When is a root canal needed?

I have a tooth with a cavity. Will the tooth need a root canal or not?

Thanks, Heather

Dear Heather,

Just because a tooth has a cavity does not necessarily mean it will need a root canal. When cavities are small most of the time just a filling is needed to repair the tooth. It’s when the decay has reached very close to the nerve of the tooth or has actually penetrated the nerve a root canal is needed.

Signs and Symptoms of a Tooth Needing A Root Canal May Be:

  • Has a dull or sharp ache. May wake you up in the middle of the night
  • Sensitive to hot and cold temperatures
  • Pressure sensitive, hurts to chew on
  • An x-ray shows in abscess at the tip of the root
  • There is a bump on the gum above the tooth

We recommend you visit your dentist who will most likely take an x-ray to determine whether or not the tooth has an infection. If there is no infection and the cavity is small a filling will be recommended, however it the cavity is large and there is no sign of infection a porcelain crown may be recommend because a large filling could cause the tooth to break. If there is an infection, you will more than likely need a root canal as well as a porcelain crown to protect the tooth from breakage once the root canal is completed.

This post is sponsored by Cleveland implant dentist Hylan Dental Care.





I’ve always been terrified of the dentist

I have been scared of the dentist for as long as I remember. Pretty much since childhood I have been terrified to go to the dentist. My mom never took me in for regular exams when I was a kid, unless I was absolutely in so much pain she didn’t want to hear it anymore.

So now that I’m 62 years old, I have some problems and I still avoid the dentist at all costs. I have a feeling that my dental health is so bad that I probably need dentures. I’ve been trying to find the right dentist but I can’t seem to find one that seems to be interested in helping me work with my fear.

My grandchildren have even noticed the fact that I never smile which makes me sad. Anyway, I was just hoping you may have some suggestions to help me in my situation.

– Dolores in Kansas


Based on what you have described about your dental history, it is normal for you to be having dental fear. The best way to overcome dental fear is with the use of sedation dentistry. When you have been traumatized, sedation can help immensely. Oral sedation simply involves taking a pill before your appointment. It is safe and effective and it is quite likely that you will remember nothing about your dental appointment. With this method, the dentist can do a lot of work in one sitting. You will need someone to drive you home from the dentist afterwards.

Many sedation dentistry patients have worked through their fear and eventually undergone treatment without the use of sedation. If you do require dentures, sedation can help you get through the initial treatment and then hopefully the following treatments should be easier on you.

Hopefully you are able to find a qualified sedation dentist in your area. Best of luck to you.

This post is sponsored by Cleveland implant dentist Hylan Dental Care.


Red and White Painful Bumps on Tongue

I’ve had red and white painful bumps on my tongue for 3 days now and it’s not going away. It’s really painful to talk and swallow. My throat and chest feel really tight too. Do you know what may be going on?

Thanks, Doug

Dear Doug,

Our tongues are covered with different types of papillae and have different taste functions. The papillae at the back of the tongue are called circumvallate papillae, and are enlarged and in a V shape. These papillae can become painful especially when one has an upper respiratory, viral, or even a fungal infection therefore making your throat sore and your chest feel tight.

Conditions that cause painful papillae, sore throat, and possibly chest tightness

  • Pneumonia
  • Tonsillitis
  • Strep Throat
  • Common cold
  • The Flu
  • Mononucleosis
  • Chicken Pox or Measles
  • Yeast Infection (Thrush)
  • Tobacco use
  • Dust allergies
  • Allergy to medications
  • Changes in temperature
  • A diet high in acidic foods and/or liquids

Ways to Relive the Symptoms of Painful Papillae

  • Stop smoking
  • Salt water rinses to reduce tongue and throat pain
  • Don’t consume to much acidic, spicy, and hot foods
  • Put yogurt in your diet to balance the bacteria in your body
  • Have good oral hygiene and a healthy diet
  • Take vitamin B-12 to help manage mouth ulcers

If your symptoms do not get better over the next week we recommend you visit your dentist or  physician. You may have some sort of viral or fungal infection that may require medication to treat your condition.

This post is sponsored by Cleveland dentist Hylan Dental Care.

A broken tooth on a 12-year-old child.

Recently, my 12-year-old son fell off his bike. He broke his front tooth and the dentist put a splint on the surrounding teeth, as well as the one that has broken off. The dentist is recommending that the broken tooth be extracted and to use a flipper to replace it. Are there any other options? I just want to make sure we explore all of our options to save the tooth if possible. It has been about a month or so since the accident. He seems to be going fine and isn’t in pain. Do you know if the broken tooth with the splint that is currently on it will repair itself as time goes by? Or do you think it will die?

– Jayne in California


It is difficult to give specific recommendations without having seen your child. Although, from what you have described it sounds as if the tooth has been fractured in the bone where it is not visible.

This likely means that the tooth root is fractured. And when this is the case, it is typically not likely that the tooth is salvageable when the bone has been broken. Now if the fracture occurred near the tip of the root, it may be surgically removed. Then, the tooth may be saved during a root canal treatment. Although this scenario may be possible, it is still quite difficult to do. It is also very unlikely that the root will refuse by itself.

You do have options for the tooth replacement, although there are some concerns you should be aware of. A dental implant will be a permanent and natural-looking solution. Although, it is not typical that a 12-year-old receives an implant. This is because his jawbone is still growing at this time and will be for many years. The general rule of thumb is that the jawbone will complete growth between the ages of 18-20. What could happen is that the natural tooth and the dental implant may differ in height. For example, if the bone continues to grow and develop after the placement of the implant, it will stay in the same position. Whereas the natural tooth will move and grow higher.

If this dental emergency was addressed right away, instead of having a period of a month pass, there may have been other options to save the tooth. But at this time it does not sound like a possibility.

Also, whenever the tooth is fixed it will be very important that you seek the talents of a true cosmetic dentist because it will need to match the surrounding teeth perfectly. And since it is in such a visible location, it will definitely be worth it to find an expert cosmetic dentist.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Related link: pediatric dentist