Do i need a Root Canal?

I went to the dentist the other day to get my tooth checked (filling chipped away slowly and i didn't do anything for a few months about it now its completely off) and when he checked it he made some "ooo" noises which kinda concerned me.





what confuses me about this though is they took X-rays but they didn't know if i need a root canal or not. i thought dentist can tell if u need a root canal just by the x-rays, no? i feel no pain at all and i heard that this could be because the nerve is dead. but if the nerve was dead, shouldn't they have noticed that in an X-ray if it got that bad? they gave me a temporary filling and told me to come back in 2 weeks to get it checked to see if i need a root canal or just a cavity filling.





i just want to know if this is normal or not because everyone i know who had a root canal said that they can tell from x-rays. i saw the x-rays myself but since i'm not a dentist i cant tell what its suppose to look like. do u think i just need a filling?

Do i need a Root Canal?
not all teeth problems appears in the x-ray...


very small caries don't appear.


acut pulpul injuries don't appear.


acut perapical injuries don't appears.


... etc..


So not all pulp { root canal } problems apear in the x-ray.. we need intreoral examination and know the pain history, with the x-ray to tell if that tooth needs root canal treatment.





x-ray alone is not enough.....
Reply:Don't be worry,because in your case the nerve could have been dead at the moment you were to the dentist or in the last case they put in the temporary feeling some medicine that will kill the nerve until the next appointment .So it won't hurt you!
Reply:In two weeks time the bacteria causing tooth decay should have gone down below the teeth into the gum (IF the nerve has been eaten away) and should be causing possibly a considerable ache, maybe redness and swelling around the tooth. The pain down there confirms that you'll need a root canal. If no pain, then it's limited to within the crown and just a cavity is needed.


As far as the x-ray diagnosis, I can only offer the suggestion that RECENT nerve damage caused by bacteria can't be confirmed by radiographic analyses... So, he wants to wait two weeks for the situation to define itself - which is reasonable.





You delayed several months, you can wait two more weeks... Oh, well, good luck.
Reply:Sorry, but all the answers you've received so far haven't explained what you have described. The reason that the dentist went "oooo" when he did an intra-oral exam is that he could see that the cavity/hole was very deep and appeared to be very close to the nerve/pulp.





You are fortunate that the x-ray did NOT show an abscess. So the dentist put in a material to try to "cap" the nerve, soothe it, and will check in a few weeks to see if it helped.





Please understand, that when a tooth is filled, the dentist needs to shape the cavity preparation, which means he has to cut away some tooth material. If the fracture is that close to the nerve, most likely, when the dentists starts to prepare the filling, he could enter the nerve and that's when you need a root canal.





By trying to cap the nerve now, maybe it will settle down. Nerves can actually shrink back a little. He is trying to help you prevent the need for a root canal. This may or may not work. That is up to how your tooth reacts, not the dentist.
Reply:No dentist can tell if a tooth needs RCT(Root canal therapy) only by a Xray.Beside that,even if your tooth's pulp chamber(nerves) is not already exposed ,a simple filling very close to the pulp chamber,may cause permanent sensitivity for you and at best,after few months you're gonna need a RCT.Trust your dentist,and pray he's right.Just kidding.If he says you need a RCT ,go for it.It's not that bad.Good luck.


Off the record if there's at least 1mm uninfected dentin between tha cavity and the pulp chamber, and there's no lesion in Apex(Bottom of the root), I may do a filling with appropriate lining(like glass Inomer) under the filling.But that's me and other dentist may prefer other methods.
Reply:Yes a real Dentist can tell if you need a Root Canal from a film(x-ray) if there is a lesion at the apex of the tooth. The nerve of the tooth can go through several phase of deterioration before becoming necrotic and abscessing. Other tests should have been completed to determine if the tooth was vital (alive or dead). If dead a root canal is needed. If alive but sick(inflamed) a condition called pulpitis, caused by the bacteria from the decay, could either get better reversible pulpitis (no root canal needed) or irreversible pulpitis (root canal needed).


To answer your final question of whether I think you just need a filling is NO!. It is not normal for healthy teeth to break and crumble for a couple of months without nerve damage being done. I would plan to have a root canal done on the tooth followed by rebuilding the foundation and then having a crown placed on it.


Your dentist may have not had enough time to start the procedure and placed a temporary in the hole to keep food out and your tongue from being tore up. Your dentist has your best interest in mind. I am sure he will treat you right.
Reply:Radiographs alone do not always tell if an RCT is needed. The dentist will also assess your symptoms e.g. sensitivity to hot/cold, tender to tapping, degree of pain, duration of pain... to build up a picture of the likely state of the nerve before commencing treatment. Sometimes we just have to clean out all the decay before we know for sure.


If they put in a temporary filling, it is more likely this is because they didn't have time to clean out the tooth, and I'm also assuming you weren't in any pain or they would've commenced definitive treatment.


Also, bear in mind that radiographs are only a 2D view of a 3D problem. What may appear as though it is a deep cavity may turn out to be a cavity to one side of the nerve that overlaps the nerve, giving a false view.


Best of luck!