Dental Pain: Do I need a root canal?


Maybe and maybe not.  Whether you need a root canal or not depends on presenting symptoms and situations.


A patient was recently referred to me with a toothache. She is a friend, about 50 years old, whom I’ve never treated professionally.

The x-rays did not indicate that there was anything immediately obvious requiring endodontic therapy. It appears that there is some decay on the inlay that she has which was performed 25 years ago.

The specifics of the toothache are that the tooth has been throbbing for 1-2 hours daily for over a week. However, it hasn’t kept her up throughout this time.

So, what are the considerations for the best outcome? She states that she has not had any sinus problems, and she is not prone to grinding her teeth, either of which can cause some prolonged pain. If a pain occurs as a response to a stimulus, like hot or cold, or sugar, then having a filling usually does the trick. But if the tooth hurts for no reason, or if takes more than 5 minutes or so for the pain from a stimulus to go away, then a root canal is usually indicated.

In some instances, like a fractured tooth, there is pain on chewing. This situation is usually remedied by placing a crown on the tooth. When there is pain from a stimulus like chewing and it goes away quickly, then a root canal is usually not indicated unless the pain continues after the tooth is prepared for a crown.

Of course, an x-ray and going to the dentist, providing an accurate history for the pain in the tooth, will help the dentist come out with a solution for the dental problem.