X-Ray is clear- Still need a root canal?

Question

I have been having some tooth pain on a tooth that has had prior fillings. It comes and goes.My "dentisit" x-rayed it and said it "looked fine" but then examined me and refered me to get a root canal with out much explanation.
Can a root canal be determined with a clear xray? I'm confused but most of all don't want to pay 900 dollars and go through a root canal for no reason!

Answer 1

It is possible that the x-ray didn't show any signs of infection, but if you have a filling there already it is likely that you have leakage (a crack in the filling). If the filling is large and there is decay underneath you do need RCT.
The reason is, when you have a large filling and it needs to be replaced and decay is underneath the Dr. must clean out the underlaying decay to reach solid tooth structure. The solid tooth structure may be close to the nerve of your tooth and if the Dr. doesn't preform RCT you will most likely develop pain and sensitivity and end up paying more to reopen the tooth to do RCT.
So technically, your Dr. is saving you money. There is also the possiblity that when he does remove the old filling and clean out the decay that you will not need RCT because the solid tooth structure is not right on top of the nerve. In this case he will just refill it and possibly put a layer of dycal below the filling as a sealant. When you go to the Dr. discuss these possibilities with him. Usually dentists don't treat healthy teeth, b/c of legal issues.
You are clearly in pain and it does sound like you need RCT. Your pain is caused by the nerve of your tooth. You are lucky that you show no signs of abcess. Be thankful of that! If you don't have this procedure done, you most likely will develop one.
The more knowledgable you are the better care you will receive.

Answer 2

Diagnosing the need for a RCT requires a few factors for consideration:
1. How long have you had the pain? The longer it has been present, the more likely the nerve has been irreparably damaged. Is it getting worse over time?
2. How long does the pain last at a time? If it is comes and goes quickly, then this is less worrisome than a persistent long-lasting pain.
3. What type of pain is it? A sharp pain is less trouble than a dull, aching pain. A throbbing pain is also bad.
4. How bad is the pain? If you are taking painkillers, or if it wakes you at night, then this is a bad sign.
5. What sets off the pain? If it is set off by cold drinks, then this is less trouble than hot drinks. If the pain comes spontaneously without provocation, this is a bad sign.
6. Can you touch the tooth without pain? If the dentist taps it with a mirror and it hurts, this is a bad sign.
7. Does it hurt when you bite down on something hard? A crack in a tooth will sometimes only appear when chewing, giving a sharp, short pain - it may be repairable. But if it just hurts when you chew even softish food, then this is a bad sign.
7. How long ago was the filling done? If it is a recent filling, then this is not a good sign.
8. Is the filling deep? A deeper filling is more likely to give trouble than a shallow filling.
9. Finally, does the Xray show a dark area about the root tip? A dark area almost always indicates an infected canal, and an abscess. But as mentioned above by others, it does not always appear for a while, so it is not always reliable on its own.
***Look thru these points and see how you rate. If you're not sure, seek a second opinion, and take this checklist along. Best of luck!
P.S. Often a tooth that has received an RCT needs to be reinforced with a crown to strengthen it. Have you talked to your dentist about this too, and been quoted?

Answer 3

it is possible to have a clear x-ray and you still need and root canal treatment. It takes at least 3 months form the time you start to have symptom to the time something is visible on the x-ray. If you have throbbing pain, or pain that linger on for more than 5 mins at a time, then you may need root canal treatment. It could be because during the process of doing prior fillings, your teeth could die and the only treatment is to have a Root canal treatment to save the tooth. However, this is just speculation. The actual diagnosis has to be made by the dentist. I suggest you ask you dentist, or if you don't trust him, then go for a second opinion. Sometimes that will give you a peace of mind, and it should not cost you that much more.

Answer 4

if you want to save the tooth, then get a root canal, if the pain doesn't go away, through other means.

Nothing is as good as a natural tooth! And sometimes your natural tooth may need endodontic (root canal) treatment for it to remain a healthy part of your mouth.Most patients report that having endodontic (root canal) treatment today is as unremarkable as having a cavity filled. If you've been told you need endodontic (root canal)treatment, you can find the answers to your questions below.


Why is there a need for endodontic treatment?

Sometimes the pulp inside your tooth becomes inflamed or infected. This can be caused by deep decay, repeated dental procedures on the tooth, a crack or chip in the tooth, or a blow to the tooth.

What are the signs of needing endodontic treatment?

Signs to look for include pain, prolonged sensitivity to heat or cold, discoloration of the tooth, and swelling and tenderness in the nearby gums. But sometimes, there are no symptoms

Answer 5

I won't write a nice essay as everyone above has, but I agree with them all. An x-ray is only part of the total picture. It will only show whether or not there has been destruction of the bone or tooth and this will not show until you have something like 10% or more loss of mineral content. In other words, abscesses and cavities are always worse than they look on an x-ray.

Answer 6

The x-ray is just one diagnostic tool. The dentist also uses the visual exam and your reported symptoms to make a good clinical decision.

The x-ray is used to see if there is an abscess, but if you have just the beginnings of an abscess, it will not show up on the x-ray, this is where the dentist relies on the other aformentioned clinical tools to make his decision.

The question is do you trust his judgement. If you do, you comply with his referral. If you don't trust his judgement, then you find a dentist you can trust