patient suffering from tooth pain who may need a root canal

Getting to the Root of Root Canal Treatments

When you get a toothache, what’s the root cause? Sometimes it might actually be the root itself, the nerve tissue within your tooth that helps keep it strong and healthy.

Yes, that’s right—your teeth have nerves. That’s why damage to your teeth can hurt so much; there’s nerve tissue, often called “pulp,” within that can be very susceptible to even the slightest knock.

When a tooth is damaged, there’s a good chance the nerve tissue will be affected in some way. Addressing this damage frequently requires root canal therapy, or endodontic therapy.

This treatment seeks to remove damaged tissue to save the surrounding tooth and provide relief from pain, but it’s gotten a bad rap over the years. Many people believe the treatment itself is the thing that hurts, ignoring all evidence to the contrary.

The fact of the matter is that root canal therapy is often required to restore dental function and maintain good oral health. But how do you know when you need this treatment? And what, exactly, does it involve?

What is a Root Canal?

Saying you need a root canal is a bit of an inaccurate statement. Casually, everyone will understand that you need endodontic treatment, or root canal therapy. But the fact every tooth already technically has a root canal: a passage or channel within the tooth that contains the nerve tissue, or pulp.

Root canal treatment or therapy, meanwhile, refers to the act of removing the damaged pulp and replacing it with a filler material to preserve the surrounding tooth.

During root canal therapy, your dentist drills into your tooth to hollow it out. Sometimes, this means removing a small amount of tooth material to access the damaged, decaying, or already dead pulp within. Other times, a more significant amount of tooth must be removed to provide access, typically if decay has started to affect the tooth itself.

Either way, once your dentist has drilled into the tooth, they will remove the pulp and replace it with a rubber-like material before placing a small bond or crown to seal it in place.

Root canal therapies are almost always preferable to crowns, as they focus on saving as much of the original tooth as possible. Yes, in some cases, you may still need a crown, but only if the tooth has taken more damage.

Do I Need a Root Canal?

Any tooth damage could potentially lead to a root canal.

For instance, dental caries (decay requiring a filling), chipped teeth, cracked fillings, and injuries can all cause issues leading to root canal therapy.

It’s often impossible to tell from observation alone. A dentist will need to either manually explore the cavity or use x-rays to determine how deep and significant the cavity is.

While there are some root canal symptoms that could indicate the need for treatment, at the end of the day, your dentist is the only one who can tell you with certainty whether or not you need a root canal.

Common Reasons for a Root Canal

While these aren’t the only reasons your dentist will recommend root canal therapy, the following issues are often frequent causes and culprit.

A root canal is necessary when there is no other way to restore the tooth without causing lingering nerve pain.

Tooth Sensitivity

General tooth sensitivity may indicate that a tooth has been damaged and needs to be repaired. If you experience pain when drinking hot or cold liquids, or when eating sweet foods, it’s a sign that the outer enamel of your tooth has either been cracked or worn down. At this stage, it may either need to be filled or may need a root canal.

Cracked or Chipped Tooth

A cracked or chipped tooth can easily require a root canal to fix, depending on how severe it is. If the crack or chip runs down the length of the tooth, simply trying to repair the outside of the tooth may still lead to lingering pain. If the nerve of the tooth has been exposed or damaged, it’s often the best choice to remove it entirely.

Noticeable Swelling Around Gums

Swelling around your gums can indicate that you have an infection. When an infection occurs around a tooth, it begins eating away at the base of the tooth. Over time, this can lead to nerve damage and pain. The root canal treatment will begin with treating the infection first, after which the root may need to be removed.

Discoloured Tooth

A discoloured or “dead” tooth has almost always damaged to the point where either extraction or a root canal is advisable. Teeth become discoloured when they aren’t getting blood. Sometimes this is painless, but other times it can be incredibly painful. As the nerve dies, it can send out signals of pain, which can only be removed by removing the nerve.

Visible Decay

Large amounts of visible decay often indicate the need for a root canal. At a certain point, it makes more sense to complete a root canal rather than sealing up the tooth. If there is only a small visible cavity, it may only need a filling. If a large portion of the tooth is already missing, then chances are the nerve has already been damaged.


Tooth pain isn’t necessarily root canal pain. However, if you’re experiencing a great deal of pain, it’s possible the nerve has already become damaged, inflamed, or infected. At this point, the easiest way to get you out of pain is usually to give you a root canal. If you’re experiencing a smaller amount of pain, a filling may be all that’s needed.

Foreign Objects Between Teeth

Flossing is important because it reduces the number of bacteria in your mouth. If you frequently get foreign objects between your teeth and don’t floss, then bacteria will build up in these areas and eventually cause decay. Over time, this decay may become significant enough to necessitate a root canal.

Bruxism/Teeth Grinding

Bruxism/teeth grinding, if caught early on, can be treated with the use of a mouth guard. If it’s not treated, though, it can eventually lead to cracked and worn-down teeth. If this damage is significant enough, a root canal will help… but the bruxism needs to be treated on its own if the issue isn’t to occur again.

Filling Damage

When fillings are pulled out and damaged, they often don’t leave a lot of the tooth behind to save. If the filling damage has been significant, it may be advisable to remove the nerve and perform a root canal, rather than just filling the cavity again. If the cavity was small enough, on the other hand, another filling can be placed.

Temporomandibular Joint Dysfunction

TMJ is a jaw disorder that can cause your jaw to lock. Sometimes it can also mimic root canal pain. This is another important reason that it’s necessary to go to a doctor to diagnose your issue. Many people will falsely identify TMJ as a root canal issue or will think their root canal pain is TMJ.

As a root canal may sound severe, many people are concerned about the experience. However, there are very limited root canal side effects: a successful root canal will remove your pain immediately, as there will no longer be nerves present in your tooth to experience pain. If you think you might need a root canal, schedule a consultation with Affinity Dental today.