Could I Really Have a Cavity with No Signs or Symptoms?

Posted on January 23, 2026 by AllSmiles.

The outside of my tooth looks fine. Even my dentist admitted it has no outward signs of wear, cracks, damage, or anything else. However, my dentist referred me to an endodontist for a root canal. The tooth doesn’t hurt, but my dentist said I have a cavity on the inside. I can’t read tooth X-rays, so I couldn’t challenge her findings? Should I see the endodontist anyway? I must mention that my dentist has a hyphenated name, and the endodontist’s last name is the same as the first half of my dentist’s last name. I am suspicious. Thanks. Phil from OH

Phil,

Root canal emergency diagram of five procedure steps — Root canal therapy

We understand the concern about your referral for a tooth with no signs of decay. Also, since your dentist and the endodontist share part of your dentist’s name, you have additional concerns.

Can Tooth Decay Start Within a Tooth?

A tooth cannot develop decay internally without bacteria entering from the outside. Cavities always start on the surface. When they progress deep enough, infection follows and may require root canal treatment.

If imaging suggests damage beginning inside the tooth, the issue likely isn’t decay.

What Is Internal Resorption?

Internal resorption occurs when the pulp begins to erode the tooth from within. This inflammatory process is rare and not fully understood. Dentists believe some form of irritation must trigger it.

Trauma may contribute, particularly if a tooth is subjected to additional force due to its position. Still, because this diagnosis is uncommon, it deserves careful verification.

Why Get a Second Opinion?

Given the uncertainty, a second opinion from an endodontist offers the safest path forward. That approach allows for an unbiased evaluation before committing to treatment.

To keep the opinion objective:

Bring copies of your X-rays.
Don’t mention previous diagnoses or providers.
Let the specialist assess the case independently.

Another Condition to Consider

External root resorption affects the outside of the tooth and can mimic internal resorption on X-rays. Taking multiple images at different angles often clarifies which condition is present and guides appropriate treatment.

Baton Rouge family dentist Dr. Ryan Perry sponsors this post. Please read about how he strives to provide his patients with the best care possible.

Is Treatment for a Gum Cyst Necessary?

Posted on April 22, 2025 by AllSmiles.

My dentist said the tender bump on my gum above my first molar is a chronic, benign abscess. I’m concerned the lump doesn’t hurt, so my dentist referred me to an endodontist. The endodontist wants to perform a root canal for a cyst or abscess. Is that necessary, or is this exploratory surgery? Am I increasing the risk of damaging my tooth and needing it whittled down for a crown? Thanks, Layla from Seattle

Layla,

It’s understandable to feel concerned about the lump in your gums, particularly when receiving unclear information from your dental providers. We want to acknowledge your concerns and provide clear information to help you navigate this situation.

Clarifying the Likely Issue and Treatment Path

Finding a lump on your gums causes worry. While a cyst is possible, it’s statistically less common in the gums than an infection stemming from a tooth’s nerve. An endodontist specializes in treating these issues, and the standard, highly effective approach is root canal therapy. This treatment focuses on cleaning the infection from within the tooth to save it. An apicoectomy (root canal treatment from the root tip) is generally considered a secondary measure, used primarily if unique circumstances prevent a successful outcome with standard root canal treatment alone.

Why Timely Treatment Matters for Your Well-Being

Addressing a dental infection, especially one that has been present for two years, is crucial for oral and overall health. Your body actively fights infection, which can be draining over time. Taking steps to resolve the infection is essential for several reasons:

Your body will no longer need to constantly fight the infection, which may increase your energy levels.
Removing the infection protects your jawbone and surrounding teeth from potential damage or spread.
Treating the source eliminates the risk of bacteria entering your bloodstream.

Root canal treatments performed by specialists boast a success rate of 85% or higher, often enhanced by modern technology. If, in a rare case, the root canal doesn’t fully resolve the problem, an apicoectomy could be considered down the line. Feeling unsure is perfectly normal, and you can seek a third opinion from another endodontist’s office for reassurance and clarity. By planning your care proactively, you can manage the situation effectively and avoid the need for urgent dental treatment.

Baton Rouge family dentist Dr. Ryan Perry sponsors this post. Please read about how he strives to provide his patients with the best care possible.

Why Can’t I Get a Root Canal Instead of an Extraction?

Posted on March 15, 2025 by AllSmiles.

Half my tooth broke off in a crown I got 20 years ago. My dentist said the tooth was infected, and there was a pus sac at the base of the tooth. My dentist says he needs to extract the tooth. Why won’t root canal treatment work? – Thanks. Tyree from GA

Tyree,

Your dentist may be correct, but some dentists are eager to extract teeth unnecessarily. Your dentist should have explained why root canal treatment wouldn’t work. So, you can ask or dentist or get a second opinion from another dentist to see if the tooth is savable.

When Might Tooth Extraction Be Necessary?

Tooth extraction may be necessary when the tooth is so decayed that insufficient structure is left to restore it. Perhaps a tooth has been missing for so long that the teeth on either side have drifted into the space, and there isn’t room to restore the tooth.

Saving and restoring teeth is hard work; sometimes, a dentist may fail. Look for a dentist with experience in root canal treatment or find an endodontist (root canal specialist) to determine whether your tooth is savable and what treatment is required to do it. Otherwise, you may get a recommendation for an extraction and dental implant.

Baton Rouge family dentist Dr. Ryan Perry sponsors this post. Read how he strives to provide some of the best dentistry in Baton Rouge.

Why Am I Having a Tooth Flare-Up Five Years After a Root Canal?

Posted on November 15, 2024 by AllSmiles.

Six years ago, my dentist performed a root canal procedure on my upper left first molar. The procedure went fine, and the tooth felt comfortable until late September. I hadn’t eaten anything unusual but noticed a dull toothache. Now, the tooth hurts daily, and the pain is getting worse. My dental appointment isn’t until two weeks after the Thanksgiving holiday when I return from vacation. Is a tooth savable if I’ve already had a root canal? – Thanks. Kaitlynn from IN

Kaitlynn,

Root canal failure occurs in 10% of teeth treated. Failure occurs when the tooth doesn’t fully heal and eventually flares up, as is the case for your situation.

Why Might a Tooth Flare Up Years After a Root Canal?

A tooth might become irritated years later if some infected tissue lingers after a root canal. Due to the intricate anatomy of teeth, particularly those with curved or branching roots, removing all infected tissue during a root canal procedure can be challenging. Any residual infection can lead to future complications.

Either root canal retreatment or surgery may be necessary to address root canal failure. A dentist may refer you to an endodontist (specialist in root canal therapy) for retreatment. The goal is to identify and eliminate the source of the persistent infection. While the success rate of retreatment or surgery is often estimated at 50%, the outcomes are usually more favorable.

It’s also possible that the tooth has developed a crack, which could contribute to the ongoing issues. Unfortunately, the prognosis for saving a tooth with a crack is generally poor. If the tooth is unsavable, your dentist will explain tooth replacement options.

Baton Rouge family dentist Dr. Ryan Perry sponsors this post. Please read about how he strives to provide his patients with the best care possible.

Is a Root Canal Worth It?

Posted on August 18, 2024 by AllSmiles.

Is a root canal worth it? My bottom right first molar will either need a root canal or extraction and dental implant. My second molar is missing. If I decide to have the dentist extract my tooth, could a snap-on smile help? – Thanks. Wendy from VA

Wendy,

You mentioned that you’ve already lost your second molar and are deciding whether to extract your first molar or get a root canal treatment. Without molars on your left side, you would be unable to chew and function properly.

Is a Root Canal Worth It?

When a natural tooth is savable, the best option is a root canal treatment followed by a crown. Root canal treatment is less expensive than a dental implant, but some prefer dental implants for long-term stability and predictability.

Given the benefits of preserving your natural tooth and the potential complications of losing it, a root canal treatment followed by a crown seems to be the most practical and cost-effective solution in your case. However, schedule an exam with an experienced dentist to determine the pros and cons of your treatment options.

Is a Snap-On Smile a Reliable Tooth Replacement Option?

While a snap-on smile can temporarily solve social situations, understand its limitations. It’s a cosmetic option, not for long-term use or heavy chewing. If you wear the appliance regularly, you need to replace it frequently.

What Are Alternatives to a Snap-On Smile?

A removable partial denture is an alternative to a snap-on smile for replacing missing teeth. However, its stability and effectiveness depend on having teeth in the back to anchor it.

Imagine a table with only two legs on one side. Similarly, your bite is unbalanced when you try to replace molar teeth with a denture supported only by front teeth. The force on the front teeth can cause them to tilt and eventually loosen.

Baton Rouge family dentist Dr. Ryan Perry sponsors this post. Read how Dr. Perry strives to provide some of the best dental care in Baton Rouge.

Why Does Cool Water Relieve My Toothache Temporarily?

Posted on June 30, 2024 by AllSmiles.

I got four fillings 12 years ago, and two fell out. The fills that fell out don’t hurt, but one of the remaining fillings causes severe pain when I chew on that side of my mouth. Swishing my mouth with cool water relieves the pain but only briefly. Why would a stable filling hurt? Thanks. Braxton from OK

Braxton,

The tooth with the filling that hurts when you chew has symptoms of dying tooth pulp. You will need root canal treatment to save the tooth. Bacteria may have seeped beneath the filling, causing decay. As the tooth pulp dies, gases from bacteria increase pressure inside the tooth and cause a toothache.

Why Does Cool Water Decrease Tooth Pain?

Cool water decreases the gases released from bacteria inside a tooth and temporarily eases tooth pain. It is like the relief from applying an ice pack to reduce swelling in a sprained wrist or ankle.

You can get relief from root canal treatment to remove the infected tissue inside your tooth. After the root canal, your dentist will seal the tooth after replacing the diseased pulp with dental filler material. A dental crown will protect the tooth from further weakening.

Your dentist will recommend replacing the fillings that fell out. Checking the remaining fillings can prevent future concerns.

Baton Rouge family dentist Dr. Ryan Perry sponsors this post. Read how Dr. Perry strives to provide some of the best dental care in Baton Rouge.

Why Is My Tooth Still Infected After an Apicoectomy?

Posted on November 28, 2023 by AllSmiles.

My tooth is still infected after an apicoectomy. I had a raging toothache and infection that required a same-day visit in early October. The dentist did an apicoectomy on a tooth that had a root canal 2 years ago. I had a checkup and x-ray two days ago. The bone is rebuilding, but a small pus sac on my gums shows an infection is lingering. My dentist gave me antibiotics to take for ten days. Is there anything else I can do to get rid of this infection? I

t’s going to be three months and counting with this. I’m waiting for it to clear before I get a new crown. I opted for a one-visit crown because I want to wrap this up and move on. Since I’ve had problems with this tooth, my dentist wants to wait before making the crown. I feel like making an emergency appointment with another dentist before I return to mine – if I return. I don’t know what to do. Thanks. Marianna from TN

Marianna

After your struggle with a tooth infection for almost two months, your concerns are understandable. We will share some information that may help you decide whether to wait for your dentist or to get a second opinion.

What Is an Apicoectomy?

Unlike root canal treatment that approaches the pulp chamber by drilling a small hole in the tooth, with an apicoectomy, a dentist or endodontist surgically accesses the tooth through the gums.
The surgery allows the dentist to access the root tip and remove infection or inflammation.
The dentist places a small filling to seal the root tip.
Stitches close the small incision.

How Will Antibiotics Help?

Root canal treatment, apicoectomy, and any other apical surgery will help the tooth heal, and the infection will eventually disappear. The dentist or endodontist needs to remove all the dead tissue inside the tooth and seal the end of the root well.

Antibiotics

Although antibiotics can speed up the healing process, removing the source of the infection determines if the treatment will succeed.

If the bone around your tooth is healing, your dentist likely removed the infection. Any residual infection will eventually disappear, and the antibiotics will speed up the healing process. It takes patience, but your tooth will heal, and you can get a dental crown.

Although you can get a second opinion from a dentist with root canal treatment experience, an emergency dental visit won’t give you the necessary information.

Baton Rouge family dentist Dr. Ryan Perry sponsors this post. Please read about how he strives to provide his patients with the best care possible.

What’s Next If I Had a Root Canal Fail?

Posted on July 21, 2023 by AllSmiles.

What’s next if I had a root canal fail? A toothache that has been bothering me for the past two months got so bad last weekend that I saw a nearby dentist for a same-day appointment. I did not want to return to my previous dentist because I didn’t like the customer service at the practice, and the hygienist is quirky. The toothache was in an upper left first molar tooth that my dentist did a root canal on two years ago. The dentist I saw most recently said she would need to refer me to an endodontist for a procedure called an apico? I have been a little slack about going to the dentist, and I haven’t seen one since I quit my last dentist, so maybe I could have avoided this. What is this apico procedure, and do I really need it? Thanks. Malachi

Malachi,

It’s good that you made a same-day appointment with a dentist. If you have a lingering toothache, you need treatment. Whether you need an apicoectomy depends on the X-ray results. You can get a second opinion from another dentist or an endodontist (root canal specialist). If you have problems with a root canal tooth, you will probably still need to see an endodontist.

What Is an Apicoectomy?

An apicoectomy is a minor surgical procedure that accesses the tooth root through an opening in the gum tissue and bone. An endodontist will remove the inflamed or infected tissue and remove the root tip. The endodontist will fit the root with a special material and seal it. Stitches will close the area and help it heal. According to the American Association of Endodontics, your jawbone will heal around the tooth root in a few months.

Why Do You Need an Apicoectomy?

If a dentist or endodontist cannot access a tooth infection near the root tip by opening the crown, they will recommend an apicoectomy. Sometimes after root canal treatment, infection in the tooth’s canals in the tooth can remain, particularly in areas that are difficult to reach. Then, you may need a second root canal or an apicoectomy.

You can get a second opinion from another dentist or an endodontist, a specialist who can provide the most accurate diagnosis and precise treatment.

Baton Rouge family dentist Dr. Ryan Perry sponsors this post. Please read about how he strives to provide his patients with the best care possible.

Dentist Said I Need an Apico Instead of Root Canal

Posted on August 31, 2022 by AllSmiles.

Our family was out of the country for three weeks. A toothache that has been bothering me for the past months got really bad, so I had to go to an emergency dentist. It’s a tooth that had a root canal 2 years ago. The emergency dentist said I need probably need to see an endodontist for a procedure called an Apico??? I have been a little slack about going to the dentist, and I haven’t seen one since I moved last year. What is this procedure, and do I really need it? – Greg from Armon, NY

Greg –

The procedure that the emergency dentist is referring to is an apicoectomy. When you receive a root canal treatment, a dentist cleans out the canals of a tooth root the very tip to remove the infection. A filler material is used in the empty space. An apicoectomy uses a different approach.

What Is an Apicoectomy?

An apicoectomy is a procedure that accesses the tooth root through an opening in the gum tissue instead of the crown of a tooth. A trained dentist or endodontist (root canal specialist) will take these steps:

Remove the inflamed or infected tissue and the root tip
Fill the root with a special material and seal the tooth
Use stitches to close the area and help it heal

In a few months, the jawbone will heal around the tooth root.

At times, infection in the canals in the tooth can remain, particularly in areas that are difficult to reach. Sometimes, a dentist or endodontist (root canal specialist) performs a second root canal. If a second root canal treatment fails or if it is impossible to complete it, an apicoectomy may be the preferred method.

You can receive a second opinion from another dentist who will examine your tooth and recommend treatment.

Dr. Ryan Perry, a Baton Rouge family dentist, sponsors this post.

Will I Need a Veneer After a Front-Tooth Root Canal?

Posted on February 17, 2022 by AllSmiles.

I have a front tooth that is turning dark and requires a root canal. Will the tooth be just as dark after the root canal? Will teeth bleaching before and after help? Or will I need a veneer? I’m sure my dental insurance will not cover all of this, but I am concerned about my smile. Thank you. Nicholas from Springfield, MO

Nicholas,

Thank you for your question.

Generally, root canal treatment darkens a tooth.

Why Does Root Canal Treatment Darken a Tooth?

Root canal treatment darkens a tooth if a dentist leaves root canal filling material in the pulp chamber, which is visible above the gumline.

How to Prevent Tooth Darkening After Root Canal Treatment

After treating the tooth, a dentist can prevent discoloration with these steps:

Remove root canal filler material from the pulp chamber
Bleach the tooth internally by sealing bleaching solution inside
Insert a fiberglass post into the root
Fill the tooth with composite

Your dentist should complete internal bleaching as soon as possible after the endodontist completes the root canal. Also, they should wait to place the post until the endodontist is confident that the root canal is successful. After removing the filler material, your dentist will wait a few weeks to check your tooth color. If it is stable, the results can last for several years.

What If Your Dentist Cannot Correct Your Tooth Color?

If your dentist is not familiar with the techniques required to lighten your tooth color after root canal treatment, we recommend scheduling a consultation with an advanced cosmetic dentist. It may be helpful to consult with two cosmetic dentists before root canal treatment to ensure you have found a dentist to treat the tooth as soon as possible after the endodontist confirms that your root canal was successful.

Otherwise, a skilled cosmetic dentist can correct your tooth color with a porcelain veneer. A dental crown is an aggressive treatment that can weaken your tooth and increase the risk of breaking. And unless the tooth is dead, you will not need to replace it with a dental implant. Talk with the dentist about making treatment affordable with payment plans or financing.

Baton Rouge, Louisiana, dentist Dr. Ryan Perry sponsors this post.