Toothache is one of the most common reasons people in Pune walk into a dental clinic, and “Will I need a root canal?” is often the next question. Many toothaches are not caused by an infected nerve: a cavity, a cracked filling, gum problems or sensitive teeth can all hurt. This guide explains the signs that point towards root canal treatment, how a dentist checks, and what to do in the meantime.
What root canal treatment is for
Inside every tooth is soft tissue called the pulp. It can become infected through deep tooth decay, gum disease, a chipped, broken or cracked tooth, or a dental abscess (NHS). Root canal treatment removes the infected pulp, cleans the inside of the tooth and seals it, so the tooth can be kept. If an infected tooth is not treated this way, it may need to be taken out.
Signs that can point to an infected tooth
- Pain that lingers after hot or cold. A short twinge that goes away in a second or two is often simple sensitivity. Pain that carries on for many seconds or minutes after the hot tea or cold water has gone is more worrying.
- Pain when you bite or chew on one tooth, or a tooth that feels “high” or tender to touch.
- Throbbing pain that wakes you at night or comes on by itself without any trigger.
- A swollen, tender gum near one tooth, or a small pimple-like spot on the gum that may leak a bad taste.
- A tooth that has turned darker than its neighbours, often after an old knock.
- A deep cavity or a large old filling with pain under it.
These signs make an infected pulp more likely, but none of them proves it. They can also be caused by a cracked tooth, a loose filling, an infection around a wisdom tooth, grinding, or gum disease (NHS: toothache).
How a dentist checks
There is no single test. Your dentist puts together what you describe with what they find:
- 1
Your story
Which tooth, what sets the pain off, how long it lasts, whether it wakes you, and any past knocks or fillings.
- 2
Looking and tapping
Checking for decay, cracks, swelling and gum pockets, and gently tapping or pressing on the teeth to find the tender one.
- 3
Cold or other sensitivity tests
A healthy tooth feels cold briefly. A tooth whose pain lingers, or that feels nothing at all, may have a damaged pulp.
- 4
An X-ray
Shows deep decay, the shape of the roots and any infection at the root tip. It is taken because it changes the diagnosis, not as a routine.
Sometimes the answer is clear on the day. Sometimes the dentist suggests a simpler step first, such as a filling, and watching how the tooth settles.
When it is urgent
A dental abscess is a build-up of pus caused by infection. It needs prompt treatment by a dentist and will not go away on its own (NHS). Call the clinic the same day if you have a swollen face or jaw, a bad taste with pain, or a high temperature.
What to do while you wait to be seen
- Take paracetamol or ibuprofen as directed on the pack, if they are safe for you. Do not take more than the recommended dose.
- Do not put aspirin or other tablets on the aching tooth or gum (ADA).
- Rinse gently with warm salt water and eat soft food on the other side.
- Avoid very hot, very cold or sweet food and drink.
- Do not leave it. Pain that settles is not the same as an infection that has gone.
Antibiotics are not a substitute for treating the tooth: the NHS describes abscess treatment as draining the infection, followed by root canal treatment or removing the tooth (NHS). If you are weighing those two, read our guide Root canal or extraction: how to decide.
What happens if you need treatment
Root canal treatment is done under local anaesthetic, so you are awake but should not feel pain while it is done (NHS). Pain is usually at its worst before treatment: a large review found that about 81% of patients had pain beforehand, falling to about 11% a week after treatment (Pak & White, 2011). Back teeth in particular usually need a crown afterwards to protect them; see Do you need a crown after a root canal?.
Frequently asked questions
How do I know if my toothache needs a root canal?
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Pain that lingers after hot or cold, pain on biting, night pain, a swollen gum or a darkening tooth all make it more likely. Only an examination and an X-ray can confirm it, because other problems cause similar pain.
Can a tooth that needs a root canal stop hurting?
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Yes. If the nerve dies, the pain can stop while the infection remains. That is why a tooth that hurt badly and then went quiet should still be checked.
Will antibiotics fix it instead?
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No. Antibiotics may be given for a spreading infection, but they do not remove the infected pulp. The tooth needs root canal treatment or removal to deal with the cause.
Is a dental abscess an emergency?
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It needs prompt dental treatment and will not go away on its own. Go to a hospital emergency department immediately if swelling affects your eye or neck, or makes it hard to breathe, swallow or speak.
Is root canal treatment painful?
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It is done under local anaesthetic, so you should not feel pain during it. Some tenderness for a few days afterwards is common, and pain usually drops sharply within a week.
Sources
- NHS: Root canal treatment (accessed 15 October 2026)
- NHS: Toothache (accessed 15 October 2026)
- NHS: Dental abscess (accessed 15 October 2026)
- Pak & White (2011), Pain prevalence and severity before, during, and after root canal treatment: a systematic review, J Endod 37(4):429–38 (accessed 15 October 2026)
- American Dental Association (MouthHealthy): Dental emergencies (accessed 15 October 2026)
This article is general information, not a diagnosis or treatment plan. What suits you depends on an examination at the clinic, and every treatment plan and cost is explained before treatment begins.
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