I went to my new dentist for a regular check up. She suggested that I need a root canal treatment because of a cavity inside a tooth. She wants to send me to a root canal specialist. I should mention at my last dental appointment, in which I had x-rays done, there were no signs of any problems. There is no sign of decay on the outside of the tooth either. Can you have a cavity without any signs? This feels like a red flag to me. I have a second red flag when I saw the name of the specialist was the same as hers. I jokingly asked if all dentists in that area had that last name. She told me it is her husband. So, I feel maybe she is just sending work his way. Can a tooth have a cavity with no signs of decay on the surface?

Natalie

Dear Natalie,

When it comes to decay, there must be an external point of entry. The decays starts on the outside working it is way in. Even then, the only time a root canal treatment would become necessary is if the decay get’s down deep enough in order for it to turn into a dental infection.

It’s possible your dentist could have been referring to something different known as internal resorption. Though, if that is the case, she should use more precise language in order to help her patients understand exactly what is going on with their bodies. Internal resorption happens as a result of an inflammatory response, which generally means that there must have been some trauma to the tooth. The result is that the pulp of the tooth begins to eat away at the tooth from the inside. I’ll be honest that we don’t yet know why this happens.

Given the concern about a conflict of interest and a sketchy diagnosis based on the terminology she used, I recommend that you get a second opinion. Your dentist is required to give you a copy of the x-rays when asked for. Take these to another dentist. Don’t tell them who your dentist is or what the diagnosis was. Just ask them what they see and would recommend based on the x-rays provided.

I hope this helps.
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