Dr. Vatsal Singh

Sudden tooth pain is usually a sign of cavities or dental caries. This is the most common form of oral disease that affects people across the world. A cavity can affect a person at any age. Caries can be categorized under two headings: pit and fissure caries and surface caries. The former usually affect the horizontal planes of the molars and the back planes of the teeth in front. Surface caries are usually found at the joints between two teeth and the gum line.

Dental caries are formed over a period of time. The earlier they are addressed, the less the damage caused and the less painful it is. Bacteria is the root cause of this problem. This bacteria causes sugar in your food to turn into acid. When the acid and bacteria are combined together, it forms plaque. This plaque dissolves the minerals in the enamel coating of a tooth and creates pits. These get larger with time and gradually the softer dentin layer below the enamel also gets decayed. This is when the patient feels a toothache. If the tooth is not addressed at this stage, the roots of the tooth can also get decayed leading to the tooth needing to be extracted.

Dental caries usually have no symptoms until the damage is done. The only way to diagnose it in its early stages is by a dental examination. Hence, it is essential to schedule dental exams every six months. If you skipped a dental exam, a toothache or increased sensitivity to hot or cold food can be taken as a sign of a cavity.

The treatment for a cavity depends on the extent of the damage caused.

A filling is the most common form of treatment for a cavity. This involves the removal of decayed tooth material and the use of a material such as silver, gold, porcelain or composite resin to replace it.

Your dentist may also choose to fit a crown on the tooth. This is done is there is extensive tooth damage and only a limited tooth structure is left. As with a filling, the decayed part of the tooth is removed and a crown made of gold or porcelain is fitted over the tooth.

If the cavity reaches an advanced stage where the nerve within the tooth dies; your dentist may want to perform a root canal. This involves the removal of the inner part of the tooth along with all the pulp and nerve cells. A sealant is then filled into the emptied areas. 

Having your dentist say to you that you need a root canal, can be a daunting affair. This means that the pulp or soft tissue inside a tooth has been damaged by bacterial infection. A root canal involves removing the damaged pulp, cleaning the infection and filling in the emptied space. Not every tooth infection requires a root canal and hence it is essential to know the indication of a root canal.

Here are a few situations when a root canal may be needed:

1. Pain: Discomfort ranging from a dull ache to a sharp pain can be a sign that you need root canal treatment. This type of pain is usually characterized by throbbing and may change as you switch positions. It is usually triggered by chewing, applying pressure on the tooth or eating something cold or hot. In some cases, the patient may not be able to indicate the exact tooth that is hurting but can only identify the painful area. 
2. Gun tenderness: Swelling that indicates the need of root canal treatment can range from being slightly red and inflamed to pronounced lumps on the gums. In some extreme cases, this swelling may extend out of the gums into the face and neck region. Sometimes, a pus filled boil with a pimple like head may also form on the gums. If this head bursts, the patient may notice a foul taste in the mouth. This swelling can come and go as the tooth decay deteriorates and may or may not be accompanied by pain. Teeth may also feel like they have been pushed out of their sockets and are taller than usual. 
3. Tooth discolouration: Discolouring of teeth can be a sign of internal tooth damage. This is especially noted if the teeth take on a dark yellow, grey or blackish tint. Tooth discolouration is fairly common in cases where the tooth has undergone trauma such as an accident etc. 
4. Exposure of the dental nerves: At times during regular dental work, the nerves in the tooth may be exposed. This indicates an exposure of pulp tissue and can trigger pulp degeneration if left untreated. 

However, all of the above symptoms can be symptoms of other types of dental problems as well and do not necessarily individually indicate the need for a root canal. Only a dentist can properly diagnose a need for root canal treatment after a physical examination and testing. If you wish to discuss about any specific problem, you can consult a Dentist.