When Does a Cavity Need a Root Canal?

Jul 4, 2021 | General Dentistry, Root Canal

When Does a Cavity Need a Root Canal?

While over 15 million root canals are performed every year in the United States, the American Association of Endodontists reports that over 59 percent of patients surveyed fear root canals more than speaking in public, spiders, or being trapped in an elevator. At New Leaf Rohnert Park, we understand that the idea of root canal therapy may be intimidating. The truth is you may not even need one to eliminate your tooth pain. But if you do, our caring staff will make sure you understand the procedure and feel as comfortable as possible.


Key Takeaways

  • A root canal is a dental procedure to save a tooth when decay reaches the nerve tissue.
  • Cavities can be treated with fillings if caught early, but may require root canal therapy if left untreated.
  • Regular dental checkups can help catch cavities early and prevent the need for root canal therapy.
  • Signs and symptoms of cavities that may require a root canal include tooth pain, teeth sensitivity, gum swelling, fistula on the gums, tooth discoloration, and tooth trauma.
  • Root canal therapy can help eliminate tooth pain and save the tooth, and the procedure can be explained by the dentist to help patients feel more comfortable.


What is a root canal?

A root canal is a dental procedure that helps save the structure of a tooth when decay has penetrated the nerve tissue. During a root canal procedure, the dentist begins by cleaning the affected tooth and numbing the area. Once numb, a small hole is drilled into the tooth and specialized tools are then used to help remove the infection and interior nerve tissue in the tooth. Once everything is removed, the tooth’s interior is cleaned and then sealed with a filling material. Once complete, a crown is usually put into place to strengthen and restore the appearance and function of the tooth.


Do you need a root canal treatment?

If you are experiencing tooth pain, it doesn’t mean a root canal is necessary. First, you must understand your teeth. Each tooth has three layers: enamel, dentin, and nerve tissue. When tooth decay and plaque build on a tooth, it begins to break down the enamel, often entering the dentin and creating a small hole. When this happens, your dentist will say you have a cavity. If caught at this stage, a simple filling is enough to fix the problem. However, if left untreated and the decay hits the nerve tissue, this is where you will need a root canal.


Do all cavities turn into root canals?

The good news is not all cavities will require root canal therapy. This is one of the reasons why dentists recommend regular dental checkups. Your dentist can see early signs of cavities and treat them with fillings before the decay penetrates the nerve tissue. Leaving the cavities untreated, however, will likely require root canal therapy to save the tooth. Without a root canal, you will likely lose the tooth completely.


Other signs and symptoms to watch out for

When it comes to signs and symptoms of a cavity, everyone may experience something different. While one person may experience these symptoms immediately when decay passes into the dentin, others may not experience symptoms until the decay hits the nerve tissue, meaning a simple filling is no longer enough to save the tooth. This again emphasizes the importance of regular dental checkups. However, if you experience any of the following symptoms, it is important to see your dentist as soon as possible.

1. Tooth pain

Tooth pain can be anything from spontaneous pain to slow-building and progressive pain. The longer you experience pain, the higher chances that decay has made its way into the nerve tissue of your tooth.

2. Teeth sensitivity

Tooth sensitivity occurs when something encounters the dentin of the tooth. But it does not always mean there is a cavity present. Some people simply have thin enamel, and hot and cold beverages still affect the dentin. However, if tooth sensitivity is new for you, chances are you have some level of decay and damage to your enamel. You can experience sensitivity to hot and cold beverages, hot and cold food, cold air, sweet and acidic food, cold water, and even become sensitive to teeth brushing and flossing.

3. Gum swelling

If you notice gum swelling around the affected tooth, decay has likely spread into the nerve tissue. When a tooth’s pulp becomes infected, that infection often spreads into the gum, leading to swelling and inflammation. As the infection increases, you may have a gum abscess or a pocket of pus and bacteria on the gum.

4. Fistula on the gums

If you notice an abscess on your gums, there is the possibility it will eventually lead to a fistula. A fistula is a canal that forms when the body can no longer handle the pressure created by the abscess, so it creates a canal and opening to allow for drainage. With a fistula, you may experience pain, though for some, it can be painless. As the abscess drains, you may have an unpleasant taste in your mouth. If you believe you have this, contact your dentist immediately.

5. Tooth discoloration

Tooth discoloration can occur from drinking red wine, eating blueberries, or smoking. But tooth discoloration can also be a sign of cavities. If you notice spots or discoloration on the surface of your tooth, see if it feels different. Discoloration caused by early tooth decay is often tricky. Watch to see if the discolored area grows larger or if a hole develops. In this case, a cavity is a likely cause. In many cases, food discoloration will improve with tooth brushing or dietary changes, while discoloration from a cavity will not.

6. Tooth trauma

While the enamel of your tooth is the hardest and most mineralized tissue in your body, it does have limits. If your tooth already has some amount of decay, the enamel may be weakened even more, leaving you more susceptible to dental trauma, such as cracks or chips. If you experience a crack or chip to your tooth, it is important to see your dentist as soon as possible. In most cases, a small crack or chip in the enamel can be fixed with a filling. However, if left untreated, even a simple chip can infect the tooth, leading to a root canal or tooth loss.


Pain after root canal therapy

While a root canal procedure aims to stop the dental pain you are experiencing and save the tooth, you may still experience discomfort after the procedure. Considered a major procedure, the cleaning out of the tooth can irritate surrounding nerves and tissues, leading to discomfort. This should subside within a few days. If it does not, you should contact your dentist immediately. You may need another cleaning session to ensure all the nerve tissue was completely removed from the tooth. Because tooth canals are very small, it is possible that a canal gets missed during the initial treatment.



Don’t let the fear of a root canal force you to live with dental pain and discomfort or increase your risk of tooth loss. In many cases, your dental pain may be from a simple cavity that is easily fixed with a routine filling. Let New Leaf Rohnert Park ease your mind and get you on the road to a healthy smile. Our caring dental team will evaluate your teeth and create an individualized plan that fits your schedule and leaves you feeling comfortable and at ease. Call our team today at (707) 586-1549 or visit us online to schedule an appointment.

Eddie Kuo, DDS

Eddie Kuo, DDS

Owner @ New Leaf Rohnert Park

Professional Degrees

University of California at Davis – BS in Biological Sciences with emphasis in Neurology, Physiology, Behaviors

University of the Pacific Arthur A. Dugoni School of Dentistry, Doctorate of Dental Surgery

State University of New York at Buffalo – General Practice Residency at Erie County Medical Center

Front Office Staff On Phone Taking Appointment

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