Do I Really Need Root Canal Treatment? Dental Pain and Options

Unsure whether root canal treatment is necessary?

Hello Doctor: On February 2nd, I experienced mild discomfort in my upper left second molar while sleeping.
On February 3rd, while eating at night, I suddenly felt a sharp pain, which later turned into intermittent mild pain that continued until I went to bed, where it became painful enough to affect my temple, lasting about 1-2 hours.
I took pain medication to fall asleep.
On February 4th, at 11 AM, I visited the dentist and informed him about my symptoms over the past few days.
The upper left second molar appeared to have no visible cavities.
The dentist asked if I was still in pain, and I mentioned it was very mild and intermittent.
He then tapped on my tooth and asked if it hurt; I said no.
The dentist explained that I had two options: the first was to take medication and see how it goes, and the second was to undergo root canal treatment.
I questioned whether medication was just a temporary pain relief and wouldn't address the underlying issue.
The dentist agreed and said that root canal treatment would be necessary.
My concern is how he could determine the need for a root canal without visible signs of decay and without taking X-rays.
He then drilled into my tooth, which caused me to cry out in pain radiating to my temple, removed the decay, filled it with a white material, and scheduled a root canal for February 19th, also prescribing pain medication.
After the filling on February 4th until February 8th, I only felt more pain when eating, took pain medication once, and occasionally felt a dull sensation.
Now, I feel that each day is less painful.
I would like to ask the doctor if I still need root canal treatment.
Thank you.

Xiao Yu, 20~29 year old female. Ask Date: 2019/02/12

Dr. Huang Tingfang reply Dentistry

Dear Miss Xiaoyu,
Hello! The dentist drilling your tooth indicates that he has detected a cavity, and it needs to be filled.
If you still experience pain afterward, it means the decay has reached the nerve, and a root canal may be necessary.
An X-ray will provide a clearer understanding of your condition.
Please communicate more with your doctor.
Thank you! Wishing you well!
Sincerely,
Dr.
Huang Ting-Fang, Dentistry

Reply Date: 2019/02/12

More Info

When it comes to dental pain and the necessity of root canal treatment, it’s essential to understand the underlying causes of your discomfort and the implications of the treatment options available. Based on your description, it seems you are experiencing intermittent pain in your upper left molar, which has prompted your dentist to suggest root canal therapy.

Root canal treatment is typically recommended when the pulp of the tooth becomes inflamed or infected. This can occur due to deep decay, repeated dental procedures on the tooth, or trauma. The symptoms you describe—sharp pain during eating, lingering discomfort, and pain radiating to your temple—are indicative of potential pulpitis or even an abscess. While the external appearance of the tooth may seem normal, internal damage can still exist, which is why diagnostic imaging, such as X-rays, is often utilized to assess the health of the tooth and surrounding bone.

Your dentist's suggestion of two paths—medication or root canal treatment—reflects a common approach in dentistry. While medication can provide temporary relief, it does not address the root cause of the pain. If the pulp is indeed infected, the infection can spread, leading to more severe complications, including the potential loss of the tooth. Therefore, while it may seem that your symptoms are improving, this does not necessarily mean that the underlying issue has resolved.

The fact that your dentist drilled into the tooth and performed a filling suggests they were addressing a cavity or decay that may not have been visible externally. If the pain persists or returns, it could indicate that the pulp is still compromised, necessitating root canal treatment to remove the infected tissue and prevent further complications.

In your case, since you have a scheduled appointment for root canal treatment, it would be prudent to follow through with that plan. The root canal procedure will help ensure that any infection is cleared and that the tooth can be preserved. After the treatment, a crown is typically placed on the tooth to restore its function and protect it from future damage.

It’s also worth noting that dental pain can sometimes be exacerbated by other factors, such as grinding your teeth (bruxism), which can lead to additional stress on the teeth and surrounding structures. If you have a history of grinding, it may be beneficial to discuss this with your dentist, as they may recommend a night guard to help alleviate the pressure on your teeth.

In summary, while your symptoms may be improving, it is essential to consider the potential risks of delaying root canal treatment. The procedure is designed to save your tooth and alleviate pain in the long run. If you have any concerns or questions about the treatment, don’t hesitate to communicate with your dentist; they can provide you with the best guidance based on your specific situation. Remember, maintaining good oral hygiene and regular dental check-ups are crucial in preventing future dental issues.

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