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Common Symptoms That Indicate You May Need a Root Canal
Not every toothache needs a root canal—but certain symptoms strongly suggest the pulp is infected.
Here are the signs to watch for:
1. Persistent Tooth Pain
Pain that lasts for hours or occurs spontaneously without chewing, often indicates nerve involvement.
2. Sensitivity to Hot or Cold
If sensitivity lingers long after the hot or cold item is removed, it may be due to nerve inflammation.
3. Swelling or Tender Gums
Sometimes swelling occurs near the infected tooth; it may be painful or painless.
4. Abscess or Pimple on the Gums
A small bump (called a sinus tract or gum boil) often drains pus from an abscess — a definite sign of infection.
5. Tooth Discoloration
A dying or dead nerve causes the tooth to turn grey or black.
6. Bad Taste or Foul Odor
Chronic infection can produce an unpleasant taste or smell, even without pain.
7. Difficulty Chewing
Pain when biting may indicate inflammation in the bone around the tooth root.
How Is a Root Canal Diagnosed?
Dentists use several tools and tests to confirm whether a root canal is necessary:
- X-rays to check infection and bone changes
- Pulp vitality tests
- Cold tests to evaluate nerve response
- Percussion tests (tapping the tooth)
- Digital imaging for crack detection
Only a dentist or endodontist can accurately determine whether root canal therapy is required. While a general dentist can perform the root canals, the expertise of an endodontist often becomes essential.
Who is an endodontist?
An endodontist is a specialised dentist, with an advanced training focussing exclusively on diagnosing and treating problems related to the tooth pulp and tissue surrounding the routes. They specialise in managing dental pain in the most painless manner and perform intricate root canal procedures with high precision. If you have discomfort in your teeth you can visit My Dental Centre on Sector 43 of Gurugram, and meet resident endodontist Dr Novsheba Showkat.
Dr Novsheba comes with a working experience of over 7 years spread across some of the best dental chains in the country including Clove Dental. Dr Novsheba has a track-record of doing over 6,500 root canal with complete success rate, as on October 31, 2025. Dr Novsheba is known for her sharp eye for diagnosis, painless root canals, high regard for medical ethics and a compassionate personality.
Step-by-Step: What Happens During a Root Canal Procedure?
Understanding the steps can make the process feel less intimidating.
1. Consultation and X-Rays
The dentist evaluates the tooth and uses X-rays to map the root canal system.
2. Local Anesthesia
The area is numbed thoroughly.
Modern anesthesia makes the procedure as comfortable as a filling.
3. Rubber Dam Placement
A small protective sheet isolates the tooth, keeping it clean and dry.
4. Access Opening
A tiny opening is made through the top of the tooth to access the infected pulp.
5. Pulp Removal and Canal Cleaning
Using fine instruments, the dentist:
- Removes the infected nerve
- Cleans the inside of the roots
- Shapes the canals for filling
6. Disinfection
Antibacterial solutions clean out any remaining microbes.
7. Filling the Canals
The cleaned canals are filled with gutta-percha, a rubber-like material.
8. Sealing the Tooth
A temporary or permanent filling seals the access cavity.
9. Crown Placement (Usually Required)
Most root canal-treated teeth need a crown to prevent fracture and restore full strength.
How Long Does the Procedure Take?
- Single-root teeth (front teeth): 30–60 minutes
- Premolars: 60–90 minutes
- Molars with multiple roots: 90–120 minutes
Some cases may require two visits, especially if the infection is severe.
Does a Root Canal Hurt?
This is the biggest myth.
The truth:
Root canals today are virtually painless.
Most patients say the procedure is more comfortable than getting a cavity filled. Pain occurs when the tooth is infected — not during treatment. After the root canal, the pain usually reduces significantly.
Today, I went to the beach front with my children. I found a sea shell and gave it to my 4 year old daughter and said “You can hear the ocean if you put this to your ear.” She put the shell to her ear and screamed. There was a hermit crab inside and it pinched her ear. She never wants to go back! LoL I know this is completely off topic but I had to tell someone!