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Q. My tooth hurts. Should I undergo an RCT?

Answered by
Dr. Tinu Thampy
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jun 14, 2017

Hello doctor,

I have tooth pain, and the dentist has suggested a root canal treatment be done on one of the lower teeth based on the x-ray attached. Do any of the lower teeth require a root canal treatment in your opinion?

Dr. Tinu Thampy

Dentistry Maxillofacial Prosthodontist Oral And Maxillofacial Surgery Oral Implantologist


Welcome to

  • When there is a tooth pain, it means that the infection has reached the pulp of the tooth.
  • The pulp of the tooth is the innermost part of the tooth where the blood vessels and the nerves are present. In the crown portion of the tooth, it is called pulp chamber, and in the root portion, it is called as a root canal. Once the infection has reached the pulp, it will involve both the pulp chamber as well as the root canal, and it spreads to the tissues below the tooth. The treatment is, to remove the infected tissues and clean the root canal and pulp chamber. This is known as a root canal treatment.
  • I have seen your x-ray (attachment removed to protect patient identity). From this x-ray, the right side first molar appears to be the tooth of concern and needs a root canal procedure. The radiograph (x-ray) is additional to a clinical examination. Radiograph alone is not conclusive for a diagnosis. Changes in angulation of x-ray machine or position of the patient can cause overlapping of images of adjacent structures, giving a false diagnosis.

For more information consult a maxillofacial prosthodontist online -->

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Hello doctor,

Thanks for replying. My dentist is suggesting a root canal procedure for the third tooth from the left in the lower jaw. Do you see anything in that tooth?

Dr. Tinu Thampy

Dentistry Maxillofacial Prosthodontist Oral And Maxillofacial Surgery Oral Implantologist


Welcome back to

  • This x-ray is called an orthopantomogram (OPG). It is a panoramic radiograph which has so many adjacent structures overlapping on each other in the image. This radiograph is used for getting a gross idea regarding bone structure, the position of the tooth, presence of any pathology, etc.
  • For inspection of individual tooth, an intraoral periapical (IOPA) radiograph would be helpful. If you have persistent tooth pain, you may need a root canal procedure in that tooth. Without knowing the tooth number in which you have the pain, I am unable to differentiate the decay lines from artifacts or overlapping shadows.
  • So, please attach the IOPA of the particular tooth that your dentist suggests treatment for, so that I can give you the treatment plan.

Revert with more information to a maxillofacial prosthodontist online -->

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