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My sister is leaning toward a solution, that if wrong, could, I think, could ultimately harm her 16 yrs olds tooth. So I hope you can help me in this regards. Her 16 yr. old son had a filling in one of his back teeth. It came out a while ago. With her hectic lifestyle she forgot about it and let it go for sometime. Now, this past weekend he complained about pain and she took him to the emergency room where they waited for about 2 hrs. At the end of the 2 hrs, before being seen, he told his mother that they could go because the pain had subsided. They left and then Monday took him to the Dentist. She just wanted them to refill it. Because they had heard that he had pain over the weekend the Dr. said that he needed a root canal. She doesn't have great dental insurance and it will cost her quite a bit. She was wondering why does the Dentist feel like he needs a root canal  instead of just filling it. I thought that when someone needed a root canal that they would be in significant pain and it wouldn't subside, esp since it went away for a day or so. Thank you so much for your help!!

Fortunately, not all teeth which abscess are painful. In fact, it is very very common for many teeth to become painful for only a short time as the nerve is dying. Once the nerve is dead, the immediate pain disappears! Unfortunately, such teeth become ticking time bombs, in a sense, because they only feel comfortable until the infection gets large enough. As a dentist, I perform just as many root canal procedures on teeth which are not hurting, as I do on patients who are in pain. If a tooth which has died does not have a root canal treatment, it will certainly become infected at some point and become a larger problem. Also, the tooth becomes brittle and can break down more easily without treatment. Of course, there are other reasons for a tooth to have pain, and it is important to assess these as well. Pain is only one factor in assessing a tooth's need for a root canal. As you may know, the dentist also considers other factors including the xray, how deep the filling is, if the nerve (or pulp) of the tooth has been exposed to bacteria, signs of infection, fractures, diagnostic pulp tests to see if the tooth still responds to stimuli, etc... It is also important to have confidence in one's dentist! I strongly recommend that your sister or nephew ask the dentist why a root canal is necessary and what he/she bases the diagnosis on. I hope you find this information useful!


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