Recognizing a symptom helps you seek care, but it does not replace a diagnosis. The dentist combines your history with an examination, sensitivity tests and appropriate X-rays to identify the cause. These five signs deserve attention.
Sign 1: Spontaneous pain that comes without a stimulus
Pain that starts without eating or drinking, or wakes you at night, may be related to pulp inflammation. Other problems can also cause dental pain. Its intensity and timing help guide the evaluation but do not determine treatment on their own. Read more: root canal.
What to do: seek prompt dental evaluation. Check with a dentist or pharmacist before taking a pain reliever if you are pregnant, take other medicines or have a condition that may limit its use. Follow the label and avoid combining products with the same ingredient. Fever with swelling needs urgent care. Difficulty breathing or swallowing, or swelling toward the neck or eye, requires hospital care without waiting for a WhatsApp reply.
Sign 2: Prolonged sensitivity to cold or heat
Sensitivity has several possible causes, including exposed dentin, decay and pulp inflammation. Pain that lingers after cold or heat is removed is useful information to report. Timing it at home does not establish a diagnosis.
What to do: arrange a review if sensitivity persists, recurs or increases. Explain what triggers it and how long it lasts; do not repeatedly test the tooth with cold or heat.
Sign 3: Swelling in the gum or face
Swelling or a draining bump on the gum may be related to an infection of the tooth or gums. It needs examination even if pain is mild. Spreading swelling or fever requires urgent attention.
What to do: seek immediate dental care. An abscess doesn't resolve on its own and can become a serious complication.
Sign 4: Tooth darkening
A color change can follow an injury or be related to decay, restorations or changes in the pulp. It does not automatically mean the nerve has died. An examination checks the cause and whether treatment is needed, even without pain.
What to do: have the color change assessed and mention previous injuries, even older ones. Treatment for discoloration is considered after checking the tooth’s health.
Sign 5: Pain when biting or pressing on the tooth
Pain when chewing may be related to decay, a crack, gum disease, the bite or inflammation around the root. It does not by itself prove that an infection has spread. Avoid chewing on the painful tooth until it has been assessed.
What to do: arrange an evaluation. The examination and appropriate tests help distinguish the causes; an isolated image does not automatically establish the need for root canal treatment.
Another reason for a review: pain that disappeared
Pain stopping does not prove that the problem has healed or that the pulp has died. Symptoms can fluctuate, and some infections cause little discomfort. Have the tooth checked if pain was severe or keeps returning, even if it feels better today.
When to seek care
- Severe pain or pain that prevents sleep: seek prompt dental care.
- Swelling, pus or fever: seek urgent care rather than waiting for a routine appointment.
- Difficulty breathing or swallowing, or swelling toward the neck or eye: emergency medical care.
- A change in tooth color needs evaluation even without pain.
- Lingering sensitivity or pain when biting: seek an assessment of the cause.
The evaluation determines treatment
At Endodontics El Salvador in San Miguel, an evaluation with a digital periapical X-ray costs $35. Initial root canal treatment is $390 when indicated; the restoration and medication are separate. A previously treated tooth that hurts again needs a diagnosis: not every painful tooth requires retreatment. Read more: root canal · root canal retreatment.
Frequently asked questions
Do these signs prove I need a root canal?
No. They are reasons to seek care. Diagnosis combines your history, an examination, sensitivity tests and appropriate imaging.
Does lingering sensitivity prove irreversible damage?
Not on its own. Its triggers and duration must be considered with other findings.
What should I do about swelling?
Seek urgent care. Difficulty breathing or swallowing, or swelling reaching the neck or eye, requires emergency medical care without waiting for a WhatsApp reply.
Does a dark tooth mean the nerve has died?
Not necessarily. Discoloration has several possible causes and needs examination, even without pain.
Do I still need a review if the pain stopped?
Improvement does not prove healing. Have the tooth checked if pain was severe, recurs or was accompanied by swelling.
Published:October 26, 2026.