Severe tooth pain and prolonged sensitivity can interrupt meals, sleep, school, and work. When a tooth aches with sharp or throbbing pain, even a sip of cold water or a gentle bite can feel overwhelming. Living with that kind of discomfort often leads people to avoid chewing on one side, skip nutritious foods, and miss social activities.
Beyond this discomfort, an infection inside the tooth can spread to the tissues surrounding the root, the gums, and even the surrounding bone if left untreated. Early diagnosis and treatment protect your health and can save the tooth.
Columbia Smiles is dedicated to preserving natural teeth and promoting long-term oral health. Our team provides careful diagnosis, clear explanations, and precise care so you can return to comfort and function as quickly as possible.
Learn more about Columbia Smiles’ root canal consultation in Columbia, MD.
Tooth issues that may require endodontic treatment
A root canal is a type of endodontic treatment, meaning therapy focused on the inside of the tooth. The word “endodontic” comes from Greek word roots: “endo” means inside; “odont” means tooth. Pain that leads to a root canal usually develops when bacteria reach the dental pulp, which is the soft tissue in the center of the tooth that contains nerves, blood vessels, and connective tissue.
Common pathways to an infected pulp include:
- Deep decay that extends through enamel and dentin into the pulp chamber
- A cracked or fractured tooth that allows bacteria to enter the inside of the tooth
- A loose or old filling that leaks, which can lead to infection
- Dental trauma from a fall or sports injury that damages the pulp
- Repeated dental procedures on the same tooth that irritate the pulp over time
When bacteria invade the pulp, inflammation and infection can develop. The pressure of inflammation inside the tooth often explains the severe pain.
Recognizing warning signs
Typical warning signs that you might need a root canal treatment include:
- Severe pain when chewing, biting, or touching the tooth
- Lingering sensitivity to heat or cold that lasts more than 10 to 30 seconds after the stimulus
- Swollen or tender gums near the tooth
- A pimple-like bump on the gums, sometimes called biting pimples or a fistula, which can drain infection
- Darkening of the tooth compared with adjacent teeth
- A bad taste or bad breath that does not go away
- Jaw tenderness or swelling in the soft tissue near the tooth
If you have one or more of these symptoms, see your dentist promptly for an examination and X-rays. Early endodontic treatment can often relieve pain and save the tooth.
Risks of delaying treatment
Delaying a needed endodontic treatment can allow infection to spread from inside the tooth to the soft tissue, the surrounding bone, and even other teeth. Potential consequences include:
- Worsening inflammation and bone loss around the root tip
- Increasing pain that becomes harder to control
- A higher chance the tooth cannot be saved and must be extracted
- Rarely, a severe infection that requires drainage or care from an oral and maxillofacial surgeon
Early treatment protects your overall health.
What happens in a root canal treatment?
Root canal therapy removes inflamed or infected pulp, cleans and disinfects the root canals, and seals the space to prevent re-infection. Most root canals are performed to relieve pain and preserve a natural tooth. The goal is to save the tooth, return it to full function for chewing, and protect the surrounding bone and gums.
Step by step: the root canal procedure
At Columbia Smiles we will refer you to a trusted endodontist. The endodontic specialist will follow a careful sequence designed for comfort, safety, and predictable results:
- Examination and diagnosis: The endodontist will review your health history, discuss your symptoms, and run tests to locate the source of pain. Digital X-rays or 3D imaging help assess the inside of the tooth, the pulp chamber, the root length, and the surrounding bone.
- Local anesthesia and isolation: If a root canal is needed, the tooth and nearby gums are numbed with a local anesthetic to keep you comfortable. A dental dam is placed around the tooth to keep the area dry and free of saliva.
- Access and pulp removal: A small opening is made in the biting surface or back of the tooth. The inflamed or infected pulp tissue is removed from inside the tooth and the root canals.
- Cleaning and shaping the canals: The endodontist uses precise files to shape the canals, then flush them with disinfecting solutions, commonly sodium hypochlorite, to reduce bacteria and clean debris.
- Sealing the canals: The cleaned canals are filled with a biocompatible material called gutta percha and a sealing cement. The opening in the tooth is closed with a temporary filling or a bonded core, depending on the plan.
- Final restoration: After healing, many back teeth will need a crown to protect the treated tooth from fracture during chewing. Columbia Smiles will schedule a time for you to meet with Dr Hsu, a board-certified prosthodontist, to discuss timing, materials, and the steps needed to restore full function.
These specialized techniques are designed to relieve pain, resolve infection, and preserve your natural tooth.
What to expect after a root canal
Most people return to normal activities the same day. It is common to feel sensitive for a few days, especially when chewing or touching the tooth. This tenderness comes from inflammation in the tissues surrounding the root and the gums as healing begins. Root canal recovery usually improves steadily over 24 to 72 hours.
If a temporary filling was placed, avoid chewing hard foods on that side until your final restoration. A crown is often recommended to protect back teeth after the root canal procedure.
Pain management and follow-up visits
While your tooth heals:
- Use over the counter pain relievers as directed by your endodontist.
- Apply a cold compress to the cheek in short intervals during the first day to reduce swelling.
- Chew on the opposite side until your dentist places the final crown or permanent filling.
- Keep the area clean with gentle brushing and flossing around the treated tooth.
- Attend follow up visits to confirm healing and complete your restoration.
If you notice increasing pain, swelling, or a new pimple on the gums, call your dentist or endodontist right away.
Long-term tooth longevity
With proper care, endodontically treated teeth can last for many years. To keep your tooth strong:
- Brush your teeth twice a day with fluoride toothpaste and floss daily.
- Limit frequent snacking on sweets, which fuels bacteria.
- Wear a mouthguard if you grind your teeth or play contact sports.
- Keep up with regular checkups and X-rays so your dentist can monitor the inside of the tooth and the surrounding bone.
Read more: 7 Tips for a Speedy Root Canal Recovery
Get expert root canal therapy
If tooth pain or sensitivity is affecting your daily life, do not wait to get an assessment. Our dentistry team at Columbia Smiles in Columbia, MD is here to help.
Schedule an appointment today for a careful evaluation and a personalized plan to preserve your natural tooth.







