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Do I Need a Root Canal?

Call your dentist and save your tooth!


When cavities are left untreated, the bacteria can travel deep into the tooth pulp and nerve. This tooth pulp houses the blood supply and nerve for the tooth. In response to bacterial invasion and to protect itself from the infection, the tooth pulp will become inflamed. This inflammation can cause pain, sensitivity to pressure or temperature, and possibly nerve damage. With inflamed dental pulp, the blood supply to the tooth can be reduced or cut off completely. Without a blood supply, the tooth pulp can die and an abscess may develop.

Once a tooth has died, it may appear to be discolored and will no longer be sensitive to hot and cold. Treatment options for infection or dead teeth are generally limited to root canal treatment or extraction.

Pulp Vitality Test

Do NOT wait until a minor toothache becomes an emergency to visit your dentist, as a developing infection can become life threatening if there is an infection present. It may also be a challenge to get a same-day appointment with your dentist, so some offices may require you to sit and wait until a spot opens up.

Once you're seated in the chair, you might hear your dentist say, "I'm going to do a pulp vitality test." Your dentist will order an x-ray to be taken and perform a few tests as part of the exam to determine if the tooth is still alive.

  • Percussion Test- your dentist will tap gently on the tooth with a hand instrument (sometimes it's the end of a mouth mirror) to check if the tooth is responsive. If the gentle tapping causes pain, the pulp (nerve) of the tooth may be dead. That can also indicate that an infection is present and the tooth is in need of a root canal.
  • Temperature Test- Your dentist may do a temperature test by chilling a cotton swab with a spray of endo-ice (cold) and placing the cotton swab on your tooth. If there's no response, your tooth pulp may be dead and in need of a root canal. If there is a severe response, it could indicate the nerve of the tooth is inflamed, which would also require a root canal.

Is the Tooth Savable?

Several factors are considered when your dentist is making that decision: how much tooth structure is left and if there's enough bone density around the tooth.

Your tooth is held in place by bone and ligaments. If there is enough bone to support the tooth, IT IS USUALLY SAVABLE! However, if you notice a wiggly tooth, there's a chance the tooth may have to be extracted.

If the tooth has broken and you're missing some of the tooth structure above the gum line, your dentist may be able to save the tooth by doing a build-up, adding a filling material to the tooth. A crown is highly recommended upon completion of a root canal and build-up.

The sooner you visit your dentist regarding a toothache, the higher the chance you'll be able to save your tooth. Ultimately, your dentist will be the best judge as to whether or not a tooth can be saved, but rest assured, the main goal of any dentist is for their patients to keep as many natural teeth as possible.

Root Canal Procedure: Single appointment vs Two Separate Appointments

A root canal appointment may be completed in a single appointment or separated into two appointments. It depends if there's infection present.

  • Single Appointment- If there is no infection present, your dentist will open the tooth, remove the nerve, clean and disinfect the tooth, and place root canal filling material.
  • Two Separate Appointments- If there is an infection present, the dentist will open your tooth, remove the nerve, disinfect the root canal and place a temporary filling. This process is called a pulpal debridement, which treats the pain while allowing time for you to be placed on antibiotics to clear the infection. Those with temporary fillings should not eat sticky food, such as caramel, or chew gum, as it may dislodge the temporary filling.

How to Avoid a Root Canal

Not everyone is excited about sitting in the dental chair with their mouth open for an hour while the dentist performs a root canal - not to mention how expensive it can be. The best way to avoid a root canal and save money is to attend your dental exams and cleanings regularly, every six months, or as otherwise directed by your dentist. This way, your hygienist and dentist can monitor your oral health and address any potential issues right away, preferably before a root canal is needed.

Another important step is keeping up with good oral hygiene by brushing for at least two minutes, twice a day and flossing at least once a day. This will reduce the amount of bacteria in your mouth, which reduces the rate of tooth decay.

Root Canal and Insurance

A root canal is considered a major restorative service and falls under Class C - Endodontic Services in your Blue Cross Blue Shield FEP Dental brochure. Be sure to check whether you are enrolled in the Standard Option or High Option, as this will determine your Annual Benefit Maximum, benefit coverage, and deductible. It is also important to visit an In-Network dentist to ensure the maximum insurance benefit for the procedure is paid, thus lowering your out-of-pocket expense.