If you have excruciating pain, you’re a lot more likely to think a root canal is a good idea. If you have just some discomfort, or no pain at all, you’re a lot more likely to think a root canal isn’t really necessary. So not true! When you’re in pain, the problem is obvious. It’s usually one of two things. Either the nerve is dying and is not going quietly into that goodnight or, infection is causing problems outside the tooth.  Since 100% of dead teeth get infected, either way, you need a root canal. The bottom line on root canal treatment is that it controls infection.

If you have little or no pain, you can still have infection that eventually will cause all kinds of issues. Your tooth may have died quietly so you never knew it happened. But, as I said, 100% of dead teeth get infected so your dentist probably saw signs of that infection during an exam and/or on an x-ray. The most common sign is bone loss at the tip of the tooth’s root. That only continues to get worse until not only that tooth but teeth around it get compromised. Not to mention the health risks of having an uncontrolled infection.

Interaction between sinuses and upper molars

Two stories to make my point. The first was someone who had an upper molar die and get infected. Because those teeth are pushing on your sinuses (in some cases they actually hold the sinus up but that’s another post), infection can move into your sinuses. Because infection had been so long-standing and she frequently had sinus infections anyway, she lost the tooth. Then she lost the implant because the infection kept returning. Then she had sinus surgery. And back and forth it goes. She is now losing another tooth to the same cycle of infection. And, implants are not an option since that cycle continues. And, it all started because she waited several years before treating the initial problem. It wasn’t really painful so it could wait, right?

For those of you who want a more detailed, academic explanation of this relationship, you can read the article Maxillary Sinusitis of Endodontic Origin on the AAE website.

18-year-old girl losing all of her lower front teeth

The second was an 18-year-old who was referred to our practice with a lower front tooth that hurt. She was actually referred 2 years before but since her pain was minimal, they didn’t pursue the referral. Now, at 18 the pain has gotten significant enough that she came to see us. The x-ray we had from when she was 16 showed some bone loss. As a healthy kid, that bone loss would have healed in no time. A year or so and there would be little or no sign of it (when we’re older, like all our aches and pains, things take a little longer to heal). Unfortunately, she did not come then. When she finally did, the bone loss was so extensive she was not only going to lose the infected tooth but also teeth to either side of it. That has to be the worst news we had to deliver to a patient. An 18-year-old girl losing all of her lower front teeth.

Don’t wait!

While those are extreme examples, someone waiting too long to see us because the pain wasn’t too bad happens nearly every week. Then they really don’t need a root canal because the tooth is unrestorable and has to be extracted. So…don’t wait!!

Our post Common concerns about root canal treatment offers more information and resources. And, our post Before your consult appointment offers suggestions for how to make the most of that appointment. You can also get more information on our website about what to expect and about root canal treatment. Finally, please remember, it only gets worse!