How does a root canal problem and pain develop?
The main causes of toothache are tooth decay, trauma (impact or blow), cracks in the tooth, leaky fillings or crowns as well as pressure differences (e.g. when flying, diving). Very rarely do the teeth hurt for one to two weeks, even with a cold. Pain caused by colds or pressure differences should initially only be observed. There is also often sensitive tooth necks that can cause toothache with cold and warm food. If necessary, we would cover sensitive tooth necks with small fillings. Root canal treatment should only be performed if the responsible tooth has been reliably identified.
If the tooth nerve inflammation leads to an uncontrolled death of the tooth nerve in the pulp chamber, the inflammation can spread to the tooth supporting structures and bones that surround the tooth (apical ostitis) via the tooth root canals. The dentist can see this on the X-ray as a dark point at the tip of the root, as minerals such as calcium and magnesium are removed from the bone by the inflammation. X-rays therefore pass through the bone more easily and expose the X-ray film more strongly. In pronounced cases, the inflammation breaks through the bone and forms a cavity filled with pus. At this stage, patients often experience very severe pain.
If the abscess drains through the periosteum and gums into the oral cavity, a so-called dental fistula forms and the pain subsides. When the inflammation becomes chronic, a tooth cyst can form. The patient usually has no pain, but the affected tooth should be treated in any case so that the infection does not spread resulting in cellulitis or sepsis.