Persistent tooth pain has a way of getting your attention — especially when it lingers, worsens at night, or flares up without warning. Many patients ask us the same question: when do you need a root canal, and how do you know if the pain is serious or something that will pass?

The truth is, some tooth pain is temporary. But other symptoms are your body’s way of telling you that the inner tooth tissue may be infected or inflamed. Understanding the warning signs can help you act early, relieve discomfort, and often save your natural tooth.

Below, we break down the five most common signs a root canal may be needed, along with answers to the most searched questions about cost, insurance coverage, treatment through a crown, and recovery time.

Understanding the Basics

A root canal is needed when the pulp inside the tooth becomes infected or damaged. This pulp contains nerves and blood vessels, and once it becomes irritated, the pain usually does not resolve on its own.

Common causes include:

  • Deep decay

  • A cracked or damaged tooth

  • Repeated dental procedures

  • Trauma to the tooth

  • Infection beneath an existing crown

Early treatment can prevent the infection from spreading and help you avoid tooth extraction.

5 Warning Signs You Shouldn’t Ignore

1. Persistent Tooth Pain

If tooth pain sticks around for days or weeks — or comes and goes without fully resolving — it may signal an issue deep within the tooth. Pain that worsens when chewing or applying pressure is especially concerning.

2. Sensitivity That Lingers

Sensitivity to hot or cold that lasts more than a few seconds after the temperature stimulus is removed often points to nerve irritation rather than surface enamel wear.

3. Swelling or Tender Gums

Swelling around a tooth, tenderness to the touch, or a small bump on the gums can indicate infection beneath the surface. Even mild swelling should be evaluated promptly.

4. Pain Under a Crown

Many patients are surprised to learn that a root canal through a crown is not only possible, but common. If you experience pain or pressure beneath a crown, the tooth underneath may still become infected and require treatment.

5. Discoloration or Darkening of a Tooth

A tooth that appears darker than surrounding teeth may be a sign of nerve damage. This often happens gradually and may not be painful at first.

How to Relieve Tooth Pain Before Your Appointment

While home remedies won’t cure the problem, they can help manage discomfort temporarily:

  • Avoid chewing on the affected side

  • Rinse gently with warm salt water

  • Use over-the-counter pain relievers as directed

  • Avoid extreme hot or cold foods

If pain persists, searching “root canal near me” and scheduling an evaluation is the safest next step.

How Much Does a Root Canal Cost?

One of the most common concerns we hear is how much does a root canal cost. Pricing depends on several factors:

  • Which tooth is being treated

  • The complexity of the infection

  • Whether a crown is involved

  • Whether retreatment is required

In most cases, root canal treatment is far more cost-effective than tooth extraction and replacement, which may involve implants or bridges.

Does Insurance Cover Root Canals?

Many dental insurance plans partially or fully cover root canal treatment, especially when it is medically necessary. Coverage levels vary by plan, and our team helps patients understand their benefits before treatment begins.

If you’re unsure about coverage, we recommend checking your plan details or asking our office for assistance.

Root Canal Recovery Timeline: What to Expect

Most patients are surprised by how easy recovery is. Here’s a general root canal recovery timeline:

  • Same day: Mild soreness or tenderness

  • 1–3 days: Discomfort continues to improve

  • Within a week: Most patients feel fully back to normal

  • After restoration: Final crown placement restores full function

With modern techniques, many patients return to normal activities the same day.

Can a Root Canal Save Your Tooth?

In the majority of cases, yes. Root canal treatment removes infection while preserving the natural tooth structure. This helps maintain proper chewing function and prevents surrounding teeth from shifting.

Why Seeing a Specialist Matters

Endodontists receive advanced training focused specifically on diagnosing tooth pain and performing root canal procedures. This specialized expertise allows for greater precision, comfort, and long-term success.

Frequently Asked Questions

How do I know if I need a root canal or just a filling?

Lingering pain, pressure, or sensitivity usually indicates deeper nerve involvement, which often requires a root canal rather than a filling.

Is a root canal painful?

Modern root canal treatment is typically no more uncomfortable than getting a filling. Most patients report relief from pain shortly after treatment.

Can a tooth with a crown still need a root canal?

Yes. A root canal through a crown is common and allows the crown to remain in place in many cases.

How long does a root canal procedure take?

Most treatments are completed in one visit lasting 60–90 minutes, depending on the tooth.

What happens if I delay treatment?

Delaying care can allow infection to spread, increasing pain and the risk of tooth loss or more complex procedures.

Take the Next Step Toward Relief

If you’re dealing with ongoing tooth pain and wondering if you need a root canal, the safest answer is: as soon as symptoms persist or worsen. Early diagnosis often means simpler treatment, faster recovery, and better long-term outcomes.