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FAQ:  Root Canal Therapy RCT



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Root Canals Ask The Endodontist Ara Nazarian Question:
Cavity becomes a root canal?: I recently visited a dentist for the first time and after taking full mouth xrays, he said I had a cavity in one of my back teeth, the tooth just before the very back one on the upper left side.

He saw this in an xray which looked like a dark shadow. He said even if I fill it now, someday I will probably need a root canal.

I have no pain, or sensitivity in that tooth and I brush and floss constantly. So, my question is, does that make sense that I would possibly need a root canal if I have him fill this now?

Also, is there any other cause for a dark shadow in a back tooth, viewable in an xray, other than a cavity? ...Visitor from RI

Answer:
You have to remember that a filling does not make a diseased tooth like new again, but rather conserves what is left of the tooth.

Molar teeth operate under extreme biting forces. Once a molar tooth is compromised by a cavity... there is the risk that the tooth will worsen over the years... but then again, maybe not. It depends on how deep the cavity is and how close the excavation (removal of diseased tooth) gets to the roots.

From what you wrote, I suspect the cavity is deep or does indeed get close to the roots, causing the doctor to make the remark about a root canal. He is guessing that, in time, you will experience pain or other complications as the root material becomes inflammed or infected.

If that is indeed the case.... it might be worthwhile to get the crown sooner rather than later. Waiting for the need to get a root canal makes things even more expensive. Plus, root canaled teeth become brittle due to the nutrient supply being cut off.

It sounds confusing, I know. For peace of mind it might be a good idea to get a second opinion from a different dentist.

Conservative treatments are usually very sensible. But.... when dealing with molar teeth (remember biting forces) getting the "best" (usually definitive) treatment makes the best sense.

A Nazarian, DDS

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