6 Symptoms That Indicate You May Need a Root Canal

Root canal therapy has a reputation for being a painful procedure, when in fact it is one of the most effective tools against an abscessed tooth that may otherwise require extracting. The root canals today are no more painful than receiving a traditional filling. The key is to catch the problem early — before the pain becomes too much to bear or an infection spreads.

Here are six of the most frequent signs that the nerve in your tooth (pulp) is infected or dying and might be a candidate for root canal therapy.

Persistent or Severe Tooth Pain

Pain that won’t go away — and particularly when you bite down or chew, or press on the tooth — is the No. 1 red flag. The pain may be intense, pounding , or constant aching. Sometimes it even jumps up toward your ear or temple. This typically indicates that inflammation or infection has affected the nerve.

Hot and Cold Sensitivity That Lasts

A lightning bolt of pain while sipping ice water or hot coffee is normal. But if the sting lasts a few seconds (or minutes) after the source of heat is removed, the nerve is probably damaged. Cold sensitivity that doesn’t go away is particularly typical of teeth that require root canals.

Dusking or Greying of the Tooth

When the nerve within a tooth dies, the tooth can lose its blood supply and darken to gray, brown or black in shade. This discoloration typically occurs slowly and it only involves a single tooth (versus being stained by coffee or cigarettes, which involves more than one tooth).

Gums Swollen or a Pimple on the Gums

A small, raised spot on the gum next to the aching tooth — sometimes described as a dental abscess or “gum boil” — is an indication of infection, which has made its way to the surface for drainage. The bump may be intermittently present, and squeezing it can cause pus or blood to ooze out. Facial or jaw swelling may also happen if the infection spreads.

Tender or Aching Gums Around It

Your gums that surround the tooth in question might be sore when you touch them or even when you floss. Sometimes, the lymph nodes near your neck and under your jaw can swell and become tender.

A Loose Tooth (in Adults) or Ongoing Pain After an Injury

If you develop a sudden feeling of wiggly teeth or tooth loosening as an adult with no signs of gum disease, it might mean that the supporting bone is being destroyed by infection. Teeth that were injured years before (a sports injury, fall or deep filling) can also have nerve issues many years later.

Bonus Signs to Watch For

• Bad breath or an ongoing bad taste in the mouth, even after brushing.
• Pain that disrupts your sleep at night
• Pain that develops for no reason.

When In Doubt — Don’t Wait It Out

Most people hope the pain will “just go away,” but tooth nerve infections are rarely resolved naturally. If treatment is postponed and an infection travels into the jawbone, illustrated here, it can create larger problems that require more costly treatments later.

If you experience any of these symptoms, contact your dentist immediately. A straightforward exam and X-ray can tell whether a root canal (or sometimes another treatment) can save your tooth and get you out of pain fast.

The sooner that you catch these signs, the less painful – both temporary and permanent – surgery has to be, and importantly, keep your natural-looking smile!