.

While a tooth's nerve initially serves an important role in growth and function, once the tooth has erupted through the gums, its role is less vital. In fact, its only function becomes a sensory tool, providing sensations of hot and cold. That means if you need to remove it, as in a root canal, the tooth’s function won’t become impaired. The tooth will, however, become weaker and more vulnerable to fractures and is therefore often shored up with a dental crown.

Reasons for removing the pulp

A tooth's pulp, while generally well protected by the enamel layer, can become irritated, inflamed, or infected as a result of deep tooth decay, large fillings, repeated dental procedures on that tooth, a crack or chip in the tooth, or trauma to the facial area.

When damaged, the pulp breaks down. Bacteria start to multiply in the chamber, and together with dying tissue, they can cause an abscess, a pus-filled pocket at the end of a tooth’s root, or an infection within the canal that can cause:

• Swelling, which can spread to other areas of the face, neck, or head
• Bone loss around the root tip
• A hole in the side of the tooth
• Drainage problems, extending from the root into the gums or through the cheek into the facial skin

Signs you may need a root canal

While a 2016 study found that specific root canal symptoms vary depending on the type of bacteria in the infection, there are some common signs that a root canal may be in your future.

Persistent tooth pain

You may feel pain deep in the tooth’s bone, or you may feel referred pain in your jaw, face, or other teeth. The pain may be constant, or it may ebb and flow, but it always returns. As long as you feel persistent pain, your nerve may be in trouble. 

Of course, tooth pain can come from other causes, such as gum disease or a sinus infection, but if you’re in pain, make an appointment to see your dentist. Early diagnosis and treatment of tooth-related pain generally leads to better outcomes.

Sensitivity to hot and cold

If you feel pain when you eat or drink something hot or cold, it may auger well that the blood vessels and nerves in your pulp chamber are infected or damaged. The pain may be sharp or dull, but if it lasts for an extended period, even when you’ve stopped eating or drinking, you may need a root canal.

Tooth discoloration

An infection in the pulp can damage the root, causing your tooth to become grayish-black. This discoloration is easier to see in the front teeth than in the back ones. Tooth discoloration can result from other causes, but it’s best to see your dentist to be sure.

Swollen gums

Swollen gums can result from periodontal disease, but swelling near the painful tooth may signal the tooth requires a root canal. The swelling comes from the buildup of acidic waste products in dead pulp tissue, and it may be painful to the touch — or not.

You may also see a pimple-sized dot on the gums, known as a gum boil, parulis, or abscess. It can ooze pus from the infection, giving you a bad taste in your mouth and foul-smelling breath. All are signs you probably need a root canal.

If you recognize any of these signs in one or more of your teeth, contact Rozenberg Dental NYC to schedule a root canal consultation. You can call us at 212-265-7724, or schedule online. You’ve got pain; we can make it go away.