Root Canal Diagnosis

By Michael Baharestani Endodontist

If you’ve been told you need a root canal or are scheduled for one soon, you’re in the right place. This is your guide to everything you should know before getting a root canal as well as what to expect during the procedure.

By the end of this post, you’ll know:

  • Exactly what questions to ask your dentist
  • What to expect during the procedure
  • What to expect in terms of pain
  • Everything that should be discussed with your dentist before you agree to a root canal

A root canal is a procedure to preserve (not save) a dead tooth.

By the time you need a root canal, it’s too late to save the life of the tooth because it’s already infected and dying.

Why not pull the dead tooth out? Well, you can, and then you would have to replace the dead tooth with an implant to fill the hole left behind in your jaw along with a new, artificial tooth — and actually, the new school of thought is that going straight to an implant is the right thing to do.

The main reason for getting a root canal instead of an implant is that it’s simpler to keep your old tooth, even though it’s dead, because you can still benefit from having the structure of the dead tooth to chew food and help you speak properly.

What Are the Pros of a Root Canal?

Root Canal Pros:

  • You don’t have to extract the tooth.
  • You can keep the tooth.
  • You don’t lose the bone around the tooth.

How Does My Dentist Know I Need a Root Canal?

Lingering pain: Your dentist will ask you about how your tooth responds to hot and cold. When you drink cold water, does your tooth get sensitive? How long does the pain last? This is a way of figuring out if you have “lingering” or “non-lingering” pain. “Lingering” means the pain sticks around. Non-lingering pain goes away. If the pain goes away, the pulp inside your tooth might be alive enough to recover from the hot and cold, indicating that the tissue could potentially recover. If you drink cold water and you’re sensitive for the next hour or more, that’s “lingering” pulpitis (infection of the pulp) which means your tooth isn’t recovering and the nerve is likely dead.

Positional pain: Does your pain get worse when you lie down or stand up suddenly or run in place? This can be the sign of an abscess and, likely, a dead tooth.

Spontaneous pain: If pain is brought on by a stimulus like a hot or cold drink, it’s possible that the pulpitis is reversible, but if you’re sitting there doing nothing and get a wave of pain, that’s probably a dead tooth.

Fistula on the gum: A fistula is a little white, yellow, or red pimple-looking thing that shows up your gum. What this tells your dentist is that there is an infection because there is pus, blood, and infectious materials trying to get out and the body is trying to vent it. The problem is that it doesn’t always go alongside the tooth that is infected — a fistula can mislead the dentist as to which tooth it is.

Abscess: leading to an abscess can be seen on an x-ray. It is essentially a hole in the jawbone that shows up as a dark spot on the x-ray because the bone doesn’t want to grow in that area. Bone won’t grow in the area around an infection and an infection typically comes from the tip of the root, which is where everything is spilling out from the dead tissue inside of the tooth.

Referred pain:  If the pain is not only in your tooth but also referring to another part of the body, like your jaw, ear, or surrounding teeth, this could mean you have an abscess. What I try to do is ask my patients in such a way that they don’t know what I’m asking so that I get the right answer.

How Long Can I Wait Before I Get My Root Canal Done?

Once you find out you need a root canal, it’s like a ticking time bomb, because the infection will eventually blow up. You’ll get more pressure and more swelling if you wait. You might get a bad taste in your mouth or might start to go numb. The infection could spread to more vulnerable tissues, like your heart. This is why people used to die of tooth infections hundreds of years ago.

Your dentist will prescribe you antibiotics for the infection. Once you start taking antibiotics, you’ve bought yourself four or five weeks. If you get on the antibiotics before the root canal is done, you’ll have less pain during the procedure because this will make it easier to get you numb.

As soon as you find out you need a root canal, you need antibiotics right away. Don’t delay! It could turn into a life-threatening condition if you don’t. Yes, a tooth infection can kill you!

What to Expect After You Go Home

You shouldn’t bite or chew on the treated tooth until you have had it restored with a crown by your dentist. A root canaled tooth is prone to fracture, so you’ll need to get the crown as soon as possible.

Until you’re able to come in to get the crown done, practice good oral hygiene and brush and floss normally.

Avoid biting on the tooth or chewing food on it.