Guide
Do I need a root canal? Signs to watch for
Tooth pain doesn't always mean a root canal, and a tooth that needs one doesn't always hurt. Here are the signs, and why an exam and an X-ray are the only way to know.
Medically reviewed by Dr. Rodolfo Rodriguez, DMD · Updated
Common signs
- Pain when you bite or chew
- Sensitivity to hot or cold that lingers for more than a few seconds
- A toothache that wakes you at night
- Swelling or tenderness in the gum
- A bump on the gum that drains
- A tooth that has turned gray or dark
When there are no symptoms
An infection can sit at the tip of a root without hurting, and show up only on an X-ray at a checkup. That's one reason regular exams matter.
When it isn't a root canal
Sensitivity can also come from receding gums, a cracked filling or grinding. Short, sharp twinges that stop as soon as the cold is gone usually don't mean the nerve is damaged. Dr. Rodriguez will test the tooth and tell you what's going on.
What to do
- Call us and describe what you feel
- Avoid chewing on the tooth
- Use over-the-counter pain relief as directed on the package
- If your face swells or you have a fever, call right away — on Friday evenings and weekends, Perla After Hours can see you by appointment
If swelling spreads toward your eye or neck, or you have trouble breathing or swallowing, go to the emergency room.
Why not to wait
An infected tooth doesn't heal on its own. Waiting lets the infection spread into the bone and can make the tooth impossible to save. Treated early, most teeth can be kept. See root canal treatment.
FAQs
Can antibiotics fix it instead?
Will the pain go away by itself?
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