Question: “Dr. Arnold, one of my teeth has been bothering me for months. I’m not excited about having a root canal. Do I have any other options?”
Answer: That is a difficult question to answer without more information. To give an accurate answer would require knowing how long the tooth has bothered you, whether or not it is sensitive to hot, cold, or pressure, the intensity of the symptoms, and the history of the tooth. Additionally, you would need an x-ray and clinical exam to determine the best treatment option. 
When minor cold sensitivity is the only symptom, it can often be treated with toothpaste made for use with sensitive teeth, fluoride rinses, or in-office treatments with desensitizers or even lasers. Sometimes this minor sensitivity can be indicative of a bigger problem, however, requiring more extensive treatment with the possibility of root canal therapy.
Sensitivity to heat usually indicates inflammation of the nerve within a tooth. This is usually treated with root canal therapy. Pressure sensitivity can be due to a variety of factors. These include, but aren’t limited to cavities, cracked teeth, sinus problems, food impaction, and trauma. Treatment options range from fillings, onlays, crowns, antibiotic therapy, thorough cleanings, and possible root canal therapy.
The necessary procedures are determined by the specific condition of the tooth, intensity and duration of pain, and the care, skill, and judgment of the particular dental team.
Teeth are covered by enamel, the hardest structure within the human body. Beneath the enamel layer is the dentin, which is also very hard. The dentin layer surrounds the pulp chamber, where the nerve and blood vessels reside within each tooth. Root canal therapy is generally necessary due to the infection of this nerve. This is usually caused by a deep cavity or fracture into the pulp chamber.
Many people express concern over the need to have root canal treatment performed. Unfortunately, there is a common misconception that this treatment is painful and unpleasant. They often associate the intense pain leading up to the need for a root canal with the procedure itself. In fact, the purpose of root canal therapy is to eliminate pain, and in many cases people experience immediate relief from their pain once local anesthetic is administered. The root canal procedure is, therefore, generally very comfortable.
Infections of the nerve will not go away without some type of treatment, generally root canal therapy or removal of the tooth. Antibiotics will sometimes fight the infection, but they will not address or alleviate the source of the infection. Untreated, this type of infection can impact your immune system, thus affecting your entire body. This really underscores the importance of seeing a dentist regularly and having radiographs (x-rays) taken periodically. Often, your dental team can find and address these “silent” problems before they become symptomatic or debilitating.
Dr. Jim Arnold is a practicing dentist in Valparaiso and Chesterton. Additionally, he serves on the Advisory Board for the Academy of Comprehensive Esthetics and is involved with many other local, state, national, and international dental organizations. Questions for Dr. Arnold can be emailed to: drarnold@smilesbyarnold.com or sent to: 1830 South 11th St., Chesterton, IN, 46304. More information on this and a variety of other dental topics can be found at: www.SmilesByArnold.com.